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Access to HIV prevention pill must be made easier

We need more support from mainstream medical community

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Truvada, Gilead, gay news, Washington Blade
Truvada, Gilead, gay news, Washington Blade, PrEP

The FDA approved Truvada to be used as Pre-Exposure Prophylaxis (PrEP) in 2012. (Photo courtesy of Gilead)

By ALEX GARNER & SHAWN JAIN

PrEP or Pre-Exposure Prophylaxis is a pretty basic concept. In its current form, a person takes a blue pill called Truvada every day, and it prevents HIV. It’s safe, available at your local pharmacy, and highly effective, just like birth control medication. But like the pill, PrEP means talking about sexual behavior and navigating a health care system that is fraught with bias, barriers, and basic misinformation. If we want to achieve Mayor Bowser’s laudable 90-90-90-50 HIV goal, we must ensure that all people at increased risk for HIV acquisition have the most current HIV prevention information and access to quality healthcare, including PrEP. On this the third anniversary of the FDA’s approval of Truvada for PrEP, we are calling on our communities to take much needed action.

Whitman-Walker Health, along with other LGBT health centers nationwide, has taken extensive steps to increase access to PrEP. Primary care providers proactively assess HIV risk and discuss PrEP with patients as part of their preventive health care. At HIV/STD testing events in the community, staff engage those who are getting tested in conversations about PrEP. And at Whitman-Walker’s in-house pharmacy, staff work with patients to make sure the medication is covered by their insurance or help them apply for co-pay assistance.

These efforts have borne fruit. Whitman-Walker Health now has more than 250 patients on PrEP. But it’s not enough for only LGBT health centers and LGBT friendly doctors to be the ones who feel comfortable having tough conversations about patients’ sexual health required to prescribe PrEP. We need far more support from the mainstream medical community for this critical intervention.

Newly released data last month from D.C.’s Department of Health makes this point crystal clear. Yes, the 40 percent decrease in new HIV diagnoses in four years is a remarkable achievement, but the HIV epidemic remains stubbornly concentrated among a handful of communities: gay and bisexual men of color, trans people, young people, and black women. PrEP access among these populations will have to be a key part of the solution. It is these communities that need PrEP the most, and they are not all accessing health care at LGBT health centers, where providers already actively engage patients in conversations around PrEP.

For communities that have been marginalized, PrEP is about agency at a time when so many of us feel powerless in so many parts of our daily lives. For far too long, black and brown bodies have been criminalized, gay sex has been pathologized, and trans people and immigrants have been dehumanized. PrEP is an opportunity for us to demonstrate that these lives matter.

There has been a great deal of misinformation about PrEP circulating among gay men, some of it is coming from organizations with lots of power and influence. But it’s irresponsible and indefensible for individuals or organizations to mislead the community about the facts. PrEP isn’t a political campaign or some controversial trend. It’s a scientifically proven prevention method that can save lives.

There are 3 key things we can all do to take action around PrEP:

• Learn the facts about PrEP and combat misinformation. Educate yourself about PrEP. There are plenty of great resources available that are provided by reputable organizations. The CDC, WHO, and almost every major HIV organization supports the use of PrEP for HIV prevention. Familiarize yourself with the CDC guidelines and visit our websites for resources, videos and infographics: NMAC and Whitman Walker Health.

• Demand access to PrEP and quality healthcare. Work to ensure that PrEP is affordable. Lobby your elected officials or health department to cover the costs of the medication and doctor visits.

• Talk about PrEP. Many of us spend so much time on Facebook, Twitter, Instagram, Scruff, etc. Let’s put it to good use. Talk to people about PrEP. Talk about it online, on hookup apps or with your kickball team. Talk to your friends, your family and your lovers. PrEP is nothing to be ashamed of. There are plenty of ways to generate conversation — post an article, share a video, repost an infographic, or participate in a PrEP education campaign like HRC’s DailyBlue.

Now is the perfect opportunity to recommit ourselves to fighting health inequities and fostering stronger and healthier communities. We can ensure that everyone has access to accurate information and that they will be supported as they choose from the ever-expanding options for prevention and sexual health.

 

Alex Garner is a program coordinator with NMAC and founding editor of Positive Frontiers. Shawn Jain is director of communications at Whitman-Walker Health.

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Words create worlds, so what kind of world do we want to live in?

Free speech comes with incredible responsibility

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It seems that each new day brings a fresh debate around speech and the weight of impact that speech holds. Back in October hundreds of Netflix employees staged a walkout protesting their company’s controversial Dave Chappelle stand-up special. At issue were a number of jokes aimed at the transgender community. The protest happened in response to Netflix CEO Ted Sarandos’ defense of the special, saying that “content doesn’t directly translate to real-world harm.” This statement could not be further from the truth. Not only do words carry impact and directly translate to real-world harm, words form our conception of the world and oftentimes what is seen as truth. The language we use and condone shapes how everything around us is perceived, which is why there is great responsibility in considering the words we use before we put them out into the world. 

We think about this every day at Reading Partners, an organization that places community volunteers in Title I elementary schools to support students in mastering reading skills. Because many of our volunteers do not share racial identity or a similar lived experience of the students we partner with, it is incredibly important to us that they understand that their role is to empower students who need a little extra support rather than coming to “help” or “save” them. The white-savior narrative has historically run rampant in spaces looking to mobilize volunteers for a cause and it is our responsibility to dismantle this narrative. This dismantling starts with the language we use and the stories we share about the communities we have the great privilege to partner with. Given that structural racism and oppression have created the current conditions facing under-resourced students, it is incumbent upon us that we recognize our role within the community and understand that we are here to act as a partner with students and their families whom have already created plans to address gaps in learning.

Because of the impact words yield, it is essential to carefully consider language choice, especially if it could affect marginalized and oppressed groups. Even those who have good intent, like journalists and public figures, often use outdated language and phrases that stigmatize communities or frame them through an othering lens. Some common examples of misguided language often used include phrases like “low-income students,” and “learning loss.” Both of these phrases place responsibility on students for the situation they are in despite the fact that students do not receive income, or have intentionally chosen to miss out on learning opportunities particularly with the disruptions that COVID-19 created. This type of framing has a direct corollary on how these students might be treated by teachers, administrators, and tutors, as well as how they are viewed by leaders, politicians and other people who hold power. It is therefore important that we use terms that accurately describe the situation, which may need to include political or historical context—so instead of “low-income students” we say, “historically under-resourced communities,” while a more accurate substitute for “learning loss” is actually “unfinished learning.” While these are subtle shifts in language, it completely reframes the situation, elucidating who shares responsibility for the current state of things and who does not.

It is also of note that the positive or negative connotations inherent in the language we use are hugely important to how we see those who may have different lived experiences than our own. At Reading Partners, we know that our students are not in fact “struggling” or “suffering from a lack of” something. We highlight our students as they are: “working hard,” “enduring,” “skill builders,” etc. despite growing up in a world where they have been denied access to high-quality literacy education. 

It is a fallacy that words cannot do harm. Language has served to dehumanize and subjugate people for as long as it has existed and it is often those in power who have the loudest voice. We as people, institutions, corporations, media, and otherwise must think through what we say and how it might impact others. Let’s be clear—this is not about censorship or ‘cancelling’ anyone. Language changes all of the time and it can be hard to keep up with. We are simply making the appeal that those in power, and with platforms, continue learning from and listening to those who have been harmed for centuries by systemic injustice. Free speech is a privilege, and with that privilege, there is incredible responsibility to utilize language that truly aligns with and demonstrates the user’s values.

Shukurat Adamoh-Faniyan is executive director of Reading Partners DC, a nonprofit that for more than 20 years has helped empower local students to succeed in reading and in life by engaging community volunteers to provide one-on-one tutoring. If you’re interested in learning more and becoming a volunteer visit readingpartners.org/volunteer-washington-dc.

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Why are gays so terrible at intergenerational friendships?

D.C. should create buddy program for elders

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Let me just start with a question. How many friends outside of your generation do you have? I mean honest-to-god friends. In my friend group, as large and fungible as that can be in the District and in the age of social media, it’s sort of me and a few other Gen Xers, and then just loads of Millennials. They do look to me to pass down some knowledge, but it’s mainly to do with the ins and outs of mortgages and things like that. 

But is it me? Or are gays just really, really terrible at having intergenerational friends? It’s striking. I’ve recently developed a friendship with — let’s call him — Bill. He’s almost 80. Maybe it’s the historian in me, but I just love the stories. But more on that later. For now, to ask another question, just why are gays bad at having friends removed from their respective generations? 

On social media this week I posted an obituary from a Houston paper dating from 1978. It was obviously from a gay man. You can tell from the coded language, “long time resident of this city despite stays on the West Coast.” And if that didn’t give it away, it ended with this rather heartbreaking language, “his parents requested that his friends not attend the memorial services!” Bill told me these sorts of obituaries — terribly vague but also cruelly pointed — were quite common in the dark days of AIDS. And this is succinctly why I think gays are so bad at having intergenerational friends, we’ve simply lost an entire generation of elders. And what was exactly lost with that generation is far more than can be enumerated in this column. 

Back to Bill’s stories for a second. There is a real value in oral histories, the telling and passing down of shared experiences make our culture certainly more valuable and rich, at the very least far more interesting. And again, this is nothing new, as cultures across the globe seek to capture personal stories and first-hand viewpoints of history unfolding. But it’s not just the story itself that’s important. It’s also the perspective and opinions. These remain nuanced between generations. Again, that’s really not saying anything new. But these varied opinions and outlooks, if not shared and debated risk isolating gay men into rigid and unchanging views crafted in echo chambers. 

Also, gays place a large premium on youth. And this, again, is nothing new, nor particularly gay. We just like what we like. But as Bill told me, he’s rather annoyed that any interest he expresses in a younger man is automatically filed under lecherous behavior. Let me just deal with this right here: We all, no matter the age, display to varying degrees lecherous behavior. Just get us a little dehydrated, a little tipsy, and throw us on the sand of Poodle Beach and watch the unwanted flirting unfold. So. But still we have to do better than mistaking anyone displaying interested in us as a simple sexual advance. That seems rather juvenile.  

With contact between our generations low, we are in danger of passing down a culture to future queer Americans that might seem a little lopsided and even a bit, well, shallow. But what’s to be done? I’ve commented in past columns on how we’re failing older LGBTQ Americans, especially in the District. To remedy this, we should use what I call the Chicago model and what is being done at the Center on Halsted, the city’s LGBTQ community center. The Center offers numerous programs geared to the city’s LGBTQ senior population. But one that sticks out is a sort of a buddy program, pairing seniors, even those in care facilities, with younger friends. This would certainly help us here in the District better care for our LGBTQ seniors, and would also of course help with the bridging of our considerable generational divide. So perhaps we could reproduce this here in the District. 

For now, I’ll continue to buddy up and enjoy my time with Bill. 

Brock Thompson is a D.C.-based writer. He contributes regularly to the Blade.

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Texas synagogue attack a reminder to fight anti-Semitism

Supporting Jewish community after latest tragedy

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Congregation Beth Israel (Screen capture via ABC News YouTube)

It was an all-too-familiar moment. A relaxed Saturday afternoon. Until an alert flashed on my screen. A gunman had taken hostages at a synagogue, Congregation Beth Israel, in Colleyville, Texas, a suburb of Dallas. He’d gone into the synagogue during Sabbath services.

It was an hours-long ordeal for the rabbi and three members of the congregation who were held hostage. The police intervened. The hostages emerged safely after 11 hours. The gunman, Malik Faisal Akram, died.

Like so many hearing this news, I was horrified, saddened, frightened, and shocked, but not surprised.

The hostage-taking at the Texas synagogue is part of a pattern of rising anti-Semitism. The Anti-Defamation League has tracked a rise in anti-Semitism in the United States in recent years – from the 2017 “Unite the Right” rally in Charlottesville, Va., where marchers threw Nazi salutes to the 2018 Tree of Life synagogue shooting that killed 11 people in Pittsburgh.

I don’t want to draw a false equivalency. Homophobia, biphobia and transphobia aren’t the same as anti-Semitism. But there are parallels. As I heard about the terrifying attack on the Texas synagogue, I remembered how frightened, enraged and sad we felt in 2016 when 49 LGBTQ people were killed in the Pulse nightclub massacre and how traumatized our community was by this attack.

As I write, much remains unknown about the hostage attack on the Colleyville synagogue. Authorities in the United Kingdom and the FBI are still investigating the situation.

Akram, the attacker at the Texas synagogue, came from Blackburn, England. In 2020, MI5 the U.K.’s counterintelligence and security agency, had investigated Akram, the BBC reported. The agency kept him on a watch list as a “subject of interest,” but determined that he wasn’t a “threat.” The FBI is investigating the hostage-taking at the synagogue as terrorism, the Washington Post reported. The authorities don’t know how Akram was allowed to get to Dallas or to buy a gun.

During the attack, Akram referred to Aafia Siddiqui, an American-educated woman known as “Lady al-Qaeda” and convicted of terrorism. Siddiqui is in a federal prison in Fort Worth for trying to kill U.S. soldiers, the Post reported.

Akram’s brother, Gulbar Akram, told media outlets and authorities that Akram had a mental illness.

Though the attacker’s motive still isn’t known, it’s clear that the Texas synagogue wasn’t randomly targeted, experts say. “It wasn’t a government office. It wasn’t another house of worship by a different faith community,” Holly Huffnagle, the American Jewish Committee’s U.S. Director for Combating Antisemitism, told NPR’s “Morning Edition.” “It was targeting Jews.”

Why should the LGBTQ community care about the attack on the Texas synagogue and the rise of anti-Semitism?

First, of course, because of the Jews in our community.

Those of us who are Jewish and LGBTQ know the double-whammy of encountering anti-Semitism along with homophobia, biphobia and/or transphobia. We run up against this prejudice in everything from slurs to stereotypes to violence.

Those of us who aren’t Jewish don’t know what anti-Semitism is like, though we may have Jewish family members or spouses who have experienced anti-Semitism. But because we’re LGBTQ, we have run into bigotry. We’ve been called names, discriminated against and wounded and killed by anti-queer violence.

Anti-Semitism and anti-queer bigotry aren’t identical, but I’d wager that many who are anti-Semitic are anti-queer.

“Then they came for the Jews,” wrote Martin Niemoller, a Christian pastor who resisted the Nazis in Hitler’s Germany in a poem, “And I did not speak out/Because I was not a Jew/Then they came for me/And there was no one left/To speak out for me.”

Our community needs to look within itself. We should work to expunge any anti-Semitism in our midst. 

Anti-Semitism has been a scourge for centuries. Combating it isn’t easy. But, let’s do all we can to support the Jewish community and to fight anti-Semitism.

Kathi Wolfe, a writer and a poet, is a regular contributor to the Blade.

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