Health
Monkeypox: History must not repeat itself
Mistakes made during the COVID-19 pandemic and the AIDS epidemic occurring again
What’s that saying? Those who don’t understand history are doomed to repeat it?
Once again, the United States is repeating mistakes made during the COVID-19 pandemic and the AIDS epidemic.
It’s been two months since the first U.S. patient with monkeypox was identified. There are now 1,900 cases that we know of. The nation’s capital, Washington, D.C., leads the country in cases per capita. The opportunity to contain the virus is slipping away.
The country needs a swift, but comprehensive response. We need more vaccines. We need uniform standards and clearer rules about testing and treatment. Trusted officials need to combat myths. And people must get vaccinated, particularly those at the greatest risk.
Testing standards are not uniform, for example, a problem that echoes what happened in the early days of COVID-19. There are not enough vaccines and we are not allocating them to areas hardest hit. Even our tech isn’t right. People looking for vaccines have dealt with crashed websites just like they did at the beginning of the COVID vaccine rollout. And, as AXIOS noted, while there is an effective, FDA-approved antiviral treatment, patients only can get it if they fit within “an onerous 120-page protocol for expanded access to investigational new drugs.”
We know what will happen if we don’t get this right. We’ve lived that reality for two-and-a-half years.
Let me be clear, though. Monkeypox is not COVID-19. It does not spread as easily as COVID since, generally, transmission requires personal or intimate contact. That fact is on our side. (Scientists have not ruled out airborne transmission, however, so this guidance could be updated as we learn more.) As the New York City Department of Health admitted “a lot of cases … are not being diagnosed.” These unknowns are halting signs. If airborne spread is confirmed, or if it’s found asymptomatic carriers can spread Monkeypox, Monkeypox spread will be much worse than we currently anticipate. We are still learning about this new viral strain. We must remember that.
Like we did at the beginning of the AIDS epidemic, we also have a media problem. In the early 1980s, the public was led to believe AIDS affected only men who had sex with men. That messaging, created stigma and fear associated with AIDS. The results were catastrophic.
As pediatric emergency medicine physician Vinay Kampalath wrote in STAT News, “Pathogens don’t discriminate like humans do — they have no innate capability of discerning race, sexual orientation, religion, or nationality.” Whether gay, straight, or bisexual, if you have close contact with someone with monkeypox, you’re at risk. Even so, it took the Center for Disease Control and Prevention until this month to update its guidance to state, “Anyone who has been in close contact with someone who has monkeypox can get the illness.”
At present, however, not everyone has the same statistical chance of getting the virus because the virus is more prevalent in some communities over others. So while we need to be careful about reinforcing stigma, we do need to target relevant messaging to the people and places most at risk. And right now, that appears to be men and trans women who have sex with men.
We can tailor monkeypox awareness campaigns and focus resources to certain groups of individuals who are most effected while educating the public at large. As the virus spreads and as vaccines become more available, public and private vaccine campaigns must target people of all orientations and racial and ethnic backgrounds. Ultimately, if a person does not see themselves in a public health campaign, they will not protect themselves.
While government officials get their act together, Americans must take charge of their own health. Like COVID-19, we can reduce spread with a dose of common sense and personal responsibility. Here’s what you can do:
- Register to get vaccinated;
- Contact your healthcare provider if you develop rashes or abnormal lesions;
- Avoid sexual contact if you’re having flu-like symptoms (COVID is still a risk);
- Avoid sexual activity or physical skin-to-skin contact if rashes or lesions are found;
- Because linens can be contaminated, sleep in a different room if your partner is infected
- Cover lesions; and
- Stay informed.
One great way to stay informed is to join DC Health, the Washington Blade, and me at a special Monkeypox Town Hall on Monday, July 25th at 7pm at the Eaton. I’ll be moderating a panel of experts to answer your questions. Join us.
Dr. N. Adam Brown is a practicing emergency medicine physician, founder of a healthcare strategy advisory group ABIG Health, and a professor of practice at the University of North Carolina’s Kenan-Flagler Business School. Previously he served as President of Emergency Medicine and Chief Impact Officer for a leading national medical group. Follow him on Twitter @ERDocBrown.
Cannabis Culture
LGBTQ people, weed, and mental health: what you need to know
Community uses marijuana at much higher rates than general population
Uncloseted Media published this story on May 7.
By SPENCER MACNAUGHTON | In 2025, the global cannabis market size was valued at nearly $103 billion. By 2034, that number is expected to explode by roughly 1,400 percent to more than $1.43 trillion.
In short, as an increasing number of countries legalize marijuana use, everyone is starting to consume a lot more weed. And LGBTQ people tend to use cannabis at much higher rates than the general population. One study found that 55 percent of lesbian and 45 percent of gay young adults use marijuana, compared to about 33 percent and 37 percent, respectively, of their straight counterparts.
As LGBTQ people face a mental health crisis, the mainstream stereotypes that depict weed as an antidote for anxiety, panic and depression aren’t painting the full picture. And that could be exacerbating the mental health struggles so many queer people, and especially youth, face.
Here’s what the research demonstrates about marijuana and its effects on mental health:
- Multiple studies suggest a link between marijuana use and an increased risk of mental health disorders, including schizophrenia, depression and anxiety in individuals who are genetically predisposed.
- One study found that daily marijuana use, especially among younger people, makes some individuals seven times more likely to develop psychosis.
The increase in higher-potency strains of marijuana could pose unknown risks. In 1995, the average content of Tetrahydrocannabinol (THC) in confiscated marijuana was less than 4 percent. In 2022, it was more than 16 percent. Researchers don’t know the full extent of the impact that these higher concentrations can have on mental health and especially on younger people whose brains are still developing.
- A systematic review of studies published between 2013 and 2025 found damning results for the mental health of young cannabis users:
They were 51 percent more likely to experience depression, 58 percent more likely to experience anxiety, between 50 and 65 percent more likely to experience suicidal ideation and 80 to 87 percent more likely to have attempted suicide.
- While the above stats paint a grim picture, there is also some research that suggests benefits of cannabis use:
- A 2025 systematic review found that “medicinal” weed showed some efficacy in relieving withdrawal symptoms of opioid use disorder. THC use has been associated with improvement of post-traumatic stress disorder symptoms, bipolar symptoms and sleep quality.
- Other studies found that THC administered in a controlled setting was associated with a decrease of symptoms and adverse effects for a range of mental health disorders, including schizophrenia, psychotic symptoms, and anorexia nervosa.
Beyond what we pulled from academia, there is an astounding lack of information about the interplay between weed and mental health. As we dive deeper into Mental Health Awareness Month, I hope advocacy organizations, influencers and news outlets ramp up their coverage of this important topic that affects the countless LGBTQ weed smokers, many of whom are already struggling.
Health
UPDATED: Trans-led HIV clinic in Portsmouth struggles amid funding cuts
As states across the U.S. cut funding for HIV care this small clinic in Va, is still fighting
Two years ago, Nyonna Byers, a transgender woman from Portsmouth, Va., founded Ending Transmission of Sexual Infections (ETSI) Health Clinic to support a community she saw struggling with rising HIV rates. Now, as costs continue to climb and funding for HIV healthcare initiatives is being cut across the United States, Byers says her transgender identity has made it harder to secure the financial support her clinic needs to survive.
Portsmouth, with just under 100,000 people, is right across the Elizabeth River from Norfolk.
“We’re an HIV-led organization here in Portsmouth, providing services throughout the Hampton Roads area,” Byers told the Blade. “As a trans-led organization—with me as the founder and executive director—I’ve received a lot of rejection when it comes to funding. That’s one of the main reasons why we’re struggling to keep the clinic open. Without funding, we can’t provide HIV treatment or care, and then we’re just a theoretical organization—we can’t be impactful in the community we serve.”
She said the data clearly shows a need for increased investment in HIV care in Portsmouth, but the response from leadership has not matched the urgency of the crisis.
“Portsmouth is one of the smallest cities with one of the highest HIV rates, and there are very few HIV-led organizations or clinics here. The need is urgent, but the response doesn’t match it. We’re doing the work on the ground, but we’re not getting the support to sustain it. That disconnect is what’s hurting people the most.”
That need, Byers explained, continues to grow as ETSI struggles to meet the financial demands of the life-saving work it provides.
Portsmouth has one of the highest HIV prevalence rates in Virginia, with roughly 736.9 cases per 100,000 people—a rate that exceeds both state and national averages.
“Leaders like the mayor and city council don’t focus on public health or social health. They focus more on development—building the city up physically—rather than investing in the health of the people. I’ve applied for funding multiple times and been denied. Every time I’ve asked for resources, I’ve been turned away.”
When asked why, Byers said the answer felt clear to her.
“I honestly believe I was denied funding because I’m trans. I told the mayor I was going to go public with it, because it’s not fair. We’re on the ground doing the work to end HIV, and we’re still not getting the support we need. That’s not just frustrating—it’s harmful.”
While she said local support has been lacking, Byers noted that the state has stepped in—though the funding still falls short of what is needed to sustain the clinic long term.
ETSI Health Clinic was included as a recipient of funding in the Virginia 2027–2028 Senate budget, receiving $50,000 per year from the Virginia General Fund. Byers specifically credited State Sen. Lillie Louise Lucas with helping secure that funding, which she said did not come from city leadership.
Byers shared that she has given up a lot to keep ETSI afloat, but the costs just keep coming.
“I’ve worked a lot of contracts—jobs paying $30 to $40 an hour—and poured that money into my clinic. But the downside is that I’m struggling personally. I’ve lost cars, I’ve lost a house—I’ve lost a lot to keep this clinic going. This work has cost me almost everything.”

She added that the impact of federal policy shifts is also being felt locally. As the Trump-Vance administration continues to roll back what it has described as unnecessary “DEI” spending, Byers said those decisions are affecting clinics like hers.
There was a time when the clinic was able to receive funding from Sentara Cares, the philanthropic program of Sentara Health, a not-for-profit healthcare system based in Virginia and North Carolina, but now they can’t.
“We had funding from Sentara Cares for three years, and it helped keep us going. Then when DEI initiatives started getting rolled back, that funding stopped. I was told directly that because of federal policy changes, they couldn’t fund the clinic. I broke down during that meeting, because it felt like they were really saying they couldn’t support us because of who we are.”
That lack of funding is compounded by broader gaps in healthcare access in the region. Portsmouth—the ninth most populous city in Virginia—does not have a hospital.
“There’s very limited access to care in Portsmouth. We don’t even have a hospital—people have to be transported to Norfolk. We’ve had high rates of syphilis, and the health department is only open a few days a week. A lot of people don’t trust it, and that leaves entire communities without care.”
Byers made it clear that this is more than a passion project for her—it is her life’s calling, and she would do nearly anything to keep it going.
“To be honest, I would go back to sex work before I let my clinic close. This is something I built from the ground up. I built this clinic with money I earned myself. I’m not going to let it disappear without a fight.”
She also pointed to gaps in education and outreach, which she says exacerbate HIV rates despite the availability of preventive measures.
“There’s almost no marketing or education about PrEP in the Hampton Roads area. If you go to places like D.C. or Atlanta, you see billboards and campaigns—but here, you don’t see anything. If people don’t see it, they don’t know about it. That lack of awareness is putting people at risk.”
It is also a deeply personal fight, she explained.
“I’ve lost friends to HIV. People say you can’t die from HIV anymore, but you can if you’re not in care. I’ve seen it firsthand, and that’s what motivates me to keep going. HIV doesn’t have to be a death sentence—but without support, it can become one.”
The Blade reached out to Portsmouth Mayor Shannon E. Glover for comment.
Glover disputed Byers’ claims that her clinic was treated unfairly, including her allegation that her transgender identity played a role in funding decisions.
“There’s no issue with Miss—with her and her organization. We have been in discussion, and quite frankly, the claims that she made as it relates to ‘we’re not treating her equitably and fairly because of her [being] transgender’ that is totally untrue,” Glover told the Blade via phone call. “I’ve talked to Miss Nyonna on a number of occasions, and that is categorically not true.”
Glover added that the city provides funding to various organizations and said he had directed Byers to seek support elsewhere.
“So I’m not understanding what her issues are,” he said. “But in any event, you know, we have funding that we provide to organizations. I’ve recommended other organizations to her. I’ve recommended that she go to the state where they have more flexibility with their budget and they could help her. So that’s what I’m prepared to tell you today. I’m not going to answer any questions. I just wanted to respond that her claim that we are mistreating her, not treating her fair, is totally untrue.”
To donate to ETSI, visit their donation page at ESTIhcvas.org/donate
Health
Housewives head to Capitol Hill to promote PrEP coverage
Bravo’s Real Housewives stars to lobby lawmakers for expanded PrEP access.
Stars from Bravo’s hit franchise “The Real Housewives” are heading to Capitol Hill next week to advocate for expanded access to HIV prevention and treatment.
On March 18, several well-known cast members — including NeNe Leakes, Phaedra Parks, Candiace Dillard Bassett, Erika Jayne, Luann de Lesseps, Melissa Gorga, and Marysol Patton — will travel to D.C. to participate in an advocacy event aimed at increasing awareness and coverage for pre-exposure prophylaxis, commonly known as PrEP.
The event, dubbed “Housewives on the Hill,” is being organized by MISTR, the nation’s largest telehealth platform focused on sexual health. The group’s founder and CEO, Tristan Schukraft, will join the reality television stars as they meet with lawmakers and legislative staff to discuss the importance of maintaining and expanding access to HIV prevention tools.
PrEP is a medication regimen that can, if taken properly, reduce the risk of contracting HIV through sex by up to 99 percent according to public health officials. Advocates say wider access to the medication — including through insurance coverage and telehealth services — is critical to reducing new HIV infections across the United States.
During their day on Capitol Hill, the Housewives are expected to meet with members of Congress and participate in conversations about federal policies affecting HIV prevention and treatment. Organizers say the reality stars will also share personal reflections about the continued impact of HIV on communities across the country and the importance of keeping prevention resources accessible.
The “Housewives on the Hill” event aims to use the cultural influence of the Bravo stars to spotlight HIV prevention efforts and encourage lawmakers to protect and expand access to lifesaving medication and treatment options. Organizers say the goal is simple: ensure that more Americans can access the tools they need to prevent HIV and maintain their sexual health.
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