Opinions
Condoms are Plan A: Back to the future of condoms
A combination of pharma greed, government squeamishness & the libertine position of advocates left us unprotected from a tidal wave of STIs
The world has completed a ten-year experiment with HIV prevention and the results are clear. PrEP and HIV treatment to prevent transmission have been found wanting. 1.5 million people globally became infected with HIV last year [1]. STIs are at an all-time high, a tragic turn from where we were just twenty years ago when syphilis was close to being eradicated. The US alone had 2.5 million combined cases of chlamydia, gonorrhea, and syphilis in 2021 [2]. Not to mention millions of teen pregnancies and unwanted babies.
For anyone looking at our circumstance objectively, it is clear that the pure biomedical interventions will never take the place of condoms as the first line of defense against HIV, STIs, and unplanned pregnancy. Yet condom promotion is virtually non-existent, and the condom culture is destroyed.
A combination of pharma greed, government squeamishness, and the libertine position of many advocates has left us unprotected against the tidal wave of STIs that is sweeping the world. It is easy enough to understand why condoms are not popular. Many people feel they’re uncomfortable, interrupt spontaneity, aren’t there when you need them, and on and on.
Governments don’t want to promote condoms because it would force them to talk about the “icky” subject of sex. Religious groups oppose them because they promote sexual pleasure over reproduction. Libertarians see them as a restriction on their freedom.
Beyond the health implications, it is time to look at condoms as an alternative to abortion. With the right to choose having been trashed by the Supreme Court, alternatives to medical abortions are getting a second look. The public health system in the US must choose an avenue to focus on where primary prevention will take place.
Plan B medication interrupts conception within 72 hours of a sexual encounter. Plan C can end a pregnancy.
Why not have a Plan A—Condoms. Hershel Walker, who recently lost his race for the Senate in Georgia, repeatedly asked a woman to have an abortion. Did he consider a condom? Arnold Schwarzenegger had an affair with the housekeeper that busted up his marriage. Did he consider a condom?
At AHF Wellness Centers, we have many frequent flyers who routinely test positive for STIs. Antibiotics do the job (for now), clearing up infections quickly so the next infection can take its place. Is using a condom such a high price to pay for preventing multiple infections? People who test positive for STIs are more likely to get HIV in the future [3].
If we continue down this route, we know where it goes. Rampant increases in STIs are costly, can result in infertility, cause still births due to syphilis (congenital syphilis rates tragically increased 184.5% over the past five years), create drug resistant gonorrhea, and incite relationship break-ups [2]. Despite these serious outcomes, we see STIs as a temporary inconvenience and do not take them seriously.
There has never been any question that biomedical interventions can help an individual and should be freely available without any stigma. However, ten years in there still isn’t any proof that biomedical interventions alone will reduce HIV, but we know they will stoke STIs. Nevertheless, we are heavily exporting this failed experiment to the world. And who benefits most—Pharma giants Gilead and GSK.
Government policy must adjust to the realities of primary prevention. We need to go back to basics and promote condoms as the primary means to prevent HIV/STIs if we are to have any chance of bringing rates down. Focusing in on condoms gives the power of prevention and control back to the individual, it won’t get tied up in medical appointments and pharma profits.
Some want us to double down and give preventative antibiotics to stave STIs. This may lead to increases in unprotected sex and inevitably to antibiotic resistance, which is a growing existential public health threat [4].
Prevention is a tough road to hoe. You will never be completely successful in promoting healthier behavior. But, having bent the stick so dangerously in one direction it is time to bend it back.
Sources
1. HIV.gov. The Global HIV/AIDS Epidemic. Available online: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics
2. CDC Preliminary 2021 STD Surveillance Data. Available online: https://www.cdc.gov/std/statistics/2021/default.htm
3. CDC STDs and HIV – CDC Basic Fact Sheet. Available online: https://www.cdc.gov/std/hiv/stdfact-std-hiv.htm
4. CDC. Antimicrobial-Resistant Gonorrhea Basic Information. Available online: https://www.cdc.gov/std/gonorrhea/arg/basic.htm
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Michael Weinstein is the president of Los Angeles-based AIDS Healthcare Foundation (AHF), the largest global AIDS organization.
The Foundation now operates in over 730 treatment clinics in more than 45 countries globally: over 68 outpatient AHF Healthcare Centers in over 16 states as well as in the District of Columbia and Puerto Rico. AHF also operates more than 60 pharmacies in over 17 states and also operates a clinical research unit.
Under its Positive Healthcare brand, AHF operates managed care programs for people living with HIV and/or AIDS in California, Florida, and Georgia.
Opinions
Evan Low is not the leader the Victory Fund needs at this moment
The board must recognize what is at stake and act before org’s legacy is lost
As co-founder and the first executive director of the Victory Fund and Victory Institute, I find the ongoing turmoil between a dozen or more employees and the organization’s new president, Evan Low, deeply distressing—particularly during such a critical election year.
The Victory Fund’s mission has always been clear and important: to elect and support qualified LGBTQ candidates for public office and, in doing so, secure a “seat at the table” from which LGBTQ issues can be advanced. That mission is too important to let internal turmoil diminish it.
I applaud the employees for going public with their concerns. When harassment allegations and other serious complaints threaten to derail an organization that was once so effective, where else are employees supposed to turn? The board of directors has a legal and fiduciary responsibility to the organization and to its donors.
I do not know Mr. Low, nor have I ever met him. Given my role as a founder, former executive director, and major donor, I found that somewhat remarkable. I was also surprised by the organization’s lack of contact with me at any level—whether to seek my financial support, ask for help with fundraising, or simply seek the perspective of someone involved in building the organization from its earliest days.
When Mr. Low was hired, members of the press contacted me about reports concerning his involvement in previous election-law matters. I declined to comment beyond saying that the board had hired an outside search firm to conduct the search and that I was in no position to assess any issues in Mr. Low’s past.
In hindsight, however, I have come to believe that Mr. Low is not the leader the Victory Fund needs at this particular moment. Ultimately, though, this is a matter for the board of directors to resolve. The board has an obligation to act decisively and independently before this internal conflict further damages an organization whose stature, effectiveness, and reputation were built over decades. The work of the founding board, subsequent boards of directors, and former leaders David Mixner, Brian Bond, Chuck Wolfe, and Annise Parker should not be so easily undone.
The Victory Fund once commanded the admiration, confidence, and financial support of countless people—including me. I hope the board recognizes what is at stake and acts before that legacy is lost.
(Correction: An earlier version of this op-ed called for the board to conduct an independent investigation of the allegations. The board did conduct such an investigation.)
William Waybourn is co-founder and the first executive director of the Victory Fund and Victory Institute.
For years, transgender Americans have been told that visibility is important. We should tell our stories, educate people, speak publicly about our experiences and show younger transgender people that a future is possible. I understand that argument because I have participated in that kind of visibility myself. Nearly a decade ago, I appeared in National Geographic’s “Gender Revolution,” in 2017, hosted by Katie Couric. I have written publicly about being transgender, participated in LGBTQ politics and spent years thinking about what it means to transition in America. My history is hardly a secret. But as I have gotten older, I have increasingly found myself wanting something considerably less dramatic: I want the right to be an ordinary man.
That does not mean I am ashamed of being transgender, nor does it mean that transgender activists should stop fighting for our rights. Many of the freedoms I enjoy exist because previous generations of LGBTQ people were willing to be conspicuous when visibility carried considerable personal risk. But equality cannot require permanent visibility. There is a strange expectation placed upon members of minority groups that our lives should contain some larger social meaning. A transgender person who overcomes adversity is called “brave.” Someone who talks openly about transition becomes “inspiring.” Someone who succeeds becomes an example of “trans resilience.” Sometimes those descriptions are deserved and sincerely appreciated. But sometimes I do not want to represent resilience. Sometimes I just want to walk my dogs, sit in a coffee shop with my laptop, complain about Northern Virginia traffic, go swimming, write books and figure out what I am having for dinner. I also want to be able to gossip with my friends in meaningless ways and do off kilter things that resemble fun: axe throwing, bowling, and karaoke.
When I was younger, being transgender occupied an enormous amount of psychological territory. Transition required decisions, explanations and difficult conversations. Other people had questions. My body seemed consequential in a way that other people’s bodies did not. There was always another milestone ahead of me, and for a while it was difficult to imagine reaching a point when gender would no longer dominate my thoughts. Eventually, however, something unexpected happened: life became life again. The questions that occupy me today are increasingly the same mundane questions that occupy millions of other adults. What kind of career do I want? Am I being a good friend? What should I write next? What kind of person do I want to become?
Most strangers who meet me today simply see a man. They do not know my medical history or what I looked like years ago. They don’t know that I looked like a skinny track star, and then was put into the resemblances of a meager nonbinary body. They do not know the chronology of my transition unless I decide to tell them. There is tremendous freedom in that, and I have come to think of it not as deception but as privacy. Nobody introduces himself by providing strangers with a complete inventory of his medical history, childhood insecurities and previous identities. Human beings reveal themselves gradually. Different people know different parts of us, and intimacy develops when we decide that somebody has earned access to more of our story.
Yet transgender people are frequently encouraged to regard disclosure as a measure of authenticity. I no longer believe that it is. There are circumstances in which being transgender matters enormously, and there are others in which it barely matters at all. When I am writing, I want somebody to care about the quality of the sentence. When I am working, I want somebody to care whether I did the job well. When I make a friend, I want that person to discover the complicated human being underneath the surface: my ambitions, flaws, anxieties, ridiculous stories and sense of humor. Being transgender may eventually become part of that conversation, but it does not have to be the first thing somebody knows about me.
That, to me, is one of the least discussed promises of equality. For decades, LGBTQ people fought for the right to be seen because invisibility was often enforced through shame and discrimination. Visibility therefore became a form of liberation. But perhaps successful visibility should eventually produce another freedom: the freedom to become unremarkable. A gay couple should be able to bore their neighbors with complaints about their mortgage. A lesbian should not have to become an ambassador for lesbianism whenever she enters a room. A transgender man should not have to turn his body into a public seminar about gender. He should occasionally be allowed to be some guy. Transgender people, in a sense, should also have the right to be flawed: sometimes we yell at our romantic counterparts, and other times we get fired from jobs for being obnoxious. But we are only human, just like you.
There are, of course, transgender people who cannot or do not want to disappear into ordinary life, and there are young transgender people desperately searching for evidence that adulthood is possible for them. Visible transgender people can provide that evidence. But there should be another story available to those young people as well: you can grow up, transition and eventually spend less time thinking about transition. You can become preoccupied with your career, fall in love, get divorced, write a terrible first draft and spend three days fixing it, worry about your parents, buy groceries and acquire all the wonderfully tedious problems of adulthood.
That might not sound revolutionary, but perhaps that is precisely what makes it meaningful. The ultimate promise of transgender equality should not be that every transgender person becomes visible, celebrated, courageous, or inspirational. It should include the possibility that a transgender man can walk into a room and nobody finds his gender history particularly interesting. He can simply be a man living his life. Increasingly, I think that ordinary freedom is what I wanted from transition all along.
Isaac Amend is a transgender man and writer based in D.C. In 2017, he starred in National Geographic’s ‘Gender Revolution’ documentary. He sits on the board of the LGBT Democrats of Virginia. His author’s portfolio is available at isaacamend.com, and you can catch him on Instagram at: @isaacamend.
Opinions
LGBTQ community must vote in big numbers
We have a chance to retake Congress and flip governors’ mansions
On Nov. 3, we have a chance to make a difference for our own community, and for so many others, who are being hurt by the lying, grifting, felon in the White House, his fascist aides, and sycophants in Congress. The danger they pose is real.
We have seen members of the LGBTQ community have their lives threatened, and some even killed. The anti-trans language, and anti-trans legislation, both supported and proposed by this administration, and their MAGA followers around the nation, is real. In the Department of Defense, we have seen trans heroes drummed out of the military. Books on our community taken off library shelves, and our history being wiped out. Even the history of the Enola Gay, the plane that dropped the atomic bomb, was wiped out before someone actually told the dangerous, moron, Pete Hegseth, Secretary of Defense, that Gay was the name of the pilot’s mother, not a reference to our community.
Many members of the Log Cabin Republicans will proudly tell you that the administration is actually pro-LGBTQ, as there are gay members of the felon’s administration. What they don’t like to dwell on, is their silence during these attacks on the community. Yes, there are people like Richard Grennell, who destroyed the Kennedy Center. He cancelled concerts by the Gay Men’s Chorus, and programs by drag queens. Then there is Scott Bessent, the highest-ranking queer, a clearly self-hating, Secretary of the Treasury. A man who benefitted from the work of all the activists in our community, so he could get married, and have children, but then won’t speak out for the community. I wrote a column suggesting when his children grow up, they will be embarrassed by what their father didn’t do. Most of the other members of the LGBTQ community in this administration are either members, or supporters, of Log Cabin, and have sworn fealty to the lying, grifting, Trump in order to get, and keep, their jobs.
So, it is beyond time, for the LGBTQ community, and our allies, to vote, and vote in large numbers, to say ‘ENOUGH’, we will not continue to stand idly by while we, and others, are being hurt by this self-serving, venal administration.
Barney Frank once said “If we aren’t at the table, we are on the menu.” But we have come to realize, not every one of us at the table, will work to protect us. There are some at the table today who either agree with what the administration is doing, or are remaining silent out of fear. They remind us every day of the truth of the slogan, ‘Silence = Death.’
So, Nov. 3 is our next chance to speak out. We can do it with our votes. If we vote in large enough numbers, we have the chance to not only take back the Congress, the House and Senate, but to impact state governments, cities, and local communities. We have the real chance to take back the governor’s mansions in Ohio, by electing Amy Acton; in Iowa, by electing Rob Sand; in Florida, by electing David Jolly; and in Georgia, by electing Keisha Lance Bottoms, among other states. These races are all close, and our voting in big numbers can make the difference. Then we can flip state legislatures, mayor’s offices, local commissions, and even school boards. We have seen even in small communities like Rehoboth Beach, Del., when we vote, we elected the first out lesbian mayor, Susan Stewart. In Key West, we elected a commissioner, Christopher Massicotte. Our votes, along with so many other decent people, do make a real difference.
It is not only electing members of the LGBTQ community. It is electing those who will have our backs, and fight for us. We must support, and vote for, candidates who will have our backs and fight against the homophobia, and vicious attacks, on our community by today’s MAGA version of the Republican Party. While the numbers vary, there have been more than 500 anti-LGBTQ bills filed in state legislatures thus far in 2026. I may have missed something, but as far as I know the felon’s administration has not opposed any of them. They have endorsed a host of them through their words and actions.
So, I beg you, as a member of the LGBTQ community, and someone who believes in equal rights, and human rights, for all; please vote. Make the effort to get all your friends and family that support you, to vote as well. Martin Luther King, Jr., who I had the honor of meeting and taking with, once told me “Each one of us can make a difference.” This is your chance!
Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist.
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