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Organ Donation in the Time of COVID-19

The nearly 112,000 people with end-stage organ failure are counting on you.

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Mike Lynch and Andrew Shunk (right) at Blue Ridge Mountain.

On a recent day off, my boyfriend Mike Lynch, our dog Bellatrix and I hit the trails on Blue Ridge Mountain for a socially distanced hike. It was an escape of sorts as we both find ourselves on the frontlines of this COVID-19 pandemic. Mike as a Critical Care Nurse, and me as an Advanced Practice Coordinator, facilitating the organ donation process so people in dire need of a transplant may live. 

Each day, we enter Critical Care Units and hospital rooms despite our fear that we too could contract COVID-19. It is risky, but healthcare workers know the only way to turn this pandemic around is to show up and do our part, even though that means putting ourselves in harm’s way. It’s a high-stress environment in hospitals these days, but if you look closely enough, you’ll see nurses, doctors, respiratory therapists and support staff still smiling under their masks while they do what they do best–-caring for patients. 

I am on the clinical team at Washington Regional Transplant Community (WRTC), the Organ Procurement Organization (OPO) in metro DC. WRTC is responsible for recovering and allocating organs and tissues used in lifesaving transplant surgeries. Unfortunately, the pandemic has led to a significant decline in organ and tissue donors, however, the good news is donations and transplantations are still happening when it is safe to do so. 

The pandemic has forced us to temporarily adjust the donation process. Changes include supplying our own PPE when we are able to not diminish hospital supplies, processing donor medical evaluations offsite to limit foot traffic in hospitals and providing local transplant surgeons to recover organs for transplant, rather than surgeons outside the region traveling to DC. In addition, we are working with hospitals to test all potential donors for COVID-19. 

In May 2020, WRTC recovered and allocated organs and tissues from 32 benevolent donors, and while that number is down, we are hopeful as COVID-19 hospitalizations decrease, we will see an uptick in the number of donors. While we cannot currently recover organs and tissues from donors who have active COVID-19 infections, we are evaluating the potential to accept organs from COVID-19 survivors, so long as they tested negative for COVID-19 at the time of their death. Our medical directors conduct comprehensive evaluations on all potential donors and determine medical suitability on a case-by-case basis.

Everyone can register to be a donor, and I urge people to visit BeADonor.org right now and register. The nearly 112,000 people with end-stage organ failure are counting on you. They desperately wait each day for the call that a lifesaving organ is available for them. There is no medicine or a magic pill they can take to live. A transplant is the only cure, and that is why our mission must always continue. 

To learn more about organ, eye and tissue donation, visit BeADonor.org. Written by Andrew Shunk, MSBS-HDS, NRP, CPTC, Washington Regional Transplant Community.

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Health

MISTR announces it’s now prescribing DoxyPE

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MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTR’s telehealth platform to receive DoxyPEP online for free, according to a release from the company.

With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.

“Despite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,” said Tristan Schukraft, CEO and founder of MISTR. “I’m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.”

An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV. 

MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.

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Health

UNAIDS to commemorate Zero Discrimination Day’s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,” she said in a press release. “Stigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyone’s rights that we can protect everyone’s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for women’s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyone’s health is synonymous with protecting everyone’s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world — for everyone,” said Byanyima.

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New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, the National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25 Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The study’s researchers noted: “Employment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.”

The study stated that trans women’s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to “survival sex work” and violence, which increases the risk of contracting HIV. 

The study’s author’s pointed out: “When economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis …demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.”

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