Uncloseted Media published this article on March 3.

This story was produced in collaboration with Rewire News Group, a nonprofit publication reporting on reproductive and sexual health, rights and justice.

This story was produced with the support of MISTR, a telehealth platform offering free online access to PrEP, DoxyPEP, STI testing, Hepatitis C testing and treatment and long-term HIV care across the U.S. MISTR did not have any editorial input into the content of this story.

By SAM DONNDELINGER and CAMERON OAKES | For two weeks, Albé Sanchez didn’t leave their house in South Minneapolis.

“[I was] forced into survival mode,” Sanchez told Uncloseted Media and Rewire News Group (RNG). “I felt like there was an invisible wall [to the outside world] that I couldn’t cross unless I really wanted to put myself in a place where there was a chance that I might not be able to come back.”

Queer and Mexican American, Sanchez was afraid of being targeted by the Immigration and Customs Enforcement presence in their neighborhood, even though they are a U.S. citizen.

“Every day is a risk,” they say, adding that even if they have paperwork, if they fit the profile, they are a target, making it scary to go even to work or the grocery store.

Sanchez, a 30-year-old sexual health care educator, has been taking oral PrEP, the daily preventive medication for HIV, for over a decade. But the mounting stress of ICE raids has made it harder to keep up with dosing.

“A missed dose here and there pushed me to make the appointment [for something more sustainable],” they say.

Sanchez says they felt like somebody would have their back at their local clinic. It was only a 10-minute drive from where they worked, they knew its staff from previous visits and community outreach, and they could count on finding Spanish-speaking staff and providers of Latino heritage. But not everybody has had that same experience accessing care.

Since ICE’s Operation Metro Surge began in early December, an increasing number of Latino patients in Minnesota are delaying or canceling what can be lifesaving care for the prevention and treatment of HIV.

These findings are particularly alarming for Latino communities, who, as of 2023, are 72 percent more likely than the general U.S. population to be diagnosed with HIV. And while overall infections have decreased, cases among Latinos increased by 24 percent between 2010 and 2022.

“I’m very concerned that there is going to be a sharp uptick in transmission,” says Alex Palacios, a community health specialist in the Minneapolis area.

In a January 2026 declaration as part of a lawsuit seeking to end Operation Metro Surge in the days following Renee Nicole Good’s killing, the commissioner of the Minnesota Department of Health said HIV testing among Latino populations has “dropped dramatically” and that “although grantee staff continue to go into the community to promote and provide testing, people are not showing up.”

Local clinics are reporting the same thing. The Aliveness Project, a community wellness center in Minneapolis specializing in HIV care, told Uncloseted Media and RNG they have seen more than a 50 percent decrease in new clients. The clinic serves a large number of Latino and undocumented clients, and while it usually sees 750 people walk through their door each week, according to providers, it reported seeing 100 fewer people each week since December.

Red Door, Minnesota’s largest STI and HIV clinic, has had a “modest uptick” in no-shows and missed appointments since December.

What happens when treatment stops

Today, there are multiple medications available that work to prevent HIV and dozens that treat it once a person tests positive. Many people who consistently take their medication have such low levels of the virus that they can’t transmit it through sex. But becoming undetectable requires patients to stay on their medication; otherwise, the virus replicates and mutates, weakening the immune system and increasing the risk of life-threatening infections.

“If patients aren’t on their medicines consistently, HIV can learn about the medication and become resistant to them. When this happens, the medicine will not work for the patient, and the new resistant virus could potentially be passed on to others,” says George Froehle, a physician assistant and provider at Aliveness Project. “Medication adherence is one of the most important aspects of HIV care.”

To maintain care and prevent dangerous, untreatable strains from spreading in Minnesota, providers at Aliveness Project have begun delivering medication to patients when possible, offering telehealth when they can, and pausing routine lab work to limit in-person appointments.

“The most important thing we can do from a public health perspective is to keep people undetectable so they don’t transmit HIV,” Froehle says, adding that providers in other cities targeted by ICE will need to make plans for missed injection visits, pivot to telehealth and prepare their teams for the “trauma that can occur.”

Sanchez understands the risks of inconsistent treatment, which is why they opted for the injectable preventative medication.

“I have a lot of risk [to HIV in my community],” Sanchez says. “With so much uncertainty about the future and whether HIV care will remain stable, I realized I couldn’t let this opportunity pass.”

But injectable HIV treatments are commonly dosed at two weeks to six months apart, and the medication must be administered in a clinic — a setting many patients are avoiding, according to providers.

“They have a two-week window” to get their shots, according to Froehle, who added that because patients are afraid to come in person, they have had to transition people off of their injectable HIV treatments. This has caused patients to return to oral HIV treatments without the testing they would normally receive had ICE not been in Minneapolis. “[Oral treatments] weren’t super successful [for these patients] to begin with and that’s why they were on injectables.”

Oral HIV medications, too, must be taken consistently to work. In response, providers have urged patients to have their pills with them at all times in case they get deported or detained.

The caution is not unfounded. Federal immigration facilities have a history of denying adequate medical care to people living with HIV, despite internal standards that require them to comply. Since 2025, at least two men living with HIV have been denied access to their medication in a Brooklyn jail, according to lawsuits obtained by THE CITY. One man said he was only given his medication after his lips broke open and he developed an open pustule on his leg. And in January 2025, another man died of HIV complications while in ICE custody in Arizona.

Beyond being detained without proper medication, patients are at risk of being deported to countries with limited access to HIV care, like Honduras and Venezuela, experts say.

“A lot of men [from Venezuela] told me they left because it wasn’t safe to be gay there and because they struggled to access HIV care,” says Froehle. “It’s a little heartbreaking to see new folks not only face the threat of deportation, but to places where they didn’t feel safe medically or identity-wise.”

“Some of these patients will die in their home country,” says Anna Person, the chair of the HIV Medicine Association. “It’s a death sentence.”

A ‘cascading disaster’

While ICE’s presence is threatening the infrastructure of HIV care that Minneapolis has built over decades, experts say there has always been a blind spot in HIV care for the city’s Latino community.

Vincent Guilamo-Ramos, executive director of the Institute for Policy Solutions at the Johns Hopkins University of Nursing, describes HIV in Latino communities as a “cascading disaster,” the result of years of compounding inequities.

“There’s been an invisible crisis among Latinos that hasn’t gotten traction,” he says. “The numbers have consistently gone up in terms of new infections, while nationally they’ve gone down. … That should be a big alarm.”

Numbers are rising because structural barriers and stigma are preventing Latinos from receiving care. A 2022 report from the Centers for Disease Control and Prevention found that between 2018 and 2020, nearly 1 in 4 Hispanic people living with HIV reported experiencing discrimination in health care settings. Lack of representation among providers, language barriers and deep-rooted medical mistrust further complicate access to care, according to Guilamo-Ramos.

Beyond the medical system, stigma within Latino communities can be equally damaging. According to Human Rights Campaign data, more than 78 percent of Latino LGBTQ youth reported experiencing homophobia or transphobia within the Latino community in 2024.

Sanchez agrees that stigma and bias are already massive barriers to care, citing the strict gender norms and Catholic beliefs many Latino communities hold. They say ICE’s presence is threatening already delicate access to HIV care.

“This has caused so much damage to people,” Sanchez says. “Not being able to access your health care appointments is such a stab in the side. … Being able to navigate any of these things in normal circumstances already has so much difficulty to it.”

Palacios, who is Afro-Latine and living with HIV, says the heightened ICE presence is worsening barriers that have long undermined the Latino community’s access to HIV care.

“The horizon has always been stark and dim,” they say. “And this just feels like one more thing to address and to fight back against.”

Sliding backwards

Navigating HIV care is becoming more difficult across the board, as the federal government has decimated HIV funding, compromising decades of progress made in the fight against the virus since Donald Trump retook office just over a year ago.

In February 2026, three months into Operation Metro Surge, the Trump-Vance administration proposed slashing $600 million in HIV-related grants, targeting four blue states, including $42 million for Minnesota programs. A federal judge has temporarily blocked the cuts.

“This would completely decimate and gut all of our HIV prevention,” says Dylan Boyer, director of development at Aliveness Project. “That’s the reality that we live in.”

“We have all the tools, and yet we are staring down this rollback of infrastructure and research dollars, prevention efforts, treatment efforts, that are going to put us squarely back in the 1980s,” says Person, a national HIV expert who grew up in Minnesota. “[There] seems to be no other rationale for that besides cruelty, to be quite frank, since there’s no scientific reason for it.”

Repair and representation

Jenny Harding, director of advancement at a Minneapolis-area supportive housing program for people living with HIV, says that while ICE’s presence is lessening in the Twin Cities, the “damage is done.”

Person says that this mending will take time, especially between the medical community and patients, since HIV providers can have a “very fragile” relationship with their clients.

“It takes, sometimes, years to build that level of trust. And I do worry that folks are just going to say, ‘I don’t feel safe here anymore. The system does not have my best interest at heart, and I’m not coming back,’” she says. “This is not something that you can flip a switch and everything will go back to normal.”

“We need to hold our federal government accountable, particularly HHS, [and] we need to ensure that HIV funding remains intact,” Guilamo-Ramos says, adding that in order to lower rates of HIV in the Latino community, there should be more specialized efforts: such as bilingual and culturally aligned health care providers, community-based outreach programs co-located where risk is highest, trust-building initiatives to address medical mistrust, mobile clinics, and targeted programs to re-engage patients who have fallen out of care.

Aliveness Project’s patient numbers have increased in the last few weeks as the ICE operation has waned, but the clinic staff is keeping “a watchful eye” and is having “difficulty reaching folks who are understandably scared.”

“Our biggest focus right now is reconnecting with people through our outreach so no one has a lapse in their HIV medications or prevention care,” Boyer, of Aliveness Project, says.

For Sanchez, seeing providers who speak Spanish and are of Latin heritage at Aliveness Project built enough trust for them to reach out and make an appointment despite the risks. Sanchez feels optimistic about their new injectable prevention strategy with the support of their clinic.

“There’s many places where you can receive care here in the Twin Cities where you might not see your skin tone. … There’s still a lot of health care professionals that unfortunately carry bias. … Aliveness is the opposite of that,” they say. “Seeing that representation and knowing someone has that cultural context of how to meet you in moments of sensitivity, it’s crucial.”

Once upon a time in the 1940s, a teenager named Roland Loomis, who lived with his devout Lutheran parents in Aberdeen, S.D., received a hand-me-down camera from his uncle. It was a gift that would change his life.

Small and effeminate, he didn’t exactly fit with the “in” crowd of his small rural town; but he had an inner life more thrilling than anything they had to offer, anyway, and that camera became the key with which it could finally be unlocked. Waiting patiently for those precious hours when he was alone in the house, he used it to capture images of himself that expressed an identity he had only begun to explore, through furtive experiments in body manipulation that incorporated exotic costuming, erotic nudity, gender ambiguity, and what many of us might call (though he would not) self-mutilation, including the piercing of his skin and other extreme forms of physical modification.

Young Roland would go on to become famous (or perhaps, notorious) in the decades to come, but it would be under a different name: Fakir Musafar, the focal figure of filmmaker Angelo Madsen’s documentary “A Body to Live In,” which opened in Los Angeles on Feb. 27 and expands to New York this weekend. 

Like Musafar himself, who died of lung cancer at 87 in 2018, it’s a documentary that doesn’t quite follow the expected rules. Eschewing “talking head” commentators and traditional narration, Madsen spins his movie from his subject’s extensive archives and allows the information to come through the voices of those who were close to him: collaborator and life partner Cléo Dubois, performance artists Ron Athey and Annie Sprinkle, and underground publisher V. Vale are among the many who contribute their memories and impressions of him, while evocative photos and film footage create a hazy “slide show” effect to provide a guided tour of his life, his art, and his legacy. Less a biography than a chronicle of profoundly unorthodox self-discovery, it details his development from those early days of clandestine self-photography through a continual evolution that would see him become a performance artist, a central figure in the burgeoning BDSM culture, a seeker who espoused eroticism as a spiritual practice, the founder of a “Radical Faeries” offshoot for the kink/fetish community, and ultimately an elder and mentor for a new generation for whom his once-taboo ideas and explorations had essentially become mainstream – thanks in no small part to his own pioneering efforts.

It’s a fascinating, hypnotic trip into a culture which might feel disturbingly transgressive to those who have never been a part of it – yet will almost certainly feel like being “seen” to those who have. It opens a window into a lifestyle where leather, kink, BDSM, gender play, and non-monogamous “situationships” are not just accepted but viewed as natural variations on the spectrum of human sexuality; and in the middle of it all is Musafar, on a deeply personal quest to connect with the deepest part of his essence through the intense and ritualistic pursuit of an inner drive that keeps pushing him further. As one reminiscing cohort remarks during the film, it’s as if he is “trying to find an answer to a question that” he “cannot form.”

Indeed, it might be said that Madsen’s movie is an exercise in forming that question; bringing his own “transness” into the mix as he examines the various aspects of Musafar’s ever-evolving relationship with self, identity, and presentation, he evokes a timely resonance in which the imperative to make physical form match psychic self-perception becomes an irresistible force, and draws a direct line between his subject’s fluid ambiguity and the plight faced by modern trans people over the bigotry of those who think gender is strictly about genitalia. Perhaps the question has to do with whether we are defined by our identities or by our physical form – or if both are malleable, adaptable, and in a constant state of flux.

In any case, with regard to Musafar, “A Body to Live In” is unquestionably a film about transformation, not just of physical manifestation but of consciousness itself. In his journey from being little Roland, the outcast schoolboy with a secret fetish, to Fakir, the spiritual psychonaut for whom sex and gender are only walls that separate us from a true and eternal essence, he is embodied by Madsen’s reverent documentary as a being in the process of breaking free from the restrictions of physical existence, of transcending all such distinctions by letting go of life itself – something underscored not only by the section of the movie dealing with the impact of the AIDS epidemic on Musafar’s deeply-bonded community, but by his own words, spoken in a deathbed interview that serves as a connecting thread throughout the film. We are kept unavoidably aware of the mortality which – for Musafar at least – seems little more than a prison that keeps us from the unfettered joy of our true nature.

But while Madsen honors his subject as a pillar – and an under-sung hero – of contemporary queer culture, he also addresses the aspects that made him a “problematic” figure; in his life, he drew criticism over perceived cultural appropriation from the indigenous American tribes whose sacred rituals inspired the kink-flavored practices which facilitated his own spiritual odyssey, and which he popularized among his own acolytes to give rise to the still-controversial “Modern Primitive” movement that has been criticized by some for turning meaningful cultural traditions into an excuse for trendy fashion accessories. Even Musafar’s survivors, whose love for him exudes palpably from the stories and memories they share of him throughout the film, make observations that point to his flaws; yet at the same time, Madsen’s documentary makes clear that Musafar himself never saw himself as perfect, either – just as someone willing to endure the kind of suffering that most of us might find unbearable in order to get closer to perfection.

Of course, it probably helped that he enjoyed that so-called “suffering,” but that’s perhaps too glib an observation in the face of a film that so clearly makes a case for the deep and sincere commitment he held for his quest for transcendence; but it’s also a helpful reminder that his practices – which might seem macabre and twisted to the uninitiated – were also an experience of joy, an exercise in rising above pain and making it a vehicle toward enlightenment, and in achieving a deeper understanding of one’s own place in this confusing place we call the universe.

Full disclosure: “A Body to Live In” is an intense experience, replete with candid sexual conversation, frequent nudity, and graphic scenes of extreme fetish practices – like suspension by metal hooks through the skin – which might be hard to handle for those who are unprepared to be confronted by them. Even so, as dark and menacing as it might be for the squeamish outsider, the world revealed in Madsen’s eloquent portrait is full of treasures and steeped in dark beauty, and it’s hard to imagine a more fitting way than that to portray a queer pioneer like the former Roland Loomis.

Most people know stand-up comedy from Netflix specials or late-night sets on Comedy Central. The reality is far different for local working comics like me. A few times a month, I might get paid $50 for a 10-minute set and my photo on a bar flyer to show off to the ladies in my scrapbooking club.

Still, it’s a joy sharing laughs about my well-worn Washington career arc — from conservative reporter to openly trans organic grocery store worker and nightclub comedian. Or, as I like to say onstage, from Fox to foxy.

Stand-up is hard. Offstage, it’s even harder. It took more than a year and nearly 80 open mics to land my first paid set. Since then, I’ve performed in coffee shops, bars, restaurants and even on a city sidewalk. I once performed in the Catskills, which felt like a big deal — even if it was a bigger deal in the 1950s.

As an older trans comic in Washington, I’ve found it nearly impossible to get stage time — or even the courtesy of a returned email — at the big, corporate-owned comedy clubs. Fortunately, there’s a thriving patchwork of queer-friendly producers in Washington and Baltimore creating shows that reflect the diversity of our communities, instead of straight male-dominated lineups that look like the cast of “Ice Road Truckers.”

“There are so many kinds of funny people, but a lot of barriers exist for women and queer people because it’s a very masculine culture,” said Dana Fleitman, who runs the Just Kidding Comedy Collective and is helping produce the Woke Mob Comedy Festival in April, featuring many women and queer comics.

Full disclosure: I’m not performing in the festival. But I am proud to be one of more than 50 women and nonbinary comics Fleitman and her colleagues have helped “train up” through an incubator program she first ran through Grassroots Comedy and now through Just Kidding Comedy Collective.

Another trans comic, Charlie Girard, who splits time between New York and Washington, runs an incubator program called Queers Can’t Take a Joke. He has trained more than 100 comics in Washington.

Girard has one rule: no punching down.

“The best comics speak truth to power,” Girard said. “Making fun of marginalized communities is simple lazy writing based on tired, old stereotypes.”

Ultimately, Girard wants to prepare students not just for queer rooms, but to find their voice and expand into all kinds of spaces.

Comics trained by Girard and Fleitman have gone on to produce or help run shows like Clocked Comedy, Backbone Comedy, the Crackin’ Up open mic and Funny Side Up. Several have found a home on Barracks Row at As You Are — one of my favorite places to perform. In Washington, comic Jenny Cavallero’s show Seltzer is a sober comedy night frequently featuring local queer comics.

In Washington, performer and producer Arzoo Malhotra, who runs Zoo Animal Productions, said it’s a critical moment to support community-based comedy producers, often the first hit by worsening economic conditions.

“We’re losing spaces faster than we’re creating them,” Malhotra said. “We are in the use-it-or-lose-it stage. If there’s a restaurant you like or a performer you want to keep seeing, patronize them now — because they’re going away.”

I’m also grateful for producers in Baltimore, which has a thriving queer comedy scene. Comic Hannah Alden Jeffrey’s monthly “The Really Cool Open Mic,” created for women and trans performers but open to all, regularly draws up to 100 people.

Hannah’s mic and Kenny Rooster’s “Dramedy” open stage have provided safety and opportunity when other stages felt out of reach. Comedians Michael Furr and Jake Leizear also produce shows regularly featuring queer comics.

“We started the REALLY COOL Open Mic because every other mic in town catered toward straight dudes that dominated the Baltimore scene,” Alden Jeffrey said. “Contrary to the lineups of many shows today, people don’t want to see a show of eight guys being bigots. Go figure.”

One of the most important moments for me came when I attended a free showcase at a well-known Adams Morgan club. Like other big venues, it hadn’t responded to emails from a new comic looking for a shot. I sat in the back row thinking maybe these comics were just way funnier than I am.

Then a straight male comedian — with hair even more gorgeous than mine — launched into a long joke comparing eating pizza to performing oral sex on a woman.

At that moment, I walked out feeling better about myself. I remember thinking: nope. I absolutely deserve to be on that stage, too.

Lots of us do.

Jamie Mack is a stand up comedian, speaker and writer. Follow them on Instagram at @jamiemack_blt or email [email protected].