When Elia Chino, Founder and Executive Director of the Fundacion Latinoamericana De Acción Social (FLAS) Inc., initially approached major HIV/AIDS agencies in Houston, Texas for support in starting an organization tailored specifically to reaching Latino populations, she was met with confusion.

“Why do you want to start a separate organization?” they asked. “We’re here!”

Chino remembers her frustration. “They didn’t understand,” she said. “Our brothers and sisters were dying, and the community needed services that they couldn’t provide.” 

Indeed, in the 1990s, barriers to HIV care and treatment for Latino populations were markedly different from those faced by other populations. Information about the HIV epidemic was largely in English, and inaccessible to many individuals who had immigrated from indigenous Latin American communities and never learned to read and write in their native language, let alone English. When they were able to access treatment, Latino individuals often faced mistreatment at primary care facilities due to a lack of culturally competent care. 

Perhaps most challenging was the culture of silence. Many Latino immigrants living with HIV in the United States fled homophobia, transphobia and stigma in their home countries, and were still grappling with lasting shame and guilt. Despite many people dying, there was little open discussion or education about the cause. In fact, Chino didn’t even know that the HIV epidemic took the lives of some of her best friends until speaking with their families years later. 

“No one was talking about their diagnosis,” says Chino. “People had come to the United States for freedom, but still weren’t ready to talk about who they were. There was a real atmosphere of stigma, taboo, misinformation and fear.”

At the time, Chino was volunteering at a hospital serving communities without insurance. The fourth, fifth and sixth floors were all dedicated to treating people with HIV. Chino began educating herself on this crisis while she volunteered at the hospital, and founded FLAS in 1994 after discovering that the majority of HIV prevention efforts were not reaching Latino individuals. 

In the beginning, without support from other organizations in the area or resources to expand, Chino was a one-woman show, conducting outreach in clubs, cantinas and bars by herself. She hadn’t anticipated the barriers she’d face as a member of the LGBTQ+ community and an immigrant. Horrible discrimination, a language barrier and intense HIV stigma in the communities she was working in made the work challenging, but also emphasized the necessity of what she was doing. 

Over time, with support and funding from organizations like Gilead Sciences, FLAS has been able to expand its services from solely HIV prevention to include HIV testing, behavioral health services, housing and social services assistance, support groups and a food pantry. The organization has started hosting educational events everywhere from churches to street corners, raising awareness about HIV in the Houston community. Chino also started collaborating with the consulate of Mexico to help newcomers navigate U.S. health systems and services when they arrive in the United States. Next year, the organization will start offering mobile HIV testing clinics for communities in need. 

Since its launch, FLAS has been able to expand its initial focus to address the holistic drivers of this crisis, moving beyond medical determinants of health to tackle the social and structural barriers that perpetuate the HIV epidemic and prevent Latino populations from accessing comprehensive treatment. 

“Everyone keeps telling Latino individuals to get tested, but this does nothing unless you actually incentivize people to do so,” says Chino. “People have to go to work. They have to pay their rent. They have to buy food. Many can’t afford to lose their salary and spend a full day coming in to do a test or get treatment. We have to make it easier to access HIV prevention and treatment, and we have to provide incentives.” 

This year marked FLAS’s 30th anniversary, which the organization celebrated with a gala in August. They have made a huge impact in Houston since their launch – providing HIV and STD education to over 500,000 Latino people, distributing over 20,000 HIV tests, referring over 40,000 people for social services and hosting over 6,000 educational events and health fairs in English and Spanish. However, many of the challenges for HIV prevention and treatment for Latino populations remain. 

“We have over 30,000 individuals living with HIV in Houston, yet when we ask for people to talk about their status, no one comes forward to tell their stories. HIV is a chronic disease, but stigmatization is still so strong in the Latino community,” says Chino. “You can say you have cancer, high blood pressure, diabetes, whatever – but nobody says I have HIV. There is still so much work to do.” 

As a testament to their important programming, FLAS is a recipient of funding through Gilead Sciences’ TRANScend® Community Impact Fund, a program aimed at empowering Trans-led organizations working to improve the safety, health and wellness of the Transgender community. Since its inception in 2019, TRANScend has awarded more than $9.2 million in grants to 26 community organizations across 15 U.S. states and territories.

TRANScend support has been critical to helping FLAS maintain its services. In 2020, in the midst of the COVID pandemic, Gilead’s funding helped FLAS continue to offer virtual behavioral and mental health services to the community when their physical offices had to close. 

According to Chino, this type of partnership is critical to ending the HIV epidemic in Latino communities, especially for meeting communities where they are. 

“Communities trust their grassroots organizations, and grassroots organizations provide for their communities,” she says. “At the end of the day, we need to continue to support the groups doing the difficult work on the ground with the people they’re serving, especially those breaking down stigma and lasting barriers to care for Latino communities.”

APLA Health will celebrate its 40th anniversary this Sunday at West Hollywood Park, by kicking off the world’s first and oldest AIDS walk with a special appearance by Salina Estitties, live entertainment, and speeches.

APLA Health, which was formerly known as AIDS Project Los Angeles, serves the underserved LGBTQ+ communities of Los Angeles by providing them with resources. 

“We are steadfast in our efforts to end the HIV epidemic in our lifetime. Through the use of tools like PrEP and PEP, the science of ‘undetectable equals intransmissible,’ and our working to ensure broad access to LGTBQ+ empowering healthcare, we can make a real step forward in the fight to end this disease,” said APLA Health’s chief executive officer, Craig E. Thompson. 

For 40 years, APLA Health has spearheaded programs, facilitated healthcare check-ups and provided other essential services to nearly 20,000 members of the LGBTQ+ community annually in Los Angeles, regardless of their ability to pay. 

APLA Health provides LGBTQ+ primary care, dental care, behavioral healthcare, HIV specialty care, and other support services for housing and nutritional needs.

The AIDS Walk will begin at 10AM and registrations are open for teams and solo walkers. More information can be found on the APLA Health’s website.  

Gov. Gavin Newsom signed California Senate Bill 729 into law on Sunday, giving California families unobstructed coverage for fertility treatments, in vitro fertilization and other family planning through major insurance plans and policies.

Senator Caroline Menjivar introduced the bill last spring and since then, Republicans have amassed an attack toward IVF and fertility treatments.

“California is a proud reproductive freedom state – and that includes increasing access to fertility services that help those who want to start a family,” said Gov. Newsom. “As Republicans across the country continue to claw back rights and block access to IVF – all while calling themselves ‘the party of families’ – we are proud to help every Californian make their own choices about the family they want.”

This is a landmark move for California – a state that, although progressive – still used archaic standards and language to refer to a family dynamic and determine eligibility for family planning until this bill was signed into law. 

The law now requires health plans to cover treatments starting July 1, 2025. An estimated 10 million Californians will now have full access to treatments and have the opportunity to become parents regardless of past sexual history, relationship status, medical history. 

The new law will not apply to Medi-Cal managed care health care service plan contracts or any entity that enters into a contract with the State Department of Health Care Services for the delivery of health care services pursuant to specified provisions.

Earlier this year, a study found systematic barriers to fertility prevention for LGBTQ+ people on the path to becoming parents. This bill will now remove those systematic barriers for all families, including LGBTQ+ and interracial family dynamics. 

Last week, Equality California announced on an Instagram post that Grindr was the latest organization to join their efforts in urging Governor Newsom to sign the bill. 

Grindr’s CEO made a statement regarding the support, using his own surrogacy journey as an example. 

“I have two kids from surrogacy. They don’t tell you when you go to the IVF clinic how difficult it’s going to be. We’re lucky, because it’s very expensive, but it worked out really well” said Grindr’s CEO George Arison. “When I took on this role, one of the things that was obvious to me is that I think a lot more gay men would have children if the cost was more affordable…”

GLAAD released its fifth State of HIV Stigma report in partnership with Gilead Sciences, highlighting Hollywood’s shortcomings in representing people with HIV, “further pushing the issue into the closet.”

The report says ‘seeing more stories of people living with HIV in the media is key to combating HIV stigma.’

GLAAD’s annual State of HIV Stigma Report, the only one of its kind, tracks Americans’ views, understandings, attitudes, overall knowledge of the illness, prevention of HIV, and stigmas surrounding care. 

According to the report, a Where We Are on TV study found that only one LGBTQ character living with HIV was portrayed in primetime scripted TV. Jonathan Bailey plays gay character Tim Laughlin in “Fellow Travelers” (2023), who is not expected to return to the series. 

Not only was this representation small, it was also short-lived.

The report finds that there has been a significant decrease over the years in Americans seeing people living with HIV in TV or film, from 39 percent to 35 percent in 2024.

“Pose” (2018), in stark contrast in terms of representation, offers not only a look into the lives and livelihoods of people with HIV, but also a comprehensive look into HIV stigma and misinformation surrounding the transmission of the illness. 

One of the main nurses is famously played by sapphic icon Sandra Bernhard. Not many people — even within the LGBTQ community — are unaware of the reason behind the community acronym starting with the letter ‘L,’ for lesbians. 

In a recent reality TV dating show on Hulu, “I Kissed A Girl” (2024), contestant Georgia Robert explained to the other contestants that the ‘L’ comes first in the acronym because lesbian nurses kept the community together during their darkest times. This history checks out, and archival research shows that lesbian nurses were the only ones who were willing to help their impacted community members. 

The lesser known, but equally as impactful on-screen representation seen in “Chocolate Babies” (1996) points to the issue lying in politics. Set in New York City in the 90s, the feature-length film follows a group of Black, queer activists who are HIV-positive and seek government recognition of the crisis and resources to ensure that less of them pass away due to the illness. 

It took Stephen Winter, director of the film, 27 years to get the recognition his film deserved because of the voices that tried to silence it. At the time it was originally released in 1996, the film became marginalized and sidelined. The issue that was central to the film, was not an issue that people — critics unimpacted by the issue — cared about. 

In an interview with Outfest Los Angeles LGBTQ+ Film Festival press staff, Winter opened up about how poorly his film was received during that time. 

“It was always extremely frustrating and painful that the film was unavailable, underseen, and under review,” Winter said. 

The recent report is academically necessary nationally and locally because information like the one found in this report is meant to produce government and industry interventions through resources and guidance. 

Overall, the report shows that “knowledge of HIV is mostly stable in the U.S. and in the U.S. South over five years, with nearly 90 percent of Americans knowing something about HIV.” 

According to the U.S. Centers for Disease Control and Prevention, ‘social and structural issues — such as HIV stigma, homophobia, discrimination, poverty and limited access to high-quality health care — influence health outcomes and continue to drive inequities.’

Though there has been a decline in new incidences, HIV still continues to affect millions of people each year and a lack of Hollywood representation of this issue affects millions of Americans each year. 

According to the findings, 85 percent of Americans say they believe HIV stigma still exists. 

More importantly, the report found that the loss of HIV stories in entertainment media “is a deafening silence, likely contributing to decreases in comfortability in interacting with a neighbor or co-worker living with HIV.” 

GLAAD’s We Are on TV and Studio Responsibility Index studies hold Hollywood accountable for their stories surrounding queer and trans issues. 

According to the report, Hollywood is missing major opportunities to accurately and fairly represent these communities and the issues they face. 

“GLAAD’s core work to eradicate HIV stigma and misinformation in media is more urgent than ever. Ending HIV and HIV stigma should be every generation’s lasting achievement, and we have never been closer to that accomplishment,” said GLAAD’s Chief Executive Officer Sarah Kate Ellis in a statement.

The report’s methodology was an online survey conducted in January 2024, with a sample of 2,511 U.S. adults. 

SAN FRANCISCO — For years, Latinos represented the biggest share of new HIV cases in this city, but testing data suggests the tide may be turning.

The number of Latinos newly testing positive for HIV dropped 46% from 2022 to 2023, according to a preliminary report released in July by the San Francisco Department of Public Health.

The decrease could mark the first time in five years that Latinos haven’t accounted for the largest number of new cases, leading to cautious optimism that the millions of dollars the city has spent to remedy the troubling disparity is working. But outreach workers and health care providers say that work still needs to be done to prevent, and to test, for HIV, especially among new immigrants.

“I am very hopeful, but that doesn’t mean that we’re going to let up in any way on our efforts,” said Stephanie Cohen, who is the medical director of the city’s HIV and STI prevention division.

Public health experts said the city’s latest report could be encouraging, but that more data is needed to know whether San Francisco has addressed inequities in its HIV services. For instance, it’s still unclear how many Latinos were tested or if the number of Latinos exposed to the virus had also fallen — key health metrics the public health department declined to provide to KFF Health News. Testing rates are also below pre-pandemic levels, according to the city.

“If there are fewer Latinos being reached by testing efforts despite a need, that points to a serious challenge to addressing HIV,” said Lindsey Dawson, the associate director of HIV Policy and director of LGBTQ Health Policy at KFF, a health information nonprofit that includes KFF Health News.

San Francisco, like the rest of the country, suffers major disparities in diagnosis rates for Latinos and people of color. Outreach workers say that recent immigrants are more vulnerable to infectious diseases because they don’t know where to get tested or have a hard time navigating the health care system.

In 2022, Latinos represented 44% of new HIV cases in San Francisco, even though they accounted for only 15% of the population. Latinos’ share of new cases fell to 30% last year, while whites accounted for the largest share of new cases at 36%, according to the new report.

Cohen acknowledged a one-year decline is not enough to draw a trend, but she said targeted funding to community-based organizations may have helped lower HIV cases among Latinos. A final report is expected in the fall.

Most cities primarily depend on federal dollars to pay for HIV services, but San Francisco has an ambitious target to be the first U.S. city to eliminate HIV, and roughly half of its $44 million HIV/AIDS budget last year came from city coffers. By comparison, New Orleans, which has similar HIV rates, kicked in only $22,000 of its $13 million overall HIV/AIDS budget, according to that city’s health department.

As part of an effort to address HIV disparities among LGBTQ+ communities and people of color, San Francisco last year gave $2.1 million to three nonprofits — Instituto Familiar de la Raza, Mission Neighborhood Health Center, and San Francisco AIDS Foundation — to bolster outreach, testing, and treatment among Latinos, according to the city’s 2023 budget.

At Instituto Familiar de la Raza, which administers the contract, the funding has helped pay for HIV testing, prevention, treatment, outreach events, counseling, and immigration legal services, said Claudia Cabrera-Lara, director of the HIV program at Sí a la Vida. But ongoing funding isn’t guaranteed.

“We live with the anxiety of not knowing what is going to happen,” she said.

The public health department has commissioned a $150,000 project with Instituto Familiar de la Raza to determine how Latinos are contracting HIV, who is most at risk, and what health gaps remain. The results are expected in September.

“It could help us shape, pivot, and grow our programs in a way that makes them as effective as possible,” Cohen said.

The center of the HIV epidemic in the mid-1980s, San Francisco set a national model for response to the disease after building a network of HIV services for residents to get free or low-cost HIV testing, as well as treatment, regardless of health insurance or immigration status.

Although city testing data showed that new cases among Latinos declined last year, outreach workers are seeing the opposite. They say they are encountering more Latinos diagnosed with HIV while they struggle to get out information about testing and prevention — such as taking preventive medications like PrEP — especially among the young and gay immigrant communities.

San Francisco’s 2022 epidemiological data shows that 95 of the 213 people diagnosed at an advanced stage of the virus were foreign-born. And the diagnosis rate among Latino men was four times as high as the rate for white men, and 1.2 times that of Black men.

“It’s a tragedy,” said Carina Marquez, associate professor of medicine in the Division of HIV, Infectious Diseases, and Global Medicine at Zuckerberg San Francisco General Hospital, the city’s largest provider of HIV care. “We have such great tools to prevent HIV and to treat HIV, but we are seeing this big disparity.”

Because Latinos are the ethnicity least likely to receive care in San Francisco, outreach workers want the city to increase funding to continue to reduce HIV disparities.

The San Francisco AIDS Foundation, for instance, would like more bilingual sexual health outreach workers; it currently has four, to cover areas where Latinos have recently settled, said Jorge Zepeda, its director of Latine Health Services.

At Mission Neighborhood Health Center, which runs Clinica Esperanza, one of the largest providers of HIV care to Latinos and immigrants, the number of patients seeking treatment has jumped from about two a month to around 16 a month.

Among the challenges is getting patients connected to mental health and substance abuse bilingual services crucial to retaining them in HIV care, said Luis Carlos Ruiz Perez, the clinic’s HIV medical case manager. The clinic wants to advertise its testing and treatment services more but lacks the money.

“A lot of people don’t know what resources are available. Period,” said Liz Oates, a health systems navigator from Glide Foundation, who works on HIV prevention and testing. “So where do you start when nobody’s engaging you?”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation. 

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa.

The U.S. Agency for International Development on Tuesday in a press release announced “up to an additional” $35 million “in emergency health assistance to bolster response efforts for the clade I mpox outbreak in Central and Eastern Africa, pending congressional notification.” The press release notes the Biden-Harris administration previously pledged more than $55 million to fight the outbreak in Congo and other African countries.

“The additional assistance announced today will enable USAID to continue working closely with affected countries, as well as regional and global health partners, to expand support and reduce the impact of this outbreak as it continues to evolve,” it reads. “USAID support includes assistance with surveillance, diagnostics, risk communication and community engagement, infection prevention and control, case management, and vaccination planning and coordination.” 

The World Health Organization and the Africa Centers for Disease Control and Prevention last week declared the outbreak a public health emergency.

The Washington Blade last week reported there are more than 17,000 suspected mpox cases across in Congo, Uganda, Kenya, Rwanda, and other African countries. The outbreak has claimed more than 500 lives, mostly in Congo. 

Medical facilities that provide treatment to gay and bisexual men in some East African countries are already collaborating with them to prevent the spread of a new wave of mpox cases after the World Health Organization on Wednesday declared a global health emergency.

The collaboration, both in Uganda and Kenya, comes amid WHO’s latest report released on Aug. 12, which reveals that nine out of every 10 reported mpox cases are men with sex as the most common cause of infection. 

The global mpox outbreak report — based on data that national authorities collected between January 2022 and June of this year — notes 87,189 of the 90,410 reported cases were men. Ninety-six percent of whom were infected through sex.

Sexual contact as the leading mode of transmission accounted for 19,102 of 22,802 cases, followed by non-sexual person-to-person contact. Genital rash was the most common symptom, followed by fever and systemic rash.

The WHO report states the pattern of mpox virus transmission has persisted over the last six months, with 97 percent of new cases reporting sexual contact through oral, vaginal, or anal sex with infected people. 

“Sexual transmission has been recorded in the Democratic Republic of Congo among sex workers and men who have sex with men,” the report reads. “Among cases exposed through sexual contact in the Democratic Republic of the Congo, some individuals present only with genital lesions, rather than the more typical extensive rash associated with the virus.”

The growing mpox cases, which are now more than 2,800 reported cases in at least 13 African countries that include Kenya, Uganda, Rwanda, and prompted the Africa Centers for Disease Control and Prevention this week to declare the disease a public health emergency for resource mobilization on the continent to tackle it.

“Africa has long been on the frontlines in the fight against infectious diseases, often with limited resources,” said Africa CDC Director General Jean Kaseya. “The battle against Mpox demands a global response. We need your support, expertise, and solidarity. The world cannot afford to turn a blind eye to this crisis.” 

The disease has so far claimed more than 500 lives, mostly in Congo, even as the Africa CDC notes suspected mpox cases across the continent have surged past 17,000, compared to 7,146 cases in 2022 and 14,957 cases last year.   

“This is just the tip of the iceberg when we consider the many weaknesses in surveillance, laboratory testing, and contact tracing,” Kaseya said.  

WHO, led by Director General Tedros Adhanom Ghebreyesus, also followed the Africa CDC’s move by declaring the mpox outbreak a public health emergency of international concern.

The latest WHO report reveals that men, including those who identify as gay and bisexual, constitute most mpox cases in Kenya and Uganda. The two countries have recorded their first cases, and has put queer rights organizations and health care centers that treat the LGBTQ community on high alert. 

The Uganda Minority Shelters Consortium, for example, confirmed to the Washington Blade that the collaboration with health service providers to prevent the spread of mpox among gay and bisexual men is “nascent and uneven.” 

“While some community-led health service providers such as Ark Wellness Clinic, Children of the Sun Clinic, Ice Breakers Uganda Clinic, and Happy Family Youth Clinic, have demonstrated commendable efforts, widespread collaboration on mpox prevention remains a significant gap,” UMSC Coordinator John Grace stated. “This is particularly evident when compared to the response to the previous Red Eyes outbreak within the LGBT community.”

Grace noted that as of Wednesday, there were no known queer-friendly health service providers to offer mpox vaccinations to men who have sex with men. He called for health care centers to provide inclusive services and a more coordinated approach.

Although Grace pointed out the fear of discrimination — and particularly Uganda’s Anti-Homosexuality Act — remains a big barrier to mpox prevention through testing, vaccination, and treatment among queer people, he confirmed no mpox cases have been reported among the LGBTQ community.

Uganda so far has reported two mpox cases — refugees who had travelled from Congo.

“We are for the most part encouraging safer sex practices even after potential future vaccinations are conducted as it can also be spread through bodily fluids like saliva and sweat,” Grace said. 

Grace also noted that raising awareness about mpox among the queer community and seeking treatment when infected remains a challenge due to the historical and ongoing homophobic stigma and that more comprehensive and reliable advocacy is needed. He said Grindr and other digital platforms have been crucial in raising awareness.

The declarations of mpox as a global health emergency have already attracted demand for global leaders to support African countries to swiftly obtain the necessary vaccines and diagnostics.

“History shows we must act quickly and decisively when a public health emergency strikes. The current Mpox outbreak in Africa is one such emergency,” said ONE Global Health Senior Policy Director Jenny Ottenhoff.

ONE is a global, nonpartisan organization that advocates for the investments needed to create economic opportunities and healthier lives in Africa.

Ottenhoff warned failure to support the African countries with medical supplies needed to tackle mpox would leave the continent defenseless against the virus.  

To ensure that African countries are adequately supported, ONE wants governments and pharmaceutical companies to urgently increase the provision of mpox vaccines so that the most affected African countries have affordable access to them. It also notes 10 million vaccine doses are currently needed to control the mpox outbreak in Africa, yet the continent has only 200,000 doses.

The Blade has reached out to Ishtar MSM, a community-based healthcare center in Nairobi, Kenya, that offers to service to gay and bisexual men, about their response to the mpox outbreak. 

The World Health Organization Wednesday again declared mpox, formerly known as monkeypox, a global health emergency.

In summer 2022, mpox reached the U.S. Thousands of recorded cases left people quarantined with minimal guidance as the medical world worked to understand the virus.

It was the first health crisis litmus test following the COVID-19 pandemic.

A swift vaccination effort mitigated public concern, though it was a slow start. Vaccine was quickly and sufficiently made available on the East Coast though far less vaccine was made available on the West Coast.

The vaccination efforts were successful, however, and the number of cases dropped quickly.

Now, a deadlier mpox strain, known as Clade 1b, has emerged.

It has in recent weeks killed more than 500 people in Africa. And with an alarming 4 percent mortality rate that means infection rates are extreme.

On Aug. 15, Sweden reported the first case outside of Africa.

Though the Los Angeles County Department of Public Health says the new mpox strain has not yet been detected in the U.S, there is grave concern.

“Cases of the more virulent clade I mpox cases have not been detected in Los Angeles County or anywhere in the United States,” it said in a statement. “However, if health care providers encounter a patient with mpox-like symptoms who has recently traveled to affected countries in Africa, they should contact Public Health to arrange for clade-specific testing at the public health lab. This will help us identify any clade I cases in Los Angeles County if they arise.”

The less severe Clade II mpox was responsible for the 2022 outbreak. According to the Los Angeles County Department of Public Health, mpox is “spread through close contact with body fluids, sores, shared bedding or clothing or respiratory droplets.” Sexual contact is an effective means of transmission. The most noticeable symptoms are pimples or blisters on the face, body and genitals. This is often accompanied by fever, chills, headaches, muscle aches or swelling of the lymph nodes.

“With the recent declaration of mpox as a global health emergency and reports of the more virulent Clade subtype outside Africa, there is a clear risk of such outbreaks reaching the U.S.,” said Jake Collins, a physician assistant who works with a large LGBTQ clinic in Los Angeles. “This is concerning especially since this Clade 1b subtype is linked to more severe illness and higher mortality. Among my patients, I’ve seen an increase in mpox cases this year compared to last, even among vaccinated individuals, but these cases have been mostly mild with no deaths or hospitalizations.”

One Los Angeles resident, who asked to remain anonymous, described his 2022 bout with mpox as “one of the most painful experiences” he’d ever had.

“[It] came with so much shame and guilt – self-hatred,” he said. “So, it definitely does scare me, but it also makes me more aware that last round I didn’t think it could happen to me, so I wasn’t smart or careful [or] educated on it because it was so new. I think there is always fear for something like this to hit our community again, because in general we can be risky in sexual practices, so I think we just need to be very cautious as a community and be mindful [in] taking care of our sexual health.”

Since August 2022, the federal Administration for Strategic Preparedness and Response has procured and distributed more than 1 million vials of the JYNNEOS vaccine across the U.S., agency spokesperson Spencer Pretecrum told reporters in an email.

But 75 percent of at-risk populations in the U.S. not fully vaccinated against mpox, according to a Centers for Disease Control and Prevention report.

People who got their first shot of the mpox vaccine but who did not return for their second dose, are at risk.

Full protection requires both doses.

During the height of the 2022 mpox epidemic, health professionals advised caution in sexual practices. A two-dose vaccine, however, was quickly distributed, and fears died down.

“I received two vaccines when mpox was initially spreading back in 2022, so I’m hoping guidance comes out soon as to the effectiveness of these vaccines against the current strain,” West Hollywood resident Gabe Perkins said. “I am worried but not enough to change my behaviors or social activities unless I hear otherwise. The queer community came together to get vaccines quickly and early which I think helped prevent the previous outbreak from becoming too widespread, so I’m hoping it remains that way.”

While the LGBTQ community was the epicenter of the previous outbreak, so far the strain in Africa, which appears to be more contagious, has not concentrated on a single demographic. It affects both adults and children. How it spreads beyond the cases so far identified is yet to be seen.

“Any outbreak freaks me out,” West Hollywood nightlife employee Eric Evans said. He added that while he thinks the fear will rise “when it gets closer to home,” he doubts it will reach the level of panic in 2022. “Kind of like when COVID rose again recently, but the reaction from people wasn’t as extreme.”

Evans also said he believed the LGBTQ community, in general, vaccinates at a higher rate than the general population.

“Hearing about the mpox outbreak in Africa and now Europe makes me even more grateful for the response of the LGBTQ community — specifically gay men — who when faced with this disease here in the U.S. immediately got vaccinated, modified our sexual behaviors for a few weeks and essentially nipped it in the bud,” nonprofit consultant and LGBTQ activist Adam Crowley said. “It’s still a threat to the unvaccinated anywhere, but our community knew how to protect ourselves. Community health is so important, and it’s our responsibility to get vaccinated. We can be a model of how to address a public health issue. I don’t live in fear, but I think it’s important to be aware and to understand how we can prevent outbreaks.”

To protect against mpox, health officials advised limiting physical contact and sexual partners, as well as wearing masks, washing hands and other prevention methods similar to COVID-19. The CDC recommends the JYNNEOS vaccine for at-risk populations.

“Getting the two-dose vaccine series remains the best way to reduce the severity of infections and curb the spread of mpox, even with the Clade 1b subtype,” Collins said. “At this time, a booster isn’t being recommended, but I have been informing my patients to continue checking for updated recommendations from trusted organizations like CDC and WHO.”

“Currently, the existing monkeypox vaccines have shown efficacy against multiple strains of the virus,” said Michael Dube, national medical director of AIDS Health Foundation’s Public Health Division. “At this time, there is no recommendation for re-vaccination for those who have already completed their series. However, we urge anyone who has not been fully vaccinated and is at higher risk to strongly consider doing so, following public health guidelines … As more information becomes available about this strain, we will better understand any new transmission dynamics. For now, general precautions like good hygiene and avoiding close contact with infected individuals remain essential.”

For up-to-date information, visit who.int/health-topics/mpox.

A coalition of 63 organizations dedicated to ending HIV called on the Biden-Harris administration on Wednesday to require insurers to cover long-acting pre-exposure prophylaxis (PrEP) without cost-sharing.

In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, the groups emphasized the need for broad and equitable access to PrEP free of insurance barriers.

Long-acting PrEP is an injectable form of PrEP that’s effective over a long period of time. The FDA approved Apretude (cabotegravir extended-release injectable suspension) as the first and only long-acting injectable PrEP in late 2021. It’s intended for adults and adolescents weighing at least 77 lbs. who are at risk for HIV through sex.

The U.S. Preventive Services Task Force updated its recommendation for PrEP on Aug. 22, 2023, to include new medications such as the first long-acting PrEP drug. The coalition wants CMS to issue guidance requiring insurers to cover all forms of PrEP, including current and future FDA-approved drugs.

“Long-acting PrEP can be the answer to low PrEP uptake, particularly in communities not using PrEP today,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The Biden administration has an opportunity to ensure that people with private insurance can access PrEP now and into the future, free of any cost-sharing, with properly worded guidance to insurers.”

Currently, only 36 percent of those who could benefit from PrEP are using it. Significant disparities exist among racial and ethnic groups. Black people constitute 39 percent of new HIV diagnoses but only 14 percent of PrEP users, while Latinos represent 31 percent of new diagnoses but only 18 percent of PrEP users. In contrast, white people represent 24 percent of HIV diagnoses but 64 percent of PrEP users.

The groups also want CMS to prohibit insurers from employing prior authorization for PrEP, citing it as a significant barrier to access. Several states, including New York and California, already prohibit prior authorization for PrEP.

Modeling conducted for HIV+Hep, based on clinical trials of a once every 2-month injection, suggests that 87 percent more HIV cases would be averted compared to daily oral PrEP, with $4.25 billion in averted healthcare costs over 10 years.

Despite guidance issued to insurers in July 2021, PrEP users continue to report being charged cost-sharing for both the drug and ancillary services. A recent review of claims data found that 36 percent of PrEP users were charged for their drugs, and even 31 percent of those using generic PrEP faced cost-sharing.

The coalition’s letter follows a more detailed communication sent by HIV+Hepatitis Policy Institute to the Biden administration on July 2.

Signatories to the community letter include Advocates for Youth, AIDS United, Equality California, Fenway Health, Human Rights Campaign, and the National Coalition of STD Directors, among others.

The Tennessee government has agreed to begin scrubbing its sex offender registry of dozens of people who were convicted of prostitution while having HIV, reversing a practice that federal lawsuits have challenged as draconian and discriminatory.

For more than three decades, Tennessee’s “aggravated prostitution” laws have made prostitution a misdemeanor for most sex workers but a felony for those who are HIV-positive. Tennessee toughened penalties in 2010 by reclassifying prostitution with HIV as a “violent sexual offense” with a lifetime registration as a sex offender — even if protection is used.

At least 83 people are believed to be on Tennessee’s sex offender registry solely because of these laws, with most living in the Memphis area, where undercover police officers and prosecutors most often invoked the statute, commonly against Black and transgender women, according to a lawsuit filed last year by the American Civil Liberties Union and four women who were convicted of aggravated prostitution. The Department of Justice challenged the law in a separate suit earlier this year.

Both lawsuits argue that Tennessee law does not account for evolving science on the transmission of HIV or precautions that prevent its spread, like use of condoms. Both lawsuits also argue that labeling a person as a sex offender because of HIV unfairly limits where they can live and work and stops them from being alone with grandchildren or minor relatives.

“Tennessee’s Aggravated Prostitution statute is the only law in the nation that treats people living with HIV who engage in any sex work, even risk-free encounters, as ‘violent sex offenders’ subjected to lifetime registration,” the ACLU lawsuit states.

“That individuals living with HIV are treated so differently can only be understood as a remnant of the profoundly prejudiced early response to the AIDS epidemic.”

In a settlement agreement signed by Tennessee Gov. Bill Lee on July 15 and filed in both lawsuits on July 17, the Tennessee Bureau of Investigation said it would comb through the state’s sex offender registry to find those added solely because of aggravated prostitution convictions, then send letters alerting those people that they can make a written request to be removed. The language of the settlement suggests that people will need to request their removal from the registry, but the agency said in the agreement it will make “its best effort” to act on the requests “promptly in the order in which they are received.”

The Tennessee attorney general’s office, which represents the state in both the ACLU and DOJ lawsuits and approved the settlement agreement, said in an email statement it would “continue to defend Tennessee’s prohibition on aggravated prostitution.”

In an email statement, the ACLU celebrated the settlement as “one step toward remedying the harms by addressing the sex offender registration,” but said its work in Tennessee was not done because aggravated prostitution remained a felony charge that it would “fight to overturn.”

Molly Quinn, executive director of LGBTQ+ support organization OUTMemphis, another plaintiff in the ACLU lawsuit, said both organizations would help eligible people with the paperwork to get removed from the registry.

“We would not have agreed to settle if we did not feel like this was a process that would be extremely beneficial,” Quinn said. “But, we’re sad that the statute existed as long as it did and sad that there is any process at all that folks have to go through after living with this extraordinary burden of being on the sex offender registry for really an irrelevant reason.”

Michelle Anderson, a Memphis resident who is one of the plaintiffs in the ACLU lawsuit, said in court records that since being convicted of aggravated prostitution, the sex offender label has made it so difficult to find a home and a job that she was “unhoused for about a year” and has at times “felt she had no option but to continue to engage in sex work to survive.”

Like the other plaintiffs, Anderson said her conviction kept her minor relatives at a distance.

“Ms. Anderson has a nephew she loves, but she cannot have a close relationship with him,” the lawsuit states. “Even though Ms. Anderson’s convictions had nothing to do with children, she cannot legally be alone with her nephew.”

The Tennessee settlement comes months after state lawmakers softened the law so no one else should be added to the sex offender registry for aggravated prostitution. Lawmakers removed the registration requirement and made convictions eligible for expungement if the defendant testifies they were a victim of human trafficking.

State Sen. Page Walley (R-Savannah), who supported the original aggravated prostitution law passed in 1991 and co-sponsored the recent bill to amend it, said on the floor of the legislature that the changes do not prevent prosecutors from charging people with a felony for aggravated prostitution. Instead, he said, the amendments undo the 2010 law that put those who are convicted on the registry “along with pedophiles and rapists for a lifetime, with no recourse for removal.”

“Having stood, as I mentioned, in 1991 and passed this,” Walley said, “it is a particular gratifying moment for me to see how we continue to evolve and seek what’s just and what’s right and what’s best.”

By Brett Kelman for  KFF Health News, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.