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.

LOS ANGELES — As a punishing heat wave grips California, Los Angeles officials have issued an excessive heat warning through July 8, prompting the city to open additional cooling centers and urge residents to take precautions.

The National Weather Service warns of dangerously high temperatures across the region, with some areas expecting highs up to 118 degrees Fahrenheit (47.8 Celsius). Death Valley could see temperatures rise above 130 degrees (55 Celsius).

In response, the City of Los Angeles is opening four augmented cooling centers from July 3 to July 8, operating from 10 a.m. to 9 p.m. daily. These include the Fred Roberts Recreation Center in South Los Angeles, Mid-Valley Senior Center in Panorama City, Lake View Terrace Recreation Center, and Jim Gilliam Recreation Center in Baldwin Hills.

More than 70 Los Angeles public libraries are available as cooling spots during regular hours. Residents can find locations and hours at LAPL.org/Branches.

“We’re taking this heat wave very seriously,” said Mayor Karen Bass. “These cooling centers provide critical relief, especially for our most vulnerable residents.”

City officials advise residents to stay hydrated, limit sugary and alcoholic beverages, and avoid outdoor activities during peak heat hours. They also encourage checking on vulnerable neighbors and keeping pets cool and hydrated.

The heat wave coincides with heightened fire danger in Southern California. A Red Flag Warning is in effect from Thursday evening through Friday night for parts of Ventura County and the Antelope Valley, with gusty winds and low humidity creating critical fire weather conditions.

“If fire ignition occurs, conditions are favorable for extreme fire behavior which would threaten life and property,” the National Weather Service warned.

As the state faces this prolonged period of extreme heat, authorities stress the importance of community awareness and preparedness. Residents are urged to stay informed about local conditions and follow safety guidelines to protect themselves and others from heat-related illnesses and potential fire hazards.

Where to stay cool around the City of West Hollywood: 

• 
  Plummer Park’s Senior Lounge (7377 Santa Monica Blvd)
  • The City’s Cooling Center is open during periods of extreme heat (above 90 degrees).
  • For more information regarding the City of West Hollywood’s cooling center, please call (323) 848-6530. 
• West Hollywood Library (625 N. San Vicente Blvd) – Cooling Center operated by LA County 
• Will & Ariel Durant Branch Library (7140 W. Sunset Blvd) – Cooling Center operated by LA County  
• West Hollywood Aquatics & Recreation Center (ARC) (8750 El Tovar Pl) – community members can visit the pool to get relief from the heat. For more information, please visit the ARC webpage.

The City provides free transportation to Plummer Park through its Cityline service. Cityline is a friendly and accessible alternative to the larger bus system and all shuttles are ADA-accessible. Cityline operates Monday through Saturday from 9 a.m. to 6 p.m. and shuttles arrive approximately every 30 minutes. For additional information and a detailed route map, visit www.weho.org/cityline.

Safety Tips For Angelenos To Avoid Heat Injury

• Seek shade and refuge from the hot sun if you must be outside.
• Stay hydrated and drink more water, especially if you drink coffee or soda.
• Check in on and prepare your household, family, friends, pets and workplace.
• Limit your exposure to direct sunlight between 10:00 AM and 4:00 PM, when the sun’s rays are strongest.
• If you feel ill, tell someone immediately. Symptoms of dehydration and heat illness may include dizziness, fatigue, faintness, nausea, muscle cramps, headache and vomiting.
• Symptoms of heat stroke include:
  • High body temperature (103°F or higher)
  •  Hot, red, dry, or damp skin
  •  Fast, strong pulse
  •  Headache
  •  Dizziness
  •  Nausea
  •  Confusion
  •  Losing consciousness (passing out)
• In the event of a heat stroke:
  • Call 911 right away-heat stroke is a medical emergency
  • Move the person to a cooler place
  • Help lower the person’s temperature with cool cloths or a cool bath
  • Do not give the person anything to drink
• Listen to your body, and remember that those with chronic illness such as asthma, heart disease etc., are more vulnerable to extreme heat. Please take extra precautions. 
• Click here for more safety tips from the Los Angeles Fire Department.
• Click here for safety tips in multiple languages including English, Spanish, Armenian, Chinese, Japanese, Korean and more.

Four months after seeking asylum in the U.S., Fernando Hermida began coughing and feeling tired. He thought it was a cold. Then sores appeared in his groin and he would soak his bed with sweat. He took a test.

On New Year’s Day 2022, at age 31, Hermida learned he had HIV.

“I thought I was going to die,” he said, recalling how a chill washed over him as he reviewed his results. He struggled to navigate a new, convoluted health care system. Through an HIV organization he found online, he received a list of medical providers to call in D.C., where he was at the time, but they didn’t return his calls for weeks. Hermida, who speaks only Spanish, didn’t know where to turn.

By the time of Hermida’s diagnosis, the U.S. Department of Health and Human Services was about three years into a federal initiative to end the nation’s HIV epidemic by pumping hundreds of millions of dollars annually into certain states, counties, and U.S. territories with the highest infection rates. The goal was to reach the estimated 1.2 million people living with HIV, including some who don’t know they have the disease.

Overall, estimated new HIV infection rates declined 23 percent from 2012 to 2022. But a KFF Health News-Associated Press analysis found the rate has not fallen for Latinos as much as it has for other racial and ethnic groups.

While African Americans continue to have the highest HIV rates in the U.S. overall, Latinos made up the largest share of new HIV diagnoses and infections among gay and bisexual men in 2022, per the most recent data available, compared with other racial and ethnic groups. Latinos, who make up about 19 percent of the U.S. population, accounted for about 33 percent of new HIV infections, according to the Centers for Disease Control and Prevention.

The analysis found Latinos are experiencing a disproportionate number of new infections and diagnoses across the U.S., with diagnosis rates highest in the Southeast. Public health officials in Mecklenburg County, North Carolina, and Shelby County, Tennessee, where data shows diagnosis rates have gone up among Latinos, told KFF Health News and the AP that they either don’t have specific plans to address HIV in this population or that plans are still in the works. Even in well-resourced places like San Francisco, HIV diagnosis rates grew among Latinos in the last few years while falling among other racial and ethnic groups despite the county’s goals to reduce infections among Latinos.

“HIV disparities are not inevitable,” Robyn Neblett Fanfair, director of the CDC’s Division of HIV Prevention, said in a statement. She noted the systemic, cultural, and economic inequities — such as racism, language differences, and medical mistrust.

And though the CDC provides some funds for minority groups, Latino health policy advocates want HHS to declare a public health emergency in hopes of directing more money to Latino communities, saying current efforts aren’t enough.

“Our invisibility is no longer tolerable,” said Vincent Guilamo-Ramos, co-chair of the Presidential Advisory Council on HIV/AIDS.

Lost without an interpreter

Hermida suspects he contracted the virus while he was in an open relationship with a male partner before he came to the U.S. In late January 2022, months after his symptoms started, he went to a clinic in New York City that a friend had helped him find to finally get treatment for HIV.

Too sick to care for himself alone, Hermida eventually moved to Charlotte to be closer to family and in hopes of receiving more consistent health care. He enrolled in an Amity Medical Group clinic that receives funding from the Ryan White HIV/AIDS Program, a federal safety-net plan that serves over half of those in the nation diagnosed with HIV, regardless of their citizenship status.

His HIV became undetectable after he was connected with case managers. But over time, communication with the clinic grew less frequent, he said, and he didn’t get regular interpretation help during visits with his English-speaking doctor. An Amity Medical Group representative confirmed Hermida was a client but didn’t answer questions about his experience at the clinic.

Hermida said he had a hard time filling out paperwork to stay enrolled in the Ryan White program, and when his eligibility expired in September 2023, he couldn’t get his medication.

He left the clinic and enrolled in a health plan through the Affordable Care Act marketplace. But Hermida didn’t realize the insurer required him to pay for a share of his HIV treatment.

In January, the Lyft driver received a $1,275 bill for his antiretroviral — the equivalent of 120 rides, he said. He paid the bill with a coupon he found online. In April, he got a second bill he couldn’t afford.

For two weeks, he stopped taking the medication that keeps the virus undetectable and intransmissible.

“Estoy que colapso,” he said. I’m falling apart. “Tengo que vivir para pagar la medicación.” I have to live to pay for my medication.

One way to prevent HIV is preexposure prophylaxis, or PrEP, which is regularly taken to reduce the risk of getting HIV through sex or intravenous drug use. It was approved by the federal government in 2012 but the uptake has not been even across racial and ethnic groups: CDC data show much lower rates of PrEP coverage among Latinos than among white Americans.

Epidemiologists say high PrEP use and consistent access to treatment are necessary to build community-level resistance.

Carlos Saldana, an infectious disease specialist and former medical adviser for Georgia’s health department, helped identify five clusters of rapid HIV transmission involving about 40 gay Latinos and men who have sex with men from February 2021 to June 2022. Many people in the cluster told researchers they had not taken PrEP and struggled to understand the health care system.

They experienced other barriers, too, Saldana said, including lack of transportation and fear of deportation if they sought treatment.

Latino health policy advocates want the federal government to redistribute funding for HIV prevention, including testing and access to PrEP. Of the nearly $30 billion in federal money that went toward things like HIV health care services, treatment, and prevention in 2022, only 4% went to prevention, according to a KFF analysis.

They suggest more money could help reach Latino communities through efforts like faith-based outreach at churches, testing at clubs on Latin nights, and training bilingual HIV testers.

Latino rates going up

Congress has appropriated $2.3 billion over five years to the Ending the HIV Epidemic initiative, and jurisdictions that get the money are to invest 25 percent of it in community-based organizations. But the initiative lacks requirements to target any particular groups, including Latinos, leaving it up to the cities, counties, and states to come up with specific strategies.

In 34 of the 57 areas getting the money, cases are going the wrong way: Diagnosis rates among Latinos increased from 2019 to 2022 while declining for other racial and ethnic groups, the KFF Health News-AP analysis found.

Starting Aug. 1, state and local health departments will have to provide annual spending reports on funding in places that account for 30 percent or more of HIV diagnoses, the CDC said. Previously, it had been required for only a small number of states.

In some states and counties, initiative funding has not been enough to cover the needs of Latinos.

South Carolina, which saw rates nearly double for Latinos from 2012-2022, hasn’t expanded HIV mobile testing in rural areas, where the need is high among Latinos, said Tony Price, HIV program manager in the state health department. South Carolina can pay for only four community health workers focused on HIV outreach — and not all of them are bilingual.

In Shelby County, Tennessee, home to Memphis, the Latino HIV diagnosis rate rose 86 percent from 2012 to 2022. The health department said it got $2 million in initiative funding in 2023 and while the county plan acknowledges that Latinos are a target group, department director Michelle Taylor said: “There are no specific campaigns just among Latino people.”

Up to now, Mecklenburg County, North Carolina, didn’t include specific targets to address HIV in the Latino population — where rates of new diagnoses more than doubled in a decade but fell slightly among other racial and ethnic groups. The health department has used funding for bilingual marketing campaigns and awareness about PrEP.

Moving for medicine

When it was time to pack up and move to Hermida’s third city in two years, his fiancé, who is taking PrEP, suggested seeking care in Orlando, Fla.

The couple, who were friends in high school in Venezuela, had some family and friends in Florida, and they had heard about Pineapple Healthcare, a nonprofit primary care clinic dedicated to supporting Latinos living with HIV.

The clinic is housed in a medical office south of downtown Orlando. Inside, the mostly Latino staff is dressed in pineapple-print turquoise shirts, and Spanish, not English, is most commonly heard in appointment rooms and hallways.

“At the core of it, if the organization is not led by and for people of color, then we’re just an afterthought,” said Andres Acosta Ardila, the community outreach director at Pineapple Healthcare, who was diagnosed with HIV in 2013.

“¿Te mudaste reciente, ya por fin?” asked nurse practitioner Eliza Otero. Did you finally move? She started treating Hermida while he still lived in Charlotte. “Hace un mes que no nos vemos.” It’s been a month since we last saw each other.

They still need to work on lowering his cholesterol and blood pressure, she told him. Though his viral load remains high, Otero said it should improve with regular, consistent care.

Pineapple Healthcare, which doesn’t receive initiative money, offers full-scope primary care to mostly Latino males. Hermida gets his HIV medication at no cost there because the clinic is part of a federal drug discount program.

The clinic is in many ways an oasis. The new diagnosis rate for Latinos in Orange County, Florida, which includes Orlando, rose by about a third from 2012 through 2022, while dropping by a third for others. Florida has the third-largest Latino population in the U.S., and had the seventh-highest rate of new HIV diagnoses among Latinos in the nation in 2022.

Hermida, whose asylum case is pending, never imagined getting medication would be so difficult, he said during the 500-mile drive from North Carolina to Florida. After hotel rooms, jobs lost, and family goodbyes, he is hopeful his search for consistent HIV treatment — which has come to define his life the past two years — can finally come to an end.

“Soy un nómada a la fuerza, pero bueno, como me comenta mi prometido y mis familiares, yo tengo que estar donde me den buenos servicios médicos,” he said. I’m forced to be a nomad, but like my family and my fiancé say, I have to be where I can get good medical services.

That’s the priority, he said. “Esa es la prioridad ahora.”

KFF Health News and The Associated Press analyzed data from the U.S. Centers for Disease Control and Prevention on the number of new HIV diagnoses and infections among Americans ages 13 and older at the local, state, and national levels. This story primarily uses incidence rate data — estimates of new infections — at the national level and diagnosis rate data at the state and county level.

Bose reported from Orlando, Fla.. Reese reported from Sacramento, Calif. AP video journalist Laura Bargfeld contributed to this report.

The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is responsible for all content.

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

A Project of KFF Health News and the Associated Press co-published by Univision Noticias

CREDITS:

Reporters: Vanessa G. Sánchez, Devna Bose, Phillip Reese

Cinematography: Laura Bargfeld

Photography: Laura Bargfeld, Phelan M. Ebenhack

Video Editing: Federica Narancio, Kathy Young, Esther Poveda

Additional Video: Federica Narancio, Esther Poveda

Web Production: Eric Harkleroad, Lydia Zuraw

Special thanks to Lindsey Dawson

Editors: Judy Lin, Erica Hunzinger

Data Editor: Holly Hacker

Social Media: Patricia Vélez, Federica Narancio, Esther Poveda, Carolina Astuya, Natalia Bravo, Juan Pablo Vargas, Kyle Viterbo, Sophia Eppolito, Hannah Norman, Chaseedaw Giles, Tarena Lofton

Translation: Paula Andalo

Copy Editing: Gabe Brison-Trezise

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.

Subscribe to KFF Health News’ free Morning Briefing.

By Paulo Murillo | WEST HOLLYWOOD – The Los Angeles County Department of Public Health administered Mpox vaccinations at an on-site pop-up clinic at the WeHo Pride Street Fair during WeHo Pride Weekend on Saturday June 1, 2024 and Sunday, June 2, 2024, on Santa Monica Boulevard in the City’s Rainbow District.

According to a LA County public health nurse, 200 Mpox vaccinations were administered during the weekend. She said she believed it was an even 100 for each day, which was a much larger number than expected.

Several Street Fair attendees lined up for their mpox vaccination, while others asked questions and gathered information to get their vaccine at a later date because they didn’t want to risk feeling side effects during the pride festivities.

The Los Angeles County Department of Public Health is hitting pride events again this year and is offering the Mpox (formerly known as “monkeypox”) vaccinations for free during various pride festivals throughout LA. county. No appointment are necessary. Individuals can simply sign up and wait their turn. The LA County Public Health booth is also condoms, swag and information on COVID, STDS and more.

The mpox vaccine is currently available to anyone who requests it and individuals do not have to disclose information about personal risk. The virus spreads primarily from prolonged skin-to-skin contact, which includes hugging, sleeping in the same bed, or sexual activity, and can also be transmitted via direct contact with scabs, rashes, or respiratory secretions from a person infected with mpox.

Large gatherings can become hubs for transmission of the virus, which disproportionately affected gay men, bisexual men, and other men who have sex with men (MSM) in a breakout in 2022.

According to the Los Angeles County Mpox case summary updated every other Friday, data as of May 30, 2024 a total of 2,605 Mpox / orthopox confirmed cases (number also includes Long Beach and Pasadena).

LA County Public Health information on the Mpox vaccine can be found at: http://publichealth.lacounty.gov/media/monkeypox/pride.htm.

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Paulo Murillo is Editor in Chief and Publisher of WEHO TIMES. He brings over 20 years of experience as a columnist, reporter, and photo journalist. Murillo began his professional writing career as the author of “Love Ya, Mean It,” an irreverent and sometimes controversial West Hollywood lifestyle column for FAB! newspaper. His work has appea

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The preceding article was previously published by WeHo Times and is republished with permission.

NEW YORK – Healthcare providers should watch out for new and highly contagious forms of ringworm or jock itch, which are emerging as a potential public health threat, according to a pair of reports.

In the first of the studies, experts at NYU Langone Health who focus on the spread of contagious rashes document the first reported case in the United States of a sexually transmitted fungal infection that can take months to clear up, even with treatment. In the second report, NYU Langone physicians partnered with authorities at the New York State Department of Health to describe the largest group of patients in the country with a similar fungal strain that resists standard therapies.

Both species of fungi are among a group that causes skin rashes, or tinea, which easily spread on the face and limbs (ringworm), groin (jock itch), and feet (athlete’s foot). However, the tinea explored in the new reports can look very different from the neat, regular circles seen in most forms of ringworm. They may instead be confused for lesions caused by eczema and can therefore go without proper treatment for months.

The first report, which published online on June 5 in the journal JAMA Dermatology, describes a man in his 30s who developed tinea on his penis, buttocks, and limbs after returning home to New York City from a trip to England, Greece, and California. Genetic tests of fungal samples collected from the patient’s rashes revealed that the infection was caused by the species Trichophyton mentagrophytes type VII (TMVII).

This sexually transmitted form of ringworm has been increasingly diagnosed throughout Europe, with 13 instances reported in France in 2023, mostly in men who have sex with men. Notably, the man in the current study said he had sex with multiple male partners during his travels, none of whom reported similar skin issues.

“Healthcare providers should be aware that Trichophyton mentagrophytes type VII is the latest in a group of severe skin infections to have now reached the United States,” said study lead author and dermatologist Avrom S. Caplan, MD. Dr. Caplan is an assistant professor in the Ronald O. Perelman Department of Dermatology at NYU Grossman School of Medicine.

“Since patients are often reluctant to discuss genital problems, physicians need to directly ask about rashes around the groin and buttocks, especially for those who are sexually active, have recently traveled abroad, and report itchy areas elsewhere on the body,” added study senior author John G. Zampella, MD.

Dr. Zampella, an associate professor in the Ronald O. Perelman Department of Dermatology, says that while infections caused by TMVII are difficult to treat and can take months to clear up, they so far appear to respond to standard antifungal therapies, such as terbinafine.

Meanwhile, Dr. Caplan says the new skin condition explored in his other new report presents a greater challenge for dermatologists. The study results, published online in May in JAMA Dermatology, center on Trichophyton indotineae, which is widespread in India and is now reported globally. First confirmed in the United States last year, the infection causes itchy and contagious rashes similar to those of TMVII, but it often resists terbinafine treatment.

To better understand how T. indotineae can evade antifungal drugs, the researchers collected clinical and laboratory data from 11 men and women treated for ringworm in New York City hospitals between May 2022 and May 2023. Their tinea was confirmed to have been caused by T. indotineae. Seven of the patients had received standard doses of terbinafine for anywhere from 14 days (the usual duration for most forms of ringworm) to 42 days, yet their rashes did not improve.

Analyzing the fungal samples’ DNA, the team reported several variations in the genetic code (mutations) that prevent terbinafine from hooking onto fungal cells and poking holes in their protective membranes. According to the study authors, these mutations might help explain why the therapy often failed in some cases to fight the infections.

The results also showed that when seven patients were treated with another antifungal called itraconazole, three recovered entirely and two improved. The problem with this therapy, Dr. Caplan says, is that while effective, the drug can interfere with many medications and can cause nausea, diarrhea, and other side effects that make it hard to use for long periods.

“These findings offer new insight into how some of the fungal skin infections spreading from South Asia can evade our go-to therapies,” said Dr. Caplan. “Beyond learning to recognize their misleading signs, physicians will need to ensure their treatment addresses each patient’s quality of life needs.”

Dr. Caplan adds that he plans to work with leading fungi experts around the United States and internationally over the next few months to expand research efforts and track emerging cases.

The researchers caution that while dermatologists should be on the alert for signs of TMVII and T. indotineae in their patients, rates so far remain low in the United States.

Study funding was provided by NYU Langone.

NEW YORK – GLAAD, which describes itself as the world’s leading LGBTQ media advocacy organization, and America’s Blood Centers, a national organization of community-based independent blood donation centers, announced on May 22 they have launched an LGBTQ supportive “Summer of Giving” national blood donation drive campaign.

The announcement says the campaign is aimed at encouraging “businesses to host blood drives and all eligible individuals to donate blood in support of the recent FDA eligibility changes that promote fairness and inclusivity in the donation process while maintaining the safety of the blood supply.”

The joint announcement was referring to the final revised blood donation rules issued in May 2023 by the U.S. Food and Drug Administration (FDA) that replaced a previous policy requiring men who have sex with men to abstain from sex for three months before they would be eligible to donate blood.

The previous policy was among the gradual changes made by the FDA from its original policy in the 1980s of automatically banning gay and bisexual men from donating blood due to their perceived risk of HIV infection. LGBTQ activists called that policy discriminatory because it banned all gay and bisexual men from donating blood even if they were not as individuals at risk for HIV infection.

The new policy, adopted in May 2023, according to a statement released by the FDA, put in place a screening process that asks all prospective donors regardless of their sexual orientation to answer a series of individual, risk-based questions to determine their eligibility for donating blood.

The FDA statement said implementation of the new policy “will represent a significant milestone for the agency and the LGBTQI+ community” as stated by Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research.

“The ‘Summer of Giving’ is a celebration of the LGBTQ community and decades of work to remove the stigma too many potential donors have to endure,” said GLAAD President and CEO Sarah Kate Ellis in the joint statement. “Removing discriminatory barriers and following facts and science will ease the critical national blood shortage,” Ellis said, adding, “This campaign sends a long-needed message that LGBTQ people are welcome and can generously contribute to their communities to help save lives.”

Kate Fry, CEO of America’s Blood Centers, said in the statement that her organization is proud to join GLAAD to promote the facts surrounding the FDA’s change in blood donor policy, which she said, “prioritizes the safety of the blood supply while bringing more equality to the donation process.”

Fry added, “The Summer of Giving campaign is a unique opportunity for individuals and businesses to donate blood and host blood drives in support of a new era of blood donor eligibility. Together we can help save lives during a time of critical need for the blood community.”

 The joint statement announcing the LGBTQ supportive blood drive says it would take place from May 28, 2024, through National Blood Donation Day on Wednesday, Sept. 4, 2024, “in recognition of the critical need for blood donations during the summer months.” According to the statement, “Despite the ongoing demand for blood products, donations typically decline during this period due to travel and the lack of school-based blood drives.”

Under the revised FDA blood donation policy, as was the case with the previous policy, anyone who tests positive for HIV is not eligible to donate blood. The new policy includes these restrictions, which apply to everyone regardless of their sexual orientation or gender:

• Any individual who has had a new sexual partner in the past three months and has engaged in anal sex in the same period is deferred for three months from the most recent sexual contact from donating blood.

 • Any individual who has had more than one sexual partner in the past three months and has engaged in anal sex during that same period is deferred for three months from the most recent sexual contact.

• Any individual who has taken any oral antiviral medication to prevent HIV (PrEP or PEP) is deferred for three months from the most recent dose. These medications may delay detection of HIV and result in false negative test results.

• Any individual who has taken any long-lasting antiviral medication by injection to prevent HIV (PrEP or PEP) is deferred for two years from the time from the most recent injection. These medications may delay detection of HIV and result in false negative test results.

• Any individual who has ever taken any mediation (i.e., ART) to treat an HIV infection is permanently deferred.

GLAAD and America’s Blood Centers say further details about the new FDA blood donation policy and to find the nearest community blood center, interested persons should access glaad.org/tag/summer-of-giving. 

By Mara Kalinoski | AURORA, Colo. –  A recent study conducted by the Kaiser Family Foundation (KFF), a nonpartisan health policy research organization, reveals that LGBTQ+ patients face discrimination at higher rates than non-LGBT patients.

The results of the 2023 survey conclude that despite most LGBT adults reporting having mostly positive interactions with health care providers, they’re still twice as likely to have a negative experience as a non-LGBT patient. Those surveyed reported instances of having questions ignored and pain medications denied by a doctor.

Social scientist Carey Candrian, PhD, associate professor of internal medicine at the University of Colorado School of Medicine focuses her research on improving the way older LGBT people are cared for during serious illnesses, especially during end of life care.

She says the results of the survey emphasize the need for more work and research to prevent further discrimination. She explains there are many obstacles and barriers in preventing proper care, and she hopes to create a more inclusive and safe health care landscape for people of all backgrounds and orientations.

Accessibility difficulties

A significant amount of LGBT older adults live at or below the poverty line, making financial insecurity and lack of proper health care one of the biggest barriers to accessing quality care.

“Lack of affirming or safe clinicians is a huge factor, which results in a lot of people not going to get routine care, because they’re fearful that they have to be silent about who they are or hide their identity to actually get the care they need,” Candrian says. “This is particularly true for the trans community. Because of this, they end up not going.”

LGBT adults who are disabled, impoverished, non-white, or dealing with mental health issues or addiction are even more likely to face discrimination when seeking health care. Of the adults surveyed by KFF, those who are Black or Hispanic, under the age of 30, and identify as women were more likely to experience discrimination than their non-LGBT counterparts.

“The fear mixed with a health care system that historically has not been inclusive and is not really designed for anyone who’s not straight, white, and cisgendered makes it extremely hard to speak up,” Candrian explains. “Then there’s the issue of refusal of care. There is still no protection that prevents people from denying care based on a variety of personal reasons.”

Risks of improper care

The prevalence of osteoporosis, various cancers (including colon, breast, ovarian, prostate, and cervical), obesity, and mental health disorders are higher in LGBTQ populations. Suicide rates are also high, especially among trans people.

“In general, LGBT people are more likely to have estranged relationships with their family,” Candrian says. “They’re less likely to be married, less likely to have kids. They are at a disadvantage insofar as they don’t have a lot of people to help advocate on their behalf. That combines with an undercurrent of discrimination that we know is happening all around the health ecosystem.”

Beyond the mental health impact and the risk of medical issues going untreated, there are also underlying health issues that can be caused or exacerbated by the stress of experiencing discrimination. This stress can manifest in physical symptoms and can take a severe toll on cardiovascular health.

“Dealing with diseases like cancer or dementia are recognized as some of the hardest things you can go through. And if you are worrying about whether you’re going to be accepted, or going to have a trusting relationship with your caregivers, it adds to the burden in extraordinary ways,” Candrian says.

Patients are not required to disclose their identities or orientations during doctor’s visits – which can provide a layer of safety, but also reinforces a culture of silence. Because doctors do not regularly ask for information on gender and sexuality, they are working with limited information and potentially missing key details that could inform care.

The opportunity for growth

Candrian suggests that providers routinely ask about sexual orientation and gender identity the same way they ask for other pieces of information, such as race and ethnicity. Coupled with strong non-discrimination policies, this normalization can lead to deeper understanding and decrease discrimination.

“Asking for this data needs to be rolled out with training and education,” Candrian explains. “This is still very dangerous information, and learning how to ask these questions in a way that doesn’t perpetuate discrimination lets people know that this is being asked to provide better care.”

Resources are available for the LGBTQ community on the CU Anschutz Campus, including the the LGBTQ+ Hub, campus mental health resources, and the UCHealth Integrated Transgender Program.

“When people are talking to patients, coworkers, family members, and friends, I would encourage them to ask themselves, ‘Does the way I ask this question give space for lots of different types of answers? What if they are trans? What if they are estranged from their family? What if they just lost a spouse? What if they have a partner of 33 years but are not legally married?’” Candrian says. “Does the way you frame your question shut them out, or invite them in?”

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Mara Kalinosk is a Communications Coordinator for the University of Colorado Anschutz Medical Campus.

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The preceding article was previously published by the University of Colorado School of Medicine Anschutz Medical Campus and was republished with permission.

By Paulo Murillo || LOS ANGELES – Health officials report that over 570 cases of mpox have been detected in the U.S. so far in 2024, marking a significant increase compared to this time last year.

While this year’s infection rate remains lower than the peak observed during the mpox outbreak in early August 2022, when the country witnessed an average of about 470 new cases per week, the latest data underscore that mpox continues to circulate. Health authorities stress the importance of vaccination, particularly for individuals at risk of infection.

Los Angeles County of Public health reports a total of 2,591 of mpox cases (includes Long Beach and Pasadena) since it began tracking infections. Two people have died in LA County.

The primary mpox vaccine used in the U.S., known as JYNNEOS, is administered in two doses, spaced a month apart. Full vaccination is achieved two weeks after the second dose, with no current recommendations for booster shots. Eligibility and vaccine distribution locations can be found on the Centers for Disease Control and Prevention (CDC) website, as well as through various local health departments, including those of New York City and San Francisco.

Vaccination is not universally recommended; specific groups, such as gay and bisexual men with recent sexually transmitted infection (STI) diagnoses, are identified as at-risk populations eligible for vaccination.

Dr. Jenni McQuiston, deputy director of the CDC’s High-Consequence Pathogens and Pathology division, emphasized that most reported cases are among individuals who are either unvaccinated or under-vaccinated, reports Live Science.

Mpox, formerly known as monkeypox, is caused by a virus related to the variola virus, which causes smallpox. There are two main types of mpox viruses: clade I and clade II. Clade I is associated with more severe and fatal disease outcomes. While clade I has not been detected in the U.S. to date, there remains a risk of introduction through travelers from regions like the Democratic Republic of the Congo.

Symptoms of mpox can include fever, muscle aches, fatigue, and swollen lymph nodes, with characteristic pox rashes that progress from discolored patches to raised bumps, blisters, and scabbing. Individuals with weakened immune systems, infants, those with a history of eczema, and pregnant individuals face a higher risk of severe disease.

Since the onset of the mpox outbreak in May 2022, the U.S. has reported over 30,000 cases, with the majority occurring in 2022. Although infection rates slowed by early 2023, recent data indicate a resurgence, with 576 cases reported between January 1 and March 23, 2024, according to provisional CDC figures.

Notable concentrations of cases in 2024 include over 110 in New York City, 64 in California, and 50 in Florida.

While mpox can affect anyone, certain groups, including gender-diverse and transgender individuals, as well as men who have sex with men, are disproportionately impacted. Efforts to increase vaccination rates among these populations are ongoing, as data suggest that many at-risk individuals have not received the recommended doses.

Dr. Brandy Darby, director of the Division of Surveillance and Investigation at the Virginia Department of Health, emphasized the continued risk posed by mpox and stressed the importance of public awareness and vaccination efforts. Virginia has already noted a significant increase in mpox cases in 2024 compared to the previous year.

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Paulo Murillo is Editor in Chief and Publisher of WEHO TIMES. He brings over 20 years of experience as a columnist, reporter, and photo journalist.

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The preceding article was previously published by WeHo Times and is republished with permission.