Health
California to HHS: LGB&T still covered here (Equality California update)
Implementation of anti-LGBTQ rule set for Aug. 18
Harper Jean Tobin, center, speaks at a rally for transgender health in front of the White House on May 29, 2019. (Washington Blade photo by Michael Key)
This federal announcement would be laughable if it wasn’t official. The U.S. Department of Health and Human Services “respects the dignity of every human being, and as we have shown in our response to the pandemic, we vigorously protect and enforce the civil rights of all to the fullest extent permitted by our laws as passed by Congress. We are unwavering in our commitment to enforcing civil rights in healthcare,” said Roger Severino, director of the Office for Civil Rights at HHS on June 12 as he declared that Section 1557 of the Affordable Care Act would no longer prohibit discrimination on the basis of sexual orientation or gender identity.
The new Trump rule is scheduled to go into effect on Aug. 18.
Lambda Legal and the Human Rights Campaign immediately filed lawsuits on behalf of clients specifically impacted by the Trump administration’s callous move. The new rule would strip away the Obama administration’s May 2016 rule implementing Section 1557 that extended the legal interpretation of sex discrimination to include bias based on sexual orientation or gender identity, as well as discrimination based on race, color, national origin, sex, age or disability.
HHS focuses narrowly on the definition of “sex” in the healthcare program and Severino apparently decided to issue the new rule before the Supreme Court’s recent decision in Bostock v. Clayton County, which explicitly links sex discrimination to discrimination based on sexual orientation or gender identity.
“An employer who fires an individual for being homosexual or transgender fires that person for traits or actions it would not have questioned in members of a different sex. Sex plays a necessary and undisguisable role in the decision, exactly what Title VII forbids,” the Supreme Court ruled.
In the name of “Protecting Civil Rights in Healthcare, Restoring the Rule of Law, and Relieving Americans of Billions in Excessive Costs,” as they announced in their June 16 press release, neither Severino nor HHS Sec. Alex Azar II has backed off implementing the new rule, despite Bostock and the global coronavirus pandemic.
“LGBTQ people, and particularly transgender people, have been under constant attack by this federal administration.”
“Our plaintiffs, Tanya Walker and Cecilia Gentili — like many others in this country — should not be treated as second-class citizens by a federal administration hell bent on removing legal protections afforded to transgender people,” said Alphonso David, president of the Human Rights Campaign, after filing the 70-page complaint on June 26 in the United States District Court for the Eastern District of New York.
“It is time to end the constant fear and anxiety felt by many in the LGBTQ community that a person’s gender identity might determine the kind of medical care they receive.”
The Washington Blade reported that the HRC lawsuit on behalf of the two trans women of color, both of whom suffer from serious lung conditions, sought a preliminary injunction against the rule change “on the basis that it violated the law in the aftermath of the Bostock decision, exceeds statutory authority under the Affordable Care Act, is arbitrary and capricious and violates the right to equal protection under the Fifth Amendment.”
Lambda Legal and Steptoe & Johnson LLP also filed a lawsuit, Whitman-Walker Clinic v. HHS, in the United States District Court for the District of Columbia challenging the HHS rule on behalf of four doctors and six organizations, including TransLatin@ Coalition and the Los Angeles LGBT Center.
“The health care discrimination rule will hurt marginalized communities who already experience barriers to care, but especially those of us who are transgender, non-English speakers, immigrants, people of color and people living with disabilities and will have an even more serious impact on those of us who hold intersectional identities,” said Bamby Salcedo, President and CEO of the TransLatin@ Coalition.
“The TransLatin@ Coalition and its affiliated organizations such as Arianna’s Center in Florida and Puerto Rico and the Fundación Latinoamericana de Acción Social (FLAS) in Texas exist because of the already present challenges in our communities and because everyone deserves easy access to care that is respectful of who we are, compassionate and competent. Our lives depend on it and we’re going to fight for it,” she said.
On July 9, Lambda Legal filed for a preliminary injunction. “We are putting a stop to the Trump administration’s immoral and legally indefensible attacks on our communities. Section 1557 of the ACA is clear in its inclusion of LGBTQ people and other vulnerable communities and the law is on our side. This rule cannot be allowed to go into effect, not even for a moment,” Omar Gonzalez-Pagan, Senior Attorney and Health Care Strategist for Lambda Legal, said in a press release. “The Trump administration has a dismal record of handling the COVID-19 pandemic and a well-documented score of attacking the rights of LGBTQ people, particularly transgender persons. Now the Trump administration seeks to double-down on both by limiting access to health care for LGBTQ people and other vulnerable individuals in the midst of a global pandemic.”
Equality California, which has filed or been part of numerous lawsuits against the Trump Administration, was also angry at HHS and furious about their timing – the anniversary of the mass shooting at Pulse, the gay nightclub in Orlando, Florida.
“We’re considering all possible avenues to block this heartless, discriminatory rule from ripping healthcare away from millions of Americans during a global pandemic,” Equality California Executive Director Rick Chavez Zbur said when HHS issued the final rule on June 12.
“The Trump-Pence Administration’s response to COVID-19 has ranged from incompetent to illogical to reckless. But this is a new low. To roll back healthcare protections for LGBTQ+ patients in the middle of a global pandemic is heartless and cruel. But to do so on the fourth anniversary of the mass shooting at Pulse Nightclub in Orlando is especially despicable.”
Zbur added: “Transgender and gender-nonconforming people deserve healthcare. Gay, lesbian, bisexual and queer people deserve healthcare. People with disabilities and people for whom English is not their first language deserve health care. No one should be denied this basic human right because of who they are or who they love. Shame on Donald Trump and his administration for saying otherwise.”
Equality California trans member Darren Stanley Lazor (photo courtesy Equality California)
On July 10, Equality California, representing trans member Darren Stanley Lazor, upped the ante in another federal court joining National Women’s Law Center, Transgender Law Center, Transgender Legal Defense & Education Fund, Harvard Law School Center for Health Law and Policy Innovation and the other plaintiffs in BAGLY v. HHS in Boston.
In their press release, Equality California briefly laid out the horror Lazor has had to endure:
“Darren lives in Ohio, where he has experienced extensive healthcare discrimination based on his gender identity. For example, in 2012, Darren sought treatment for symptoms that later turned out to be endometriosis and a large ovarian cyst. Darren was denied treatment by four healthcare providers because of his transgender status before finally receiving treatment for his life-threatening condition.
In December 2017, Darren began experiencing shortness of breath as the symptom of a recurring health problem. He returned to the emergency room closest to his home where he once again experienced a hostile and disrespectful hospital staff who discriminated against him in several ways, from misgendering his hospital bracelet as female, to making audible expressions of disgust when affixing EKG stickers near Darren’s mastectomy scars, to ignoring him in the treatment room with no explanation.
When the Trump-Pence Administration issued its decision to undermine LGBTQ+ nondiscrimination protections in the Affordable Care Act, Darren decided to step forward and share his story as a plaintiff in BAGLY v. HHS to ensure that no one else will be denied life-saving healthcare or be discriminated against simply because of who they are.”
That may have prompted the California Department of Managed Health Care (DMHC) to ‘affirm its commitment to protect consumers’ healthcare rights, including the right to be protected from discrimination based on categories like gender identity and sexual orientation that are enshrined in California law,” according to a DMHC email distributed to LA County healthcare providers and policy makers.
“The DMHC Nondiscrimination Statement was issued in response to the finalized rule issued by the U.S. Department of Health and Human Services that eliminated regulations that protected individuals from discrimination based on categories like gender identity and sexual orientation,” DMHC’s Marisa Ramos wrote in a “Dear Colleagues” letter. “The rule also eliminated a federal requirement that health plans include information about the availability of language assistance services for people with limited English proficiency (LEP).”
The DMHC statement reads, in part: “Notwithstanding the new federal rule, all California-licensed health plans must continue to comply with California law, which protects all Californians from discrimination based on, among other things, gender identity and sexual orientation. Likewise, California-licensed health plans must continue to comply with California’s requirements to provide enrollees with notice of the availability of free language assistance services in English and the top 15 languages spoken by LEP individuals in California.”
Out California Insurance Commissioner Ricardo Lara also re-issued the statement he sent June 15 to “All Health Insurance Companies, All Licensed Insurance Producers, and Other Licensees and Interested Parties” alerting them to comply with California’s Health Insurance Anti-Discrimination Protections – specifically noting that the HHS federal rule does not preempt state law.
Health insurance that is regulated by the California Department of Insurance (CDI) “remains subject to California’s antidiscrimination law. Consequently, health insurers must continue to comply with the existing antidiscrimination standards in California law, beyond the minimum requirements of federal law,” he said. Lara’s Notice to insurance carriers notes that state anti-discrimination requirements include the following:
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“Anti-discrimination and language and disability assistance services notification requirements, including a that “[a]n insurer does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.”
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A prohibition against discriminating based on an insured or prospective insured person’s actual or perceived gender identity, or on the basis that the insured or prospective insured is a transgender person, including discrimination in the following: denying, cancelling, limiting or refusing to issue or renew an insurance policy; premium rating; designating gender identity or transgender identity as a pre-existing condition for the purpose of denying or limiting coverage; denying or limiting coverage or denying a claim for the following services due to gender identity or because the insured is a transgender person; health care services related to gender transition if coverage is available under the policy for such services when not related to gender transition; including but not limited to reconstructive surgery; health care services ordinarily or exclusively available to individuals of one sex when the denial or limitation is due only to the fact that the insured person is enrolled as belonging to the other sex or has undergone, or is in the process of undergoing, gender transition.”
Lara says the CDI will continue to “vigorously enforce these and other existing provisions of California law to protect Californians against wrongful discrimination.”
Anyone who thinks they have been subject to unlawful discrimination should contact the Department’s Consumer Complaint Center at 1-800-927-4357, or submit a complaint through the Department’s website at www.insurance.ca.gov.
Health
Breaking down the latest mpox vaccination survey results
The survey focused on the LGBTQ+ community of Southern California
Of the 255 people surveyed at Pride events throughout 2024, about 74% of respondents who have been vaccinated against mpox identified as gay, and of those, 41% identified as Latin American, 36% as White, and 18% as Black.
The California HIV Research Policy and Research Centers released the new survey this month, highlighting characteristics and prevention behaviors of Southern Californians who have been vaccinated against mpox.
According to the World Health Organization, mpox is an illness caused by the monkeypox virus. There are groups of organisms that share a common ancestor and all of its descendants, called clades. The virus has 2 distinct clades–clade 1 and clade 2, with both of those clades having a and b subclades. During 2022 and 2023, a global outbreak of mpox was caused by the clade 2b strain.
Today, mpox continues to be a threat globally, with cases caused by the clades 1a and 1b still surging in Democratic Republic of Congo and other countries, raising concerns.
The Blade spoke with Dr. Ian Holloway, researcher at the Southern California HIV/AIDS Policy Research Center, to get more details on the survey.
“We recently saw the first clade 1 infection in California, up in San Francisco,” said Dr. Holloway. “It was the first claude 1 infection in the United States and it happened up north, adding some additional urgency to this work.”
He further explained that though the recent infection in California added urgency to this work, the survey results had been collected over 2024, with specific focus on pooling vaccination data from Pride events across SoCal counties which include Los Angeles, Santa Barbara, Orange and San Diego.
Black and Latin American people are overrepresented in terms of mpox cases in Los Angeles County.
Infographic courtesy of the California HIV/AIDS Policy Research Centers
“There is a higher percentage of mpox cases among those groups, than their representation in the general population. They also have lower vaccination rates, compared to their White counterparts, so our efforts certainly highlight the need for culturally tailored and culturally relevant mpox education and community outreach materials in order to close the gap and provide more robust vaccine coverage, especially for Black and Latinx, queer people.”
The study found that 67% of those surveyed received the first of 2 mpox vaccine doses during the 2022-23 outbreak, with 91% of those having received both necessary doses. The survey also pointed out that people did not rely on vaccination alone to protect against mpox, because about 20% of respondents also reduced their number of sexual partners or made other behavioral adjustments to reduce the risk of contracting the virus.
To reduce the risk of infection, 20% of respondents reduced their number of sexual partners, 18% had less group sex, 15% attended fewer sex venues or parties, and 18% had fewer one-time sexual encounters.
The survey also noted that over half of respondents were ‘somewhat or very concerned about mpox in their community.’ Another point of research in the survey found that 32% of respondents listed social media as their source of information, followed by 30% who listed a health care provider.
Dr. Holloway, who is also a professor of social welfare at UCLA, said that community input is essential in creating and improving public health strategies to combat mpox infections and raise awareness about the effectiveness of vaccinations.
This survey was done as a partnership between the research center and StickItin.LA.
“Through StickItIn.LA, we’re creating a platform to listen and connect to those who’ve been directly impacted by mpox and by doing so, we can shape a more inclusive vaccination strategy that addresses both stigma and mistrust,” said Dr. Holloway.
Over 300 people gathered last Monday to commemorate World AIDS Day in an event hosted by Bienestar Human Services. The non-profit focuses on identifying and addressing emerging health issues faced by Latinx and Lesbian, Gay, Bisexual, Trans Queer and more (LGBTQ+) populations.
The main objective of the annual event was to light a candle to honor those who passed away due to Human Immunodeficiency Virus (HIV) and celebrate those who, despite the condition, keep going.
HIV is the virus that causes Acquired Immune Deficiency Syndrome (AIDS). Once you have HIV, the virus stays in the body for life, and while there is no cure. There is, however, medicine that can help people stay healthy, states Planned Parenthood. HIV destroys the cells that protect the human body from infections. If a person doesn’t have enough of these CD4 or T cells, the body can’t fight off infections as normal. This damage can lead to AIDS, which is the most serious stage of HIV, and it leads to death over time.
In the U.S., there are about 1.3 million people newly infected with HIV in 2023 and 39.9 million living with HIV, according to the Joint United Nations Programme on HIV/AIDS.
Living with HIV for decades
Among the participants at the event at the Ukrainian Culture Center on Melrose in East Hollywood was Marcela, a transgender woman who was diagnosed HIV positive 33 years ago. She said when she learned about her diagnosis, she was so depressed she tried to commit suicide. She ended up at the hospital, and after getting better, she heard about an organization that was helping people with health issues such as hers.
“Since then, I learned to live with this condition because it is not an illness; it’s a condition,” she said.
Bienestar celebrated the World AIDS Day on December 2, 2024. (Courtesy of Bienestar)
Marcela, who didn’t provide her last name, said she not only found a new way of living with HIV but also found an extended family at Bienestar. They have guided her on how to receive the proper treatment and medicines, to be part of a support group and even to pay her rent when she needed it the most.
The 64-year-old woman doesn’t have any family members in the United States. She said five years ago, her husband passed away of pneumonia. She was living alone in Long Beach and got behind her payments during the pandemic. She said Bienestar helped her apply for a grant of over $20,000 that secured the payment for her rent, and now she is debt-free.
“I’m extremely grateful to them and all the help they provide,” she said.
Working for the community
This year, Bienestar is celebrating 35 years of serving the LGBTQ+ community. Among the many programs they offer is the Support Group for Transgender Women, which Marcela belongs to.
Mia Perez, the support group manager, said 15 to 20 members attend the group every Friday from 3 to 5 p.m. They talk about their feelings, share experiences, and plan and participate in social events.
Perez said one of the participants’ biggest concerns is accepting reality once they have been diagnosed. “However, with all these new treatments people that are HIV positive can have a normal relationship with someone who doesn’t have HIV. It’s all about getting informed,” said Perez.
Other concerns include what will happen to them once the new presidential administration takes office since they have plans to deport immigrants and many of the transgender women are immigrants.
“That’s why we are trying to get in contact with an immigration attorney or an organization so they can keep them informed of their rights,” said Perez.
Bienestar events, like World AIDS Day, help those affected create a stronger community, and they realize the recognition is not just for those who are HIV positive but also for their families and friends.
Marcela said when she is feeling down or bored at home, all she has to do is go to Bienestar and the people there always give her a warm welcome.
“They give me coffee, they offer me lunch. Being there is like being at home,” she said.
AIDS and HIV
New monument in West Hollywood will honor lives lost to AIDS
In 1985, WeHo sponsored one of the first awareness campaigns in the country, nationally and globally becoming a model city for the response to the epidemic
December is AIDS/HIV awareness month and this year West Hollywood is honoring the lives lost, by breaking ground on a project in West Hollywood Park that has been in the works since 2012.
Members of Hollywood’s City Council joined representatives from the Foundation of AIDS Monument to announce the commencement of the construction of STORIES: The AIDS Monument, which will memorialize 32 million lives lost. This monument, created by artist Daniel Tobin, will represent the rich history of Los Angeles where many of those afflicted with HIV/AIDS lived out their final days in support of their community.
Tobin is a co-founder and creative director of Urban Art Projects, which creates public art programs that humanize cities by embedding creativity into local communities.
The motto for the monument is posted on the website announcing the project.
“The AIDS Monument:
REMEMBERS those we lost, those who survived, the protests and vigils, the caregivers.
CELEBRATES those who step up when others step away.
EDUCATES future generations through lessons learned.”
The monument will feature a plaza with a donor wall, vertical bronze ‘traces’ with narrative text, integrated lighting resembling a candlelight vigil, and a podium facing North San Vicente Blvd.
World AIDS Day, which just passed, is on December 1st since the World Health Organization declared it an international day for global health in 1988 to honor the lives lost to HIV/AIDS.
The Foundation for the AIDS monument aims to chronicle the epidemic to be preserved for younger generations to learn the history and memorialize the voices that arose during this time.
The HIV/AIDS epidemic particularly affected people in Hollywood during the onset of the epidemic in the 1980s. The epidemic caused a devastatingly high number of deaths in the city. The city then became one of the first government entities to provide social service grants to local AIDS and HIV organizations.
In 1985, the city sponsored one of the first awareness campaigns in the country, nationally and globally becoming a model city for the response to the epidemic.
Earlier this year, the U.S. Centers for Disease Control and Prevention released the theme for World AIDS Day, ‘Collective Action: Sustain and Accelerate HIV Progress.’
The city of West Hollywood continues to strive to become a HIV Zero city with its current implementation of HIV Zero Initiative. The initiative embraces a vision to “Get to Zero” on many fronts: zero new infections, zero progression of HIV to AIDS, zero discrimination and zero stigma.
Along with the initiative and the new AIDS monument, the city also provides ongoing support and programming through events for World AIDS Day and the annual AIDS Memorial Walk in partnership with the Alliance for Housing and Healing.
For more information, please visit www.weho.org/services/human-services/hiv-aids-resources.
Latin American News
Report finds LGBTQ+ Latin American youth face discrimination at higher rates
A majority of youth who are both Latin American and LGBTQ+ are proud of their identity, but many are still worried about their safety and future, according to a recent report.
In 2022, the Human Rights Campaign Foundation partnered with the University of Connecticut to survey 2,236 LGBTQ+ youth from 13 to 17 years old in all 50 states. These results were released in a 2023 LGBTQ+ Youth Report, and a separate report released this month from HRC focuses on the statistics for LGBTQ+ youth who are also Latin American.
Charleigh Flohr, Associate Director of Public Education and Research at HRC who co-created the study, says the overall resiliency of youth surveyed and the extra challenges that youth face when they have overlapping identities were the main takeaways.
For example, 70.5 percent of Latin American LGBTQ+ youth and 75.4 percent of Latin American transgender and gender-expansive youth say they experience anti-Latin American bias in the LGBTQ+ community. About 8 percent more Latin American LGBTQ+ and transgender or gender-expansive youth experience homophobia or transphobia in the Latin American community.
Youth also even struggle with building lateral relationships with others. More than 60 percent of Latin American LGBTQ+ or transgender participants say they find it difficult to make friends who are both LGBTQ+ and from the same ethnic community.
“[The statistics] underscored to me the importance of having resources and education, and leadership that meets people at the intersections of their identities,” Flohr said. “Making sure that we have things that speak directly to Latine youth because of their Latine and their LGBTQ+ identities.”
HRC’s survey addresses the ways the attitude toward Latin American LGBTQ+ youth within their communities, also impact their hopes and fears. According to the report, 67.6 percent of Latin American LGBTQ+ youth and 76.4 percent of Latin American transgender and gender-expansive youth fear they will face discrimination in the future because of their LGBTQ+ identity.
Fears about joining the workforce are substantiated, not only by their current experiences of discrimination, but also by separate data surveying adult LGBTQ+ workers. A study from the Williams Institute at UCLA School of Law, showed that LGBTQ+ employees who are out to their coworkers are three times more likely to experience discrimination and almost half of LGBTQ+ employees report experiencing discrimination or harassment at work because of their sexual orientation or gender identity during their lifetime.
When adding race as a factor, LGBTQ+ employees of color were also more likely to report experiencing discrimination than white LGBTQ+ employees. Transgender and nonbinary employees and LGBTQ+ employees of color were about twice as likely as cisgender LGBTQ+ and white workers to experience discrimination or harassment in the past year.
“More robust protections, including monitoring and enforcement, are needed to ensure that LGBTQ+ people, particularly transgender and nonbinary people and LGBTQ+ people of color, are fully protected from discrimination and harassment in the workplace,” said Brad Sears, lead author and founding executive director at the Williams Institute.
Flohr said the 24.5 percent of youth who said they wish they were not LGBTQ+, also overlapped with those 90 percent who said they are proud to be both Latin American and LGBTQ+. She inferred from these results, that the sentiment of Latin American youth is less that of self-hate and more the desire to move freely in the world without the challenges queer and transgender people face.
“I think that it’s important to understand the experiences of trans youth, including Latina trans youth, within the context of the political and cultural climate right now across state legislatures in the United States,” Flohr said. “Someone who is transgender like myself might wish they aren’t transgender so they don’t have to worry about how they’re going to be treated if they go use a public restroom. I think those are all really universal experiences of all LGBTQ+ people.”
More than 650 anti-trans bills have been considered by U.S. legislators in the past year, according to independent research from the Trans Legislation Tracker. Of those hundreds of bills, 44 have been signed into law, including restrictions on curriculum and bathroom usage. One law in Iowa, SF 2435, prohibits the establishment of Diversity Equity and Inclusion offices at all.
Yalitza “Yaya” Vasquez-Lopez is a community organizer at MiSELA, an LGBT Youth Center in Bell, Calif., and she also works at St. Bede’s Episcopal Church. She said that despite micro-aggressions from other employees and being the only transgender Latina working at the church, Vasquez-Lopez said she feels welcomed by details at the church, such as having a woman reverend, a booklet for attendees sharing what to expect throughout the service and the display of a TGI-inclusive pride flag.
In the past, Vasquez-Lopez worked as a member of Mariachi Arcoiris, the only LGBTQ+ Mariachi in the world.
Vasquez-Lopez said her mostly-positive experiences in workplaces have stemmed from specifically pursuing opportunities to work with other LGBTQ+ people of color. She advised youth to do the same and find inclusive workplaces early on.
“I think even just that representation of visiting an organization and seeing the synergy of a queer staff is such a good resource for kids. I wish I would have done that a little bit more when I was growing up,” Vasquez-Lopez said. “I think I could have seen the value of a queer-forward staff as a young, growing professional.”
Flohr says she hopes organizations will remember that they may be serving Latin American LGBTQ+ youth without knowing. She also shares that using affirming language around both Latin American and LGBTQ+ issues, is meaningful and impactful.
Despite Latine LGBTQ+ youth’s fears and doubts, Flohr says another memorable result from the study, was reading about the hope that youth displayed in their responses.
“Many [Latin American] youth know that a future for them is possible and they want those futures, whether it’s going to college or pursuing careers that are right for them,” Flohr said. “How successful they can be in those things … is also dependent on institutions and adults in those institutions to deliver the appropriate care and resources and education to them.”
AIDS and HIV
National Latino AIDS Awareness Day: Breaking down stigma, silence and silos
FLAS provides HIV and STD education
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.”
AIDS and HIV
40th anniversary AIDS Walk happening this weekend in West Hollywood
AIDS Project Los Angeles Health will gather in West Hollywood Park to kick off 40th anniversary celebration
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.
Health
How will California’s new IVF law impact LGBTQ+ families?
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…”
Health
Holding Hollywood accountable: GLAAD’s annual report points to lack of HIV representation
Shortcomings ‘further pushing the issue into the closet’
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.
AIDS and HIV
Cautious Optimism in San Francisco as New Cases of HIV in Latinos Decrease
The decrease could mark the first time in five years that Latinos haven’t accounted for the largest number of new cases
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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Monkeypox
US contributes more than $90 million to fight mpox outbreak in Africa
WHO and Africa CDC has declared a public health emergency
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.
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