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Posts for December, 2015

AHF’s Michael Weinstein mocks the CDC about PrEP

Timothy Kincaid

December 22nd, 2015

michaelIn 1987 there was little to no hospice care available for dying AIDS patients. Several activists united and petitioned LA County Board of Supervisors for funding and the AIDS Hospice Foundation was born with Michael Weinstein at its helm.

In 1995 – 1996, antiretroviral medication changed the face of HIV. Those infected with the virus no longer could expect an onset of opportunistic maladies followed by an early painful death. Now HIV, if properly treated, has no significant impact on quality of living or life expectancy. And the need for specialized AIDS hospice care diminished significantly.

So Weinstein rebranded the organization as AIDS Healthcare Foundation, and began offering medical services to those infected with HIV. Over time, AHF has grown tremendously, with revenues in the hundreds of millions of dollars (much of it through either grants or Medicare) and programs dotting the globe. Also growing has been Weinstein’s political power (and compensation – about $400,000 in 2012).

Michael Weinstein has not been hesitant to use his connections and power, using public media attacks and lawsuits as his primary methods. In 2012, they spent over a million dollars on legal fees.

Many of Weinstein’s efforts have been controversial, and most come across as heavily moralistic. Taken cumulatively, they paint a picture of a man and an organization determined to stop others from having sex in ways in which he disapproves.

In 2007, Weinstein decided that Viagra was being used by people who were doing drugs. Disapproving, AHF held a press conference accusing Pfizer, the maker of Viagra, of contributing to HIV and announced a lawsuit against them over their marketing and demanding that they contributed to AHF. (Bay Area Reporter)

The Los Angeles-based AIDS Healthcare Foundation has charged the pharmaceutical company Pfizer with “promoting Viagra as a party drug … leading to more infections with sexually transmitted diseases such as HIV,” according to its president Michael Weinstein.

AHF filed suit in a Los Angeles court Monday, January 22 to force the company to end those ads, begin an education campaign on the responsible use of Viagra, and pay an unspecified sum to the organization to help care for people infected with HIV.

Weinstein had no facts to back up his assertions.

When pressed during a telephone conference call Monday to back up his assertion with data, Weinstein mentioned recently speaking with a group of black youth who said crystal meth “use is rampant” within their community.

I can’t find the results of that lawsuit, so it may have been nothing more than a bluff or an attempt at extortion.

Also in 2007, AHF began running ads in Indian newspapers accusing Cipla, an Indian company, of price-gouging. They did not get the support of local non-profit organizations who saw a conflict of interest. At the time, a leading Gilead exec was on AHF’s Board and they provided funding to Weinstein’s organization. (Gilead denied any connection with Weinstein’s effort.) (IndiaTimes)

Cipla had refused Gilead’s offer to sell the latter’s anti-AIDS drug Viread under a licensing agreement. Cipla is also the only Indian company opposing Gilead’s patent application for its blockbuster anti-HIV drug Viread in India.

In recent years, Weinstein has decided that he disapproves of people watching bareback porn and waged a war of accusation and innuendo against producers. Even though there is testing and prevention efforts in porn – both gay and straight – Weinstein and AHF seemed determined to stop its production altogether and in all circumstances.

In 2012 AHF spearheaded an initiative on the ballot in Los Angeles County which required porn actors, gay or straight, to wear condoms during anal or vaginal sex. Weinstein was not shy about his desire to monitor other’s desire. (Weinstein op-ed)

The fact that most straight porn is made without condoms sends a horrible message that the only kind of sex that is hot is unsafe.

Though opposed by the Libertarian Party, the Republican Party, and local newspapers, Measure B passed the vote with 60% of the vote. And, as could be expected, the $6 billion industry – and its economic benefits – moved out of Los Angeles County with sadly ironic consequences. (SF Weekly)

Last year, after Measure B pushed several companies to Nevada, the industry saw its first on-set transmission in over a decade. Though the performer tested negative for HIV before his shoot, the test used was not the RNA plasma test that is the standard here in California. By the time he shot the scene, his viral load had increased to the point where he could transmit the virus to someone else.

Undeterred by real life consequences, Weinstein presses on seeking a statewide initiative forcing his ideas about acceptable porn production throughout California. There may be an initiative on the 2016 ballot to mandate Weinstein’s views.

In 2012, as the result of a county audit finding that AHF had overcharged LA County by millions of dollars, Weinstein sued the County in an effort to punish Supervisor Yaraslovsky, with whom Weinstein had feuded. (LA Times)

The lawsuit arose out of an audit by the county, which claimed the foundation had overcharged $1.7 million for its AIDS services by billing for costs that should have been allocated to other sources. The judge did not rule on which side was correct, only saying that the county has the right to audit its contractors.

Weinstein, defending his political tactics, told the paper that regardless of who was billed for the costs, the money was spent serving patients: “We would not have gotten to where we are today if we hadn’t fought like hell on behalf of our clients and our mission.”

A U.S. District judge ruled for the county this week. “Rather than a sincere attempt to vindicate their First Amendment rights,” the paper quotes the judge saying, “the court fears that plaintiffs instituted this action in an effort to obtain a tactical advantage in their ongoing political battles.”

To illustrate his conclusion, he included an excerpt from an email Weinstein sent to a foundation staff member shortly before the suit was filed:

“It is time to take the gloves off,” Weinstein wrote, according to the written decision reported in the Times, “We need to go after Zev [Yaroslavsky] directly and hard. He is the real power behind our problems with the county on porn, the audit and fee-for-service. Plus he is a lame duck and an arrogant jerk. His Berman-Waxman power base is dead and he and others need to be taught a lesson. The voters are with us.”

But it isn’t just the big-dollar fights and power plays that have caused controversy. So too have many of AHF’s public pleas for the public to get tested.

In Los Angeles, one can’t get away from AHF’s billboards. And they seem to share a common theme: sex is dirty and bad and people who want to have sex with you are liars who want to give you diseases.

One such campaign featured a number of couples of various races and sexes with the tag line “Trust Him?”

TrustHim_GayWhite_1130x400

Though nothing in the ads tells you why one would not trust the other, but Weinstein apparently assumes that sex must include some sleazy component and had this to say about the immensely unpopular billboards. (Poz)

“While infidelity is nothing new, the level of risk in contracting STDS from bed-hopping partners is at an all-time high. We want to remind couples that STDs linger around much longer than a wandering eye and that secret sexual experiences can often produce much more than what one bargained for.”

This message has many HIV/AIDS activists disgusted at Weinstein and his organization. (HIVPlusMag)

This stigmatic view of sex and trust is both reductive in personal responsibility and stigmatizing towards HIV-positive people. It suggests that people living with the disease are akin to criminals who lie in order to have sex, or even intentionally spread the virus. Sure, the people behind the AHF campaign may argue differently. However, it is hard to ignore the criminal theme of the advertisements that, by default, further marginalize people living with HIV and keeps fear in the forefront of safer sex messaging. As one Facebook user stated, “This does not say ‘fear HIV.’ It says, ‘fear people living with HIV.’”

In addition to all the ways that Weinstein doesn’t want people to have sex, he also has opinions about how they meet. Earlier this year, another of AHF’s billboard campaigns went on the direct attack against hook-up sites.

ahf tinder

As usual, when Tinder objected, Weinstein bulldozed over them and hinted that it all could be fixed by coughing up. (Guardian)

“They’re tone deaf,” Michael Weinstein, president of AHF, told the Guardian. “It would have been much wiser for them to say that they’re concerned about their customers and look forward to working with us to help people get the checkups that they need. This would not have been the global story that it has become if they had not responded that way.”

And lest you think these ads come across as sex-negative,

“There are consequences to hooking up,” Weinstein told the Guardian. “That’s not a moralistic judgement. It’s just a fact and minimizing that is important.”

But nothing has set Weinstein and AHF apart from the HIV/AIDS community more than Weinstein’s obstinate opposition to pre-exposure prophylaxis. The battle between anti-PrEP forces (Weinstein and AHF) and pro-PrEP forces (The Centers for Disease Control, the World Health Organization, AIDS Project Los Angeles, amFAR, Gay Men’s Health Crisis, the National Minority AIDS Counsel, and virtually every gay and AIDS/HIV advocate that seeks to see an end to the transmission of the Human Immunodeficiency Virus) has turned into all out war.

The opening salvo was fired by Weinstein on April 7, 2014 (AP)

“If something comes along that’s better than condoms, I’m all for it, but Truvada is not that,” said Michael Weinstein, president of the AIDS Healthcare Foundation. “Let’s be honest: It’s a party drug.”

Obviously, Truvada is not a party drug. It is not a euphoric, a hallucinogen, a mood enhancer, nor does it have the hallmark of any other pharmaceutical whose primary purpose is to feel good. What Weinstein meant here is what he meant when he accused Viagra of being a party drug: that it was used by people doing drugs and having bad bad sex. That it prevented these naughty naughty gay boys from infecting each other with HIV was secondary to his objection to their behavior.

In August 2014, Weinstein started running ads in gay newspapers which, at first glace, appeared to say that PrEP was not very effective at preventing transmission.

AHF prep facts

Those who read the text would learn that any effectiveness was low due to low adherence – not exactly a surprise for research in high-risk and third world populations. But even if you get beyond the graph, Weinstein extrapolated from that data a conclusion set that is not supported in science: Low adherence means low effectiveness in preventing HIV and effectiveness measures whether Truvada works in the real world.

In other words, Truvada doesn’t work.

This infuriated those who have been taking strides to eliminate HIV transmission in the real world. They particularly noted the dishonesty of Weinstein who never notes that for those who DID adhere to the drug protocol effectiveness was 99% or better.

But Weinstein seems uninterested in facts. He has positions. And a sizable salary based on continued services to those who become newly infected each year.

In fact, there have been raised questions about the ethics of AFH’s testing facilities and how they feed a stream of income into the organization. In April of this year, three former staffers filed a whistleblower lawsuit against AHF:

The plaintiffs accuse AHF of an “organizational-wide criminal effort” across at least 12 States in the form of kick-backs to AHF clients and staffers. They believe that AHF has defrauded governmental programs out of tens of millions of dollars, based on their own experience with the agency going back to at least 2010.

The three plaintiffs, all former managers at AHF who were in a position to be familiar with agency policy, also include Mauricio Ferrer of Florida and Shawn Loftis of New York.

When someone tested positive in an AHF clinic, the suit claims, they were offered cash or other inducements to be linked to care in AHF clinics. Furthermore, AHF staff were provided commissions when they successfully linked someone with a positive test result to AHF services. This procedure was developed first in Los Angeles and then spread across all States where AHF has a presence.

Of additional concern is whether AHF’s (grant funded) testing centers inform those who test HIV negative that they have an options to persue PrEP. Although some communities, like West Hollywood, require all testing facilities to give PrEP referral information, many do not.

And Weinstein has made it clear that he is the face and voice of opposition to PrEP. While some, like Larry Kramer, initially had concerns, they’ve come to see the potential of the drug. Kramer joined Peter Staley and others earlier this month in releasing a statement that reads in part:

We – AIDS activists, new and old, aged 24 to 80 – have just broken bread in the same apartment where GMHC was formed, coming together for a lively discussion on how to reduce HIV infections among gay men and trans women. Although we may not see eye-to-eye on every issue we debated tonight, we all agree that Pre-Exposure Prophylaxis (PrEP) is highly effective at protecting a person from HIV infection. While PrEP isn’t for everyone, any individual who thinks they are at risk of getting HIV should have easy access to it, without judgement.

Weinstein appears to be the sole hold-out. But he is always ready to speak to any news source which is looking for “controversy” on the issue.

At the heart of Weinstein’s objections is the assertion that people at greatest risk won’t take the drug consistently. Which may be true. But it’s very implausible to assume that those who don’t have enough structure in their lives to take a pill once a day do have enough structure to have condoms ready and use them every time. Of the two, a daily pill requires far less forethought. Weinstein’s argument is laughable.

Also conveniently ignored is the consequences of occasional lapses. Failing to use a condom just one time can result in HIV transmission. But failing to take the pill just one time, or two times, or three times a week still provides enough protection to prevent transmission. In testing, those whose blood revealed adherence to the protocol four times per week have nearly 100% effectivity.

And, unlike condoms, PrEP doesn’t break.

As a corollary argument Weinstein insists that those who use PrEP won’t use condoms, which will lead to an increase in other STIs. And that too might be true. But it raises the natural question: if we find a true vaccine or a cure for HIV, will Weinstein oppose that measure as well because it would mean less condom usage? Will he insist that some continued HIV infection is a small price to pay for preventing increased gonorrhea?

That may be less rhetorical of a question than one might imagine. Weinstein has actually penned an op-ed to the LA Times calling on the federal government to cease funding for the search for a vaccine for HIV. Framed as a complaint against the wasting of funds that could otherwise be used (by AHF, I presume) to pay for treatment, it still is a chilling idea that the head of a prominent HIV/AIDS care organization opposes the search for a vaccine which could end the pandemic.

Although the opinions of both the activist and the science community have reached near consensus about the efficacy and value of PrEP as a tool in the fight against the transmission of HIV, Weinstein has been effective in his opposition. He has sown doubt in the gay community as to whether PrEP works. He has done his best to shame those who use this “party drug”. At least in part, he has contributed to the slow uptake in PrEP usage in the gay community.

And, having slowed the PrEP movement, now he’s decided that it’s time to mock the Centers for Disease Control for their struggle in convincing gay men that this preventative measure is neither shameful not ineffective.

AHF PrEP

You see, you shouldn’t push PrEP, but treatment. After all, if you pay AHF to treat people once they’ve contracted HIV, then their virus is brought down to undetectable levels and they are non-infectious. And as for PrEP, leave it to the Truvada whores who have multiple partners and never use condoms.

But the word is – finally – getting out. I see PrEP becoming a regular discussion point in some subsets of West Hollywood. Activists in New York are becoming more vocal. San Francisco City government is dedicating city resources. Social approval is on the uptick and the community – though originally fearful of another “solution” – has had time to observe and see how things went for the earliest guinea pigs.

Weinstein should get his gloating out of his system. Because I think that PrEP is going to become as common as condoms were in the 90’s and AHF is going to have to come up with some other business plan.

Appeals court upholds conviction in Miller-Jenkins case

Timothy Kincaid

December 21st, 2015

Kenneth Miller

Isabella Miller-Jenkins is fifteen and she hasn’t seen her mother, Janet Jenkins, in at least five years.

In 2010, Lisa Miller (Isabella’s other mother) took her and fled to Nicaragua so as to avoid compliance with court orders to first allow visitation and – when she defied the court – to turn primary custody over to Janet Jenkins. Miller and Jenkins had been in a civil union when the child was conceived and both had parental rights. When the relationship soured, Miller claimed a conversion to conservative Christianity and used her newfound religious ideologies to gain allies in her custody battle.

The parental kidnapping was planned and assisted by her attorneys, Liberty Counsel’s Mat Staver and Rena Lindevaldsen along with a network of other supporters. Among them was Kenneth Miller (no relation), a Mennonite minister who provided plane tickets and facilitated people to assist Miller in her abduction.

In 2012, Kenneth Miller was found guilty of aiding in the kidnapping and sentenced to 27 months in jail. Rev. Miller appealed the decision arguing that the Virginia courts did not have jurisdiction as his criminal act did not occur in that state (the Virginia courts had jurisdiction over the parental rights, the abduction took place in Tennessee, Kenneth Miller performed his role in Virginia, and Lisa fled with Isabella first to Canada and then to Nicaragua).

Now the appeals court has responded. (Reuters)

On appeal, Miller argued that Vermont, where the custody battle between the women took place, was an improper venue, as he personally was not alleged to have committed any criminal act there.

But U.S. Circuit Judge Susan Carney, writing for a three-judge panel, said it was Lisa Miller’s removal of her child from the United States that allowed that allowed for the jurisdiction.

“It was not, for example, simply violating a state court custody order and crossing a state line: Its international nature endowed it with a different character and consequences,” Carney wrote.

To date, Mat Staver and Rena Lindevaldsen have not been held accountable for their role in the abduction.

Gay basher found guilty

Timothy Kincaid

December 18th, 2015

knott Does this look like the face of an innocent woman? It’s not, it’s Kathryn Knott.

Kathryn was out drinking with 14 of her good friends from her Catholic high school last September in downtown Philadelphia when the group ran into a gay couple. So they decided that they’d beat them while screaming homophobic slurs. One of the couple was knocked unconscious and left with broken cheekbones and a fractured upper jaw that needed to be wired shut for eight weeks.

Perhaps they forgot that anything that is done on a street in a major city is likely to show up on a surveillance camera. So they just went on to the next bar and thought nothing of it. Until their faces were flashed across the screens of everyone watching the news.

The prosecutors isolated three of the participants to charge with assault and conspiracy. Two of them, Philip Williams and Kevin Harrigan, plead guilty to assault and conspiracy. They got off pretty easy. (Philly.com)

Philip Williams, 24, of Warminster, and Kevin Harrigan, 26, of Warrington, were both sentenced to probation, community service at a LGBTQ center yesterday before Common Pleas Court. Both men will also voluntarily stay out of Center City as part of their probation deal, though an attorney for one admitted it would be difficult to enforce.

But the third assailant decided that punishment – even light punishment – was for fools and suckers. After all, she’s a pretty blonde girl whose daddy is a chief of police in one of the nearby suburbs.

So Kathryn Knott decided to fight her arrest in court.

And so for the past several days, a jury has heard character witness say that she’s lovely and non-violent. Others in the party all claimed that they didn’t see her throw a punch. And she swore, up and down, that she only tried to stop the fight. And never ever ever did she hurl homophobic slurs. No, not her.

But they also heard the victims tell that she did, indeed, throw punches and scream slurs. And several witnesses did as well.

Then there was Knott’s social media history which suggested that she held animus towards gay people.

And, after three days of deliberation, the jury just didn’t find her believable. (Philly Voice)

After a series of contentious, “heated” deliberations, a Philadelphia jury returned a mixed verdict Friday in the assault trial of Kathryn Knott, finding the Bucks County woman guilty of simple assault and conspiracy to commit simple assault against Zachary Hesse, one of two victims beaten as they walked to get pizza in Center City on Sept. 11, 2014.

Knott also was found guilty of reckless endangerment against both Hesse and his boyfriend, Andrew Haught, but acquitted of aggravated assault, a felony and the most serious charge against her.

Several on the jury were fighting for a guilty charge on all counts. And though they disagreed as to the extent of her culpability, jurors found Knott’s demeanor, obvious lies, and lack of remorse to be disgusting.

Kathryn Knott will receive her sentencing on February 8. Having put the victims through the trauma of reliving the event and having taken jurors away from their lives and insulted them with lies, I sincerely hope that Knott’s sentence is significantly more severe than that of her fellow assailants who admitted their crimes and expressed remorse for their actions.

Ultra-Orthodox declaration on homosexuality disappears

Timothy Kincaid

December 18th, 2015

Jewish newspaper Haaretz has noted that an ultra-orthodox statement on homosexuality has disappeared

The Torah Declaration, the paper that outlines the ultra-Orthodox position on homosexuality, is no longer accessible online, signaling that at least some of its backers in the community may be distancing themselves from the document’s uncompromising stance on LGBT identity.

Haaretz notes the strong connection between the statement and Arthur Goldberg, founder of JOHAH, and speculates that the removal of the document may reflect a growing distrust in ex-gay efforts following a fraud lawsuit against JONAH.

JONAH ordered out of existence

Timothy Kincaid

December 18th, 2015

jonah logoIn 2000, Arthur Goldberg (a felon convicted of fraudulent financial dealings) founded Jews Offering New Alternatives to Homosexuality (JONAH, now renamed Jews offering New Alternatives to Healing). As most other ex-gay organizations had a strong evangelical Christian emphasis, JONAH provided a place for same-sex attracted Jews to rediscover their heterosexuality in a space that was respectful of their religious and cultural heritage.

But, as was the case with the Christian ex-gay groups, they failed. It turns out that Jews are no more likely to be counseled into changing their sexual orientation than are evangelical Christian.

In 2013 a number of former clients of JONAH filed a lawsuit against JONAH, Arthur Goldberg, and counselor Alan Downing claiming that they had fraudulently offered services and made promises that they could not fulfill (in addition to some really creepy “therapy” techniques). After significant testimony and consideration, on June 25, 2015 the jury unanimously determined that consumer fraud had been committed and that JOHAH was liable for $72,400.

Today Judge Peter Bariso of the Superior Court of New Jersey has entered his order. It could not be worse for JONAH, Goldberg, and Downing:

1. JONAH, Inc. shall permanently cease any and all operations within thirty (30) days of the entry of this Order, including its educational functions, its provision of referrals and/or direct services, and operation of its websites and listservs, which it shall cause to be taken offline, provided however that it shall be permitted to maintain use of “@jonahweb.org” email addresses, only for those purposes not prohibited by this Order, for one hundred eighty (180) days from the entry of this Order;

2. JONAH, Inc. shall permanently dissolve as a corporate entity and liquidate all its assets, tangible or intangible, within one hundred eighty (180) days of the entry of this Order;

3. As of the date of this Order, pursuant to the New Jersey Consumer Fraud Act, N.J.S.A. §§ 56:8-1, et seq., Defendants are permanently enjoined from engaging, whether directly or through referrals, in any therapy, counseling, treatment or activity that has the goal of changing, affecting or influencing sexual orientation, “same sex attraction” or “gender wholeness,” or any other equivalent term, whether referred to as “conversion therapy,” “reparative therapy,” “gender affirming processes” or any other equivalent term (“Conversion Therapy”), or advertising, or promoting Conversion Therapy or Conversion Therapy-related commerce in or directed at New Jersey or New Jersey residents (whether in person or remotely, individually or in groups, including via telephone, Skype, email, online services or any delivery medium that may be introduced in the future, and including the provision of referrals to providers, advertisers, promoters, or advocates of the same), provided however that Alan Downing shall have thirty (30) days from the date of the entry of this Order to cease the provision of Conversion Therapy to his current clients;

4. Plaintiffs’ counsel is awarded attorneys’ fees and expenses in the amount of three million five hundred thousand U.S. dollars ($3,500,000) to be paid by Defendants (the “Fee Award”) within such time as mutually agreed upon by the Parties. Plaintiffs shall submit to this Court a notice of satisfaction upon Defendants’ payment of the Fee Award.

[emphasis added]

So one more ex-gay group is gone.

Guernsey moves toward equality

Timothy Kincaid

December 10th, 2015

The Bailiwick of Guernsey is a possession of the British Crown in the English Channel. Though it relies on the United Kingdom for defense, the collection of islands with a population of about 65,000 is politically autonomous and has its own legislature.

Guernsey’s legislature has now voted to introduce a bill to recognize same-sex marriages (BBC)

The move to introduce same-sex marriage was approved 37-7.

It is not clear when the legislation, which will be voted on separately, will come back to the States or when the law will come into effect.

A Policy Council spokesman said it depends on the “priority given to the legislation” and time needed to draft it. He said at the earliest this “would not be before 2017”.

They rejected, with similar margins, bills which would provide for civil unions or other secondary recognition.

Of the other two Crown possessions, Jersey adopted marriage equality earlier this year and the Isle of Man passed a civil partnership bill in 2011 and is in the public consultation process of changing to marriage.

South Africa approves PrEP

Timothy Kincaid

December 9th, 2015

South Africa has joined the United States and France in approving the use of Truvada as pre-exposure prophylaxis (PrEP) in the prevention of the transmission of the human immunodeficiency virus (HIV). (The Citizen)

Medicines Control Council (MCC) held their 75th meeting from November 27-28, where Truvada, the HIV prevention drug, was approved.

MCC approved the use of the fixed-dose combination of tenofovir disoproxyl fumarate and emtricitabine to include pre-exposure prophylaxis of HIV (commonly referred to as PrEP).

As South Africa’s public healthcare system is woefully understaffed and underfunded, it is not clear how well this step will be implemented in that nation’s most vulnerable population. However the wealthiest 20% of South Africans use private healthcare so there is some hope that the availability of PrEP could reach at least that portion of the population.

PrEP, at last

Timothy Kincaid

December 9th, 2015

IMG_4155The last step in my quest for pre-exposure prophylaxis (PrEP) is complete. My liver is functioning fine and I received clearance to begin the process. I’ve taken my first pill and in about seven days I’ll be effectively immune from the virus.

In a few weeks I’ll return to the doctor for tests to determine whether my body is acclimating to the medication or if side effects have occurred. And, going forward, I’ll require testing every three months.

But finally! Hallelujah!

No, trans is not a box with defining characteristics

Timothy Kincaid

December 8th, 2015

My friend, the beautiful and talented Arisce Wanzer, discusses the assumptions that are far too often made about trans women. Give it a read. Here’s the entro:

Being transgender means facing no shortage of struggles, whether they be internal, interpersonal, or societal. These pressures run the gamut from feeling passable, finding love, and securing housing to being hired for dependable, well-paying jobs or receiving proper healthcare. They weigh differently on each trans person individually—no one problem affects all trans people in exactly the same way.

Holly Woodlawn, rest in peace

Timothy Kincaid

December 7th, 2015

Andy Warhol transvestite Superstar Holly Woodlawn, acclaimed for her performance in 'Trash', photographed in 1970. (Photo by Jack Mitchell/Getty Images)

Andy Warhol transvestite Superstar Holly Woodlawn, acclaimed for her performance in ‘Trash’, photographed in 1970. (Photo by Jack Mitchell/Getty Images)

Holly came from Miami, F.L.A.
Hitch-hiked her way across the U.S.A.
Plucked her eyebrows on the way
Shaved her legs and then he was a she
She says, “Hey, babe,
Take a walk on the wild side.”
Said, “Hey, honey,
Take a walk on the wild side.”

At 15, Haroldo Danhakl left Miami and headed to the Big Apple, where Haroldo became Holly Woodlawn. A street kid, Holly turned tricks and did whatever she had to do to survive.

In the late 60’s, Holly fell into a group along the periphery of Andy Warhol’s world and eventually caught the notice of Warhol’s film director Paul Morrissey and costarred in the 1970 film Trash. Despite critical acclaim for her role, it did not lead to more mainstream work. Although immortalized in Lou Reed’s 1972 song, Woodlawn’s entertainment career was sketchy and mostly underground theater.

Yesterday Holly passed away. (NY Times)

Holly Woodlawn, a transgender actress who achieved underground stardom with her affecting performance as a starry-eyed down-and-outer in the 1970 film “Trash,” died on Sunday in Los Angeles. She was 69.

The cause was complictions of cancer, her manager, Robert Coddington, said.

Getting Prep, Step Two

Timothy Kincaid

December 6th, 2015

truvadaSince late October I have been trying to get a prescription for Truvada to be used as pre-exposure prophylaxis (PrEP) to prevent the possible contraction of HIV. It has not been an easy process and has involved being dumped by my primary physician and a complicated search for a replacement.

But finally I found care through APLA’s Gleicher / Chen Health Center and two weeks ago I went in for a series of tests, both general health and sexual health. On Thursday I returned for my results.

I was happy (though not very surprised) to learn that I did not test positive for HIV, gonorrhea, chlamydia, or syphilis. Blood pressure was fine. My triglycerides are just slightly high, but so is my “good” cholesterol. In general, I’m a healthy man.

Except one test wasn’t present. Although the clinic had requested the usual full analysis, the lab hadn’t run the tests necessary to evaluate my liver. And testing liver function is absolutely necessary to issuing a prescription for PrEP.

So the wait goes on.

On Monday, I’ll take the trip back to the clinic to draw more blood. And at some point on Tuesday I should know whether my liver is functioning properly and, assuming that all is well, I should be able to start the program.

Planned Parenthood WeHo to offer PrEP

Timothy Kincaid

December 6th, 2015

Planned Parenthood is an organization that can be, at times, politically polarizing. Depending on where one gets their news, they may think of Planned Parenthood as either an abortion mill selling baby parts or a necessary provider of women’s reproductive health in underprivileged communities. But in some areas they are becoming something unexpected: an access point for pre- and post-exposure prophylaxis (PrEP and PEP). (scpr)

Planned Parenthood Los Angeles says it will begin offering two powerful anti-HIV drugs at its clinics next year. The effort will begin at the group’s newest health center in West Hollywood, which opened Tuesday.

The reproductive health provider joins 27 public and private health care clinics across the county in providing one or both of these medications to those most at risk of contracting HIV, according to the Los Angeles Department of Public Health.

I don’t know how accurate their count is, but if there are only 27 clinics across the country providing PrEP or PEP, then Planned Parenthood’s participation is not only welcome, it’s essential. There are roughly 4.8 million gay or bisexual men in the country and the Centers for Disease Control recommends that a quarter of them, 1.2 million men, be on PrEP. There is no way that this goal is achievable through 27 clinics. [As a reader noted, it’s County not Country. Duh!! Shouldn’t have missed that. But still 27 is far too few for the more than 100,000 gay/bisexual men in LA County.]

Planned Parenthood offers a sliding scale, which will be of relief to younger gay men who may be uninsured. THey are starting with their clinic in West Hollywood but expect all 20 of their clinics in Los Angeles to provide PrEP and PEP by the end of 2016. Let’s hope that soon spreads to areas in which access may be even less available.

Australian gay men form a ‘Dallas buyers club’ for getting PrEP

Timothy Kincaid

December 1st, 2015

As in every nation in the world other than the US (and soon France), Truvada has not been approved in Australia for pre-exposure prophylaxis (PrEP). Thus it is not covered through the Pharmaceutical Benefits Scheme and must be paid out of pocket, a cost of about $1,200 per month.

However, there are a number of pharmacies in India that make a generic version of Truvada (for example Cipla makes and sells Tenver-EM) and a group of gay Australian men have decided not to wait for official government approval. They are going through a pharmacy in Africa to get the generic version of PrEP. (SMH)

To get around this, a group of men have started a website called “PreP access now” to help people order cheaper generic versions of the drug from multiple online sources, including Africa for about $60 a month.

One of its founders, Steve Spencer, said dozens had ordered the drug with the group’s help since it began in the middle of the year. It is now offering free orders for people who cannot afford the $60 monthly fee because the African pharmacy offers one free order for every two made.

“A bunch of us gay men who saw nothing happening said ‘stuff it’ we’re going to come together and make a change,” he said. “Our numbers are increasing every day, but it’s the government’s responsibility to ensure the health of Australians, and… to ensure equal and easy access to PrEP if we want to end new HIV infections in Australia.”

I find this a bit concerning. While Cipla and other Indian companies have a long track record and their drugs are considered reliable, African pharmacies have less credible reputations. I hope that these guys are having the drugs spot-checked for accuracy.

World AIDS Day

Timothy Kincaid

November 30th, 2015

Red RibbonToday is World AIDS Day, a time to reflect on lives lost and opportunities diminished. It is also a time to look forward to ways to eliminate this human immunodeficiency virus and reclaim the health of not only the LGBT community, but other communities ravaged by the HIV/AIDS pandemic.
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France supports PrEP

Timothy Kincaid

November 28th, 2015

One of the fascinating things about the use of pre-exposure prophylaxis (PrEP) as a tool for preventing the spread of HIV is that, until this week, the United States alone has supported this measure and encouraged its use.

In the US, costs are covered by all insurers (it’s seen as a preventative measure which will result in lower costs in the long run). Some regions (though certainly not all) have established funds which can take care of those without insurance, and the CDC and other private and/or public health services have committed to finding a way to get anyone who wishes to be on PrEP to be able to acquire the medication. Finally, Gilead (the manufacturer of Truvada) has established programs to cover costs. For many in the US (though certainly not all), the out of pocket cost for being on PrEP is zero.

But if you live in Canada or the UK or Sweden, PrEP is not publically available. There are clinical trials and, should you be fortunate enough to be part of the trial, your costs are covered. But otherwise, the cost is born entirely by the patient. A Canadian told me recently that he pays about $1,200 per month for his Truvada prescription.

However, this week another nation has committed to this step in the prevention of HIV transmission. (AIDSMap)

In a historic move, France has become the first country outside the USA, and the first country with a centrally-organised, reimbursable health system, to approve no-expense pre-exposure prophylaxis (PrEP) for people who need it.

The French Minister of Health, Marisol Touraine, announced today that PrEP would be available from mid-December, and reimbursable through the French health system from the beginning of January.

In addition to the daily regimen procedure, France will also support incident based prevention (two pills two hours before sex and one pill each of the next two days).

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