GMHC Supports H.R. 2704, the JUSTICE Act, and Urges NYC Federal Reps to Cosponsor

In August 2011, Congresswoman Barbara Lee (D-CA), an outstanding leader on HIV/AIDS issues, introduced H.R. 2704, the Justice for the Unprotected against Sexually Transmitted Infections among the Confined and Exposed (JUSTICE) Act. This bill allows prisons to provide condoms to incarcerated individuals. The JUSTICE Act also calls for automatic re-enrollment in Medicaid for former beneficiaries who are HIV-positive.

For HIV-positive prisoners who had either no Medicaid benefits before prison or lost their benefits, this bill would provide automatic enrollment for Medicaid.  This would substantially increase access to HIV treatment upon re-entry and would keep formerly incarcerated people living with HIV, and their communities, much healthier.

This legislation is tremendously important to public health.  On August 4, 2011, Representative Lee released a statement regarding the importance of this legislation as follows:

"As we mark the 30th anniversary of the first discovery of AIDS cases in the U.S., we can no longer afford to ignore the reality that sexually transmitted infections can be spread within our correctional system. I introduced The JUSTICE Act to provide a comprehensive response to the spread of STIs in correctional facilities."

"Among confirmed AIDS cases in prisons, minorities account for the majority, with African-Americans 3.5 times more likely than Whites, and 2.5 times more likely than Hispanics to die from AIDS-related causes. Without uniform prevention, testing, and treatment programs, incarcerated persons living with HIV or other STIs can unknowingly infect others. Often left untreated, incarcerated persons with STIs are frequently in the more advanced stages of their disease, and once released can be even more costly for the public health system to treat."

GMHC calls on all members of Congress representing New York City to cosponsor H.R. 2704, and to voice their strong support of better access to healthcare for all people living with HIV.

Lady Bunny Reflects on Being the "Gayest Thing on Earth" and Practicing Safer Sex

photo by Joan Marcus

Sorry I missed the World AIDS Day memo, but I was very moved by everyone's remembrances of their losses, and touching personal stories which they shared on Dec. 1st.  And I join you in mourning—we all know that the drag community was one of the hardest hit.  World AIDS Day is also about educating in order to help reduce the spread of the disease.  I'd like to share my personal story, hoping it resonates with some of you.

What are the 3 high risk groups? Gays, people of color and IV drug users.  Well, I'm the gayest thing on earth, a bottom who only dates black and Latino guys, and I spent most of my 20s and 30s in NYC's East Village which probably has the highest percentage of junkies in the nation.  So, chances are that I’d have one foot in the grave and the other on a banana peel by now.  I also love to party, and we know how altered states can lead to poor judgment in sexual situations.

I spent the last few decades assuming that I either had HIV or that I’d get it.  I’m a bit of a hypochondriac, so I feverishly imagined that every pimple was a lesion and that every cold was pneumonia.  I could never bring myself to get tested because I was certain that if diagnosed positive, my gloomy disposition would worry me into the grave within months when I might otherwise live for years.  While my doctor repeatedly urged me to get the test, I was too scared.  I assumed that I had HIV, so I never did anything which would transmit it or allow me to get it from someone else on the off chance that I hadn’t contracted it yet.  It didn’t help that if you test positive for the virus in NYC, the results are given to the government.

With religious freaks like Sarah Palin running for the VP with old John McCain who could blow at any time, the government is not the entity with whom you want to share delicate info about your health.  Thinking they were doing God’s bidding, religious freaks like Bachmann or Palin could round up all the infected people and quarantine them if (GOD FORBID) they ever got into office.

However, on a day off in LA and with the moral support of a friend, I steeled myself to go into an anonymous testing center.  The Valium was in hand because the results were quick but not instant, and I just didn’t know how I would cope with even taking the test—much less the results.  Just to add a little edge, some queen who was also there for a test arrived with his pit bull. I thought, “Fab! Watch me avoid a killer disease just in time to get mauled by a killer dog.”

The test came back negative!  No words could describe the joy and relief I felt.  But once that subsided, I realized that I now have a tremendous responsibility to stay negative.  Through all of my drunken sprees and the promiscuity which covered all 3 high risk groups, somehow I had avoided this virus.  It seemed like a miracle to me.

People probably look at flamboyant drag queens and think of them as fearless and not bound by social norms which box others in.  But I wasn’t born a drag queen, and as much as I frown on organized religion, I was raised a Christian in Tennessee.  The predominant message from the backward church folks in that part of the country was that gays are sinful perverts.  I don’t care how strong a person you are, when you’re young these messages sink in until you may start to believe them.  On some level, I believed that I deserved AIDS because of my lifestyle, so my infection was inevitable.  Sometimes this dire outlook can lead, as it did in my case, to wild abandonment with alcohol and drugs and why not, I felt? It was only a matter of time until my trashy ass got the virus.  I know I’m not the only one among us who feels this way.  I can only imagine the struggles that a religious gay endures while trying to reconcile their disapproving church and their lifestyle.

But I’m here to tell you that infection is not inevitable if you protect yourself.  While part of it was luck, I’ve also always practiced safe sex.  Have there been slip-ups? Of course! Human beings make mistakes.  But as much of a slut as I was, I was always vigilant (when not blacked out and blithering) about safe sex.  A safe slut, I call myself—because the more sex you have the more vigilant you have to be.  And let’s face it, many gays are very promiscuous.

What’s going on here? We know how the disease is spread and we ignore it? While I understand the importance of early testing if there’s been an accident.  I don’t understand my friends who get tested every 6 months. That means they obviously aren’t having safe sex—or they would have no need to get tested that often.  I discussed this with a straight friend and he said, “So they are basically just waiting to catch AIDS.” That really stung me, probably because the truth hurts. Many of us aren’t using safe sex. Maybe it’s low-risk behavior like sucking without a condom, but when you’re dealing with your one life should you choose low risk or no risk? Everyone I mention oral sex with a condom says, “I could never do that,” and that it’s low risk.

We all choose which risks we’re prepared to take. I’m fat and far from young, so eating cholesterol-rich foods is risky behavior.  Smoking and driving are risks which many of us take on a daily basis.  And I understand that many can’t warm up to the idea of sucking on latex. Some guys gripe that it reduces their sensitivity. To which I say, “Not as much as being in my grave reduces my sensitivity.” And oral is low-risk ONLY if there are no cuts in the mouth.  Haven’t you ever bled from flossing?  Does that constitute as a cut? Eating pizza or potato chips (I just gave away my diet secret) can abrade the skin on the roof of the mouth.  There’s no blood, but I feel skin flapping sometimes after eating these foods.  Is that a cut? So does that mean that oral sex after flossing, which we’re supposed to do daily, is higher risk? How long after we floss is it safer for us to blow someone?

I just don’t think we’re talking about these things enough. We file these uncomfortable questions away under the file called “Denial” even though they concern our protection.  I see reckless behavior and plenty of new infections, so the information is either not getting out there or we’re choosing to ignore it.  We know how to prevent the spread of this disease.  A friend with AIDS told me that just-infected youth imagined that he’d be sympathetic, but he wasn’t because when he caught HIV, we didn’t yet know how to prevent it.  Now we do. So get on it.

Contrary to what anyone else may have told you, you’re worth it!

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Lady Bunny is a successful comedienne, emcee, singer, songwriter, actress, DJ, and most famously, the founder, organizer, hostess of Wigstock, the outrageous festival of drag and music that delighted up to 40,000 New Yorkers every Labor Day, for nearly 20 years. For more info, visit her website--ladybunny.net.  Her article was originally published in Odyssey Magazine in Volume 3/Issue 6 (December 21, 2011-January 3, 2012).

Are Our Future Doctors Receiving Enough Training to Care for LGBT People?

by Andrew Silapaswan

After relocating halfway across the country to New York City, finding an LGBT-friendly and culturally competent doctor was not high on my priority list. However, my priorities changed when I required medical services in November. I quickly realized I would have to find a new primary care physician who is both knowledgeable in LGBT health care, and who will treat me with understanding and respect.


My experience is not unique, as many others in the LGBT community face similar challenges. In a 2005 survey 22 percent of lesbian, gay, and bisexual patients reported having experienced some form of discrimination in a health care setting. So why are so many health care providers ill-equipped to handle the health care needs of LGBT people? As a medical school candidate with my sights set on starting medical school in fall 2012, I am cross-comparing prospective M.D. programs and actively examining components of medical school curricula.


A medical school's curriculum must meet rigorous standards established by the Liaison Committee on Medical Education (LCME) to receive accreditation. Nonetheless, recent studies and testimony on behalf of medical school administrations indicate that there are significant gaps in curricular content. More specifically, the quality and breadth of LGBT health-related content is lacking and remarkably uneven across medical schools.


One of the most comprehensive studies examining the incorporation of LGBT content in medical education was recently published in the Journal of the American Medical Association. The report indicated that the median time dedicated to teaching LGBT-related content was five hours (during the entire four years of medical education) in the 132 U.S. and Canadian medical schools that were surveyed. Additionally, nine schools reported zero hours taught during the preclinical years, and 44 schools reported zero hours of clinical training.


In terms of overall assessment of quality, the results are equally discouraging. A majority of medical school administrators revealed that their coverage of LGBT-related content was fair or worse. Thirty-two deans responded that their school's coverage of LGBT health care was "good" or "very good," while 58 reported that it was "fair," and 34 indicated that it was "poor" or "very poor."  The results are especially problematic given the fact that LGBT people have historically faced barriers in accessing competent medical care in addition to having specific health care needs.


Research findings reported by the American Psychological Association indicate that LGBT individuals may be at an increased risk for negative health behaviors and outcomes and experience a number of health disparities compared with their heterosexual peers. For example, gay men and lesbians report higher rates of smoking. Cardiac and cancer risk factors are also more prevalent among lesbians compared with heterosexual women. A large-scale study published in 2000 found that breast cancer rates and several associated risk factors are higher among lesbians and bisexual women.

Furthermore, men who have sex with men (MSM) continue to face disproportionate rates of HIV and are the only demographic in which new infections are rising in the U.S. According to the Centers for Disease Control and Prevention (CDC), MSM represent 2 percent of the general population yet accounted for 61 percent of all new infections in 2009. Clearly, the health care needs of LGBT individuals, which are largely complicated by stigma, homophobia, and other structural factors, underscore the necessity for comprehensive LGBT-related content in medical school curricula.


Medical students' ability to effectively care for LGBT patients has also been measured. Survey results from an online study in 2006 indicated that third- and fourth-year medical students with greater clinical exposure to LGBT patients reported performing more frequent sexual history assessment with their patients. This is a critical component of comprehensive health assessment and management and provides patients an opportunity to indicate their sexual experiences. Furthermore, the students had more positive attitude scores and achieved higher knowledge scores compared to their peers with less clinical exposure to LGBT patients.


At the end of the day, some may question why medical school administrators should care about LGBT health services. The reality is that although many doctors primarily treat patients at the individual level, they also have the social responsibility to act as community-level providers. They have an obligation to deliver unbiased, culturally competent health care, and they also have a role to play in reducing health-related disparities at the population level.


Part of the solution to the problem is rooted in education. With the identified gap in medical school curricula, momentum has been building toward reform.

The Association of American Medical Colleges (AAMC), the Institute of Medicine (IOM) of the National Academy of Sciences, and the U.S. Department of Health and Human Services (HHS) have released their own respective reports on strategies to improve the health and well-being of LGBT communities. In 2007 the AAMC recommended that "medical school curricula ensure that students master the knowledge, skills, and attitudes necessary to provide excellent, comprehensive care for [LGBT] patients." Thereafter, in 2011, the IOM and HHS reports formally acknowledged how the lack of culturally competent provider training and knowledge are structural barriers to care for many LGBT patients. The IOM explicitly stated that "few physicians are knowledgeable about or sensitive to LGBT health risks or needs." Moreover, the IOM recognized that "medical schools teach very little about sexuality in general and little or nothing about the unique aspects of lesbian, gay, and bisexual health, and it is rare for students to receive any training in transgender health."


Although these recent policy recommendations are a promising step forward, the fact remains that many LGBT patients continue to face numerous challenges in accessing health care. Moreover, inadequate coverage of LGBT health-related content in medical school curricula may not meet the LCME's cultural competency requirements as stated in the ED-21 mandate of their accreditation standards. In order to remain in compliance, internal reviews of LGBT curricular content are needed in order to address the reported deficiencies.


Furthermore, the LCME and the American Osteopathic Association (AOA) should initiate a comprehensive review of LGBT health-related content in medical school curricula and expand curricular requirements as part of their accreditation standards in order to ensure that LGBT health care is sufficiently represented in medical school education. Many patients, including me, will benefit from this reform in medical education, and future doctors will receive the necessary training to more effectively care for LGBT patients.

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Andrew Silapaswan is a public policy intern at Gay Men’s Health Crisis (GMHC). His article was originally published in The Huffington Post on January 4, 2012.

A Joyful Note About GMHC's Annual Holiday Dinner

On Friday, December 16, GMHC hosted the annual holiday dinner and gift give-a-way to about 500 clients.  It was a festive and beautiful evening.  Our Chef, Wilson Rodriguez, received the following e-mail from a client who attended the dinner:

"Dear Wilson,

"I left your dining room last Friday on cloud 9.  I have difficulty believing anybody cares for me but the amount of caring I received from all your wonderful regular crew and the volunteers for the evening was incredible.  Together, you all gave us another wonderful dinner, like the one for Thanksgiving. (I had planned on writing to you then to say THANKS, but I'm doing it now!)

"It's as if you thought of everything for our comfort.  I notice the little things in life,  like the decorative napkins already on the tables.To the egg nog, who would have thought that would be available to us. It's my favorite beverage! 

"Serving the hors d'oeuvres on the line makes good sense and gets the whole thing started.  I had the hen, perfectly glazed & so tasty. That evening I didn't even mind the carrots, among the vegetable medley.

"Your kitchen is as famous now as it was at 24th Street for the amazing soups you create each day.  Hiding the spinach in the pumpkin soup went down a treat, as I'm not really a fan of spinach either.

"With all those vegetables out of the way...dessert for me is always the best part of the meal.  And you did not disappoint! In fact I want to say that it is very noticeable that since the move to 33 Street, the desserts have become more experimental, elaborate, tasty and attractive to the eye.  Well done!

"The meals are very important to me and I do really appreciate them and all the effort you put into the different daily menu. I also though want to point out that an equally large part of the whole experience of eating at GMHC is the welcoming and friendly attitude of all the staff & volunteers.  They are not just "doing things" for me,  you can actually feel that they want to be there, doing for us all.

"The coat check also  adds comfort to the experience.  And I was impressed by the one way flow of the arriving and leaving system. I learned about it when I went to get the gift bag without my jacket.  I was told I could only get a bag when leaving...through the back stairs. All very orderly.

"It was all a jolly good show!

"Wishing you and yours a blessed holiday season and good health in the New Year.

"Sincerely,

G"

The SOMWA Foundation Hosts Annual Holiday Party for Families Affected by HIV/AIDS

On Monday, December 19, Shacazia Brown, Founder of the SOMWA (Survivors of Mothers with AIDS) Foundation hosted GMHC's Women’s Care, Prevention and Support Services (WCPSS) family holiday party for a third year.  Shacazia founded SOMWA (pronounced "someway") a few years ago in honor of her mother who died of AIDS 15 years ago. She approached GMHC in 2009 about wanting to host the holiday party for families affected by HIV/AIDS.  Her arrival at GMHC came at miraculously pivotal time when funding for some of the women's programming had been cut.  At the first party, Shacazia was able secure a venue, food, thousands of dollars worth of toys and electronics, guest DJs and much more.  She even got a weekend trip sponsored for an HIV-positive mother and her daughter to Florida. The experience was truly mesmorizing.

Three years later, Shacazia's inspiring work remains consistent.  At this holiday party, there were over 110 children and 80 parents.   There were over 60-70 volunteers who helped during the party and distributed gifts. Below are some of the highlights:

• A couple came to the agency a couple of weeks ago for the first time. One of their needs was a new wheel chair for their six-year-old son.  This was provided for the little boy along with a Wii game.

• One young girl’s birthday was also on the same day as the party.  A new bike and other toys were provided for her.

• Hundreds of toys and electronics, worth tens of thousands of dollars, were provided for the children of all ages.  Teenagers were given gift cards valued at $25 to 50 dollars and MP3 players.

• Cash and toys were given out during the dance contests.

• Project Sunshine donated an electronic keyboard with stand which was raffled off to teenagers.  Also raffled were DVD players, a CD / AM and FM music system,  IPod clock radios, and 3-in-1 headphones.

• Delicious dinner, dessert and snacks were donated by “Taste of Seafood” restaurant.

• Shereé Whitfield, of Bravo TV’s “Real Housewives of Atlanta” visited with the families.

• Yandy, cast member of VH1 “Love & Hip Hop” also visited.       SpongeBob SquarePants even stopped by. 

• DJ Lady Wells and DJ Pauze provided great dance music.

• A quilt was made by the mothers in WCPSS that was given to Shacazia along with a beautiful poem about her being an angel in our lives.

AND….On Mother’s Day in May 2012, 70-80 mothers will again be treated to a day cruise on the Circle Line.

Our collective thanks to Shacazia (NY1’s recent “New Yorker of the Week”), her volunteers, the donors of the toys, electronics and food, the celebrities and DJs, WCPSS staff, Senior Managers and Directors, our Facilities Department and the cleaning crew, and everyone who helped and was supportive.  This party was truly a miracle on West 33rd Street.

Transpeople: Don't Just Dance, Start a Movement!

By Jayne Henson

Why would anyone want to be transgender? As my granddad would say, "there's no future in it." This statement has been supported in the past by media portrayals of transgender people as sexual deviants, tragic jokes, or lives that ends in violence and definitely not success. With these kinds of images being all that one sees, it is easy to understand why many trans people seek to transition, pass, and "go stealth" as quickly as possible.

I myself remember tears in my mother's eyes as I told her that her son was really her daughter, after which she replied with a string of reasons why this "could not be," as well as her fears for my safety. The certainty in my mother's mind that my life as a trans woman was doomed to tragedy was asserted when I told her that I would be moving to New York City to pursue a career in HIV prevention, to which she replied, "I might as well be shipping you off to Afghanistan." Now, part of this statement could be the result of living in rural Kansas for all of her (and my) life, but what I heard echoed in that statement was the societal belief that trans people are not successful or respected.

But is that still true today? I reflected on this as we felt the digital fallout on blogs and message boards across the country, where people responded to ABC's announcement that Chaz Bono would be a contestant on Dancing with the Stars. Here we had a very visibly out, transsexual man whose family ties to pop icon Cher caused his transition to be thrust into the spotlight. This media onslaught landed him an Oprah special and documentary (nominated for three Emmy Awards), numerous book deals, several speaking engagements, and a future reality TV show and painted him as the representative and poster boy for trans people everywhere -- not to mention also bringing him a host of horrible, hateful things said about him in such media outlets as Chelsea Lately and FOX News, as well as countless independent blogs and message boards. It seems that the Internet remains the last bastion of anonymous slander and defamation in our society, especially toward the disenfranchised.

I commend Chaz Bono for his courage to transition in the public eye, thus making society at large confront the issues of gender identity and transsexuality and letting the world know that trans people are part of the fabric of America. Though it came as no surprise to me, I was hurt by the lack of sensitivity and hate displayed so excessively by today's media in response to Chaz's coming out. But this is where my lavishing praise upon Chaz Bono ends, and where I ask, why him? Why is he the face that represents me and my kind to the world? What will Chaz Bono spinning and cha-cha-ing on Dancing with the Stars do for trans people in America, aside from providing more media fodder?

To be clear, Chaz Bono does not speak for me. To me he represents an ideology and rhetoric surrounding trans identities that only serves to further stereotypes that make it easier for conservative-minded cis-gendered people (i.e., people whose gender identity matches the gender they were assigned at birth) to grasp the concept of transsexuality. This ideology is the notion of becoming a man or woman through medical intervention (and a very stereotypical and misogynistic man, at that).

There are several reasons why I find this problematic. For one, it is not accurate. When I decided to transition from male to female, I never felt as though I became a different person. In reality, I felt that now everyone else around me could see and acknowledge the person I always had been. Furthermore, the thought that trans people must exist in two different lifecycles (pre- and post-transition), as opposed to having a linear existence that embraces both our past and our future, is what keeps us from feeling pride in our existence as trans women and men.

This notion of "becoming" through transition is prevalent throughout all of Chaz's endorsed media ("Becoming Chaz" and "Transition: The Story of How I Became a Man") and is an underlying theme that saturates its messages. I am tired of dialogue that insists that I must become a certain ideal of what a woman is, and that someone else gets to decide what that is and when my identity is valid. I'm tired of trying to make the world think trans people are "just like everyone else," because we're not; we're different, and that's awesome! What I want is an ideology that allows us to be proud of our trans identities and be excited about being trans, and value what that means in today's world, instead of viewing trans identities as diseases that need to be cured so that we can become valid.

Trans women have been shown in the media time and time again on Jerry Springer, Law and Order, 20/20, Dirty Sexy Money, 30 Rock, Saturday Night Live, and many other shows. However, almost none of these portrayals is a positive image of what it means to be a trans woman. In fact, 2010 marked a monumental year when trans woman Amanda Simpson was appointed to the presidential cabinet, making her the first out trans woman to serve in the White House. Yet there were no Oprah specials for Amanda, and about the only acknowledgement she got was jokes made about her on The Daily Show.

The fact remains that in our society, the voiceless rarely get to choose who represents them, and too often that responsibility is taken over by the media. Yet in a market that is dominated by ratings, poignant, smart, positive dialogue often takes a back seat to sensationalism and mass appeal. To those of you reading who view trans people as some kind of mystified species seen on National Geographic, I want you to know this: we are more than Jerry Springer specials, cheap jokes, mistakes of nature, sexual fetishes, and abominations. We are strong, powerful men and women. We are everywhere. We are in your office, on the subway, in your high school class, behind you in line at the bank. We are firefighters, pilots, computer programmers, musicians, actors, dancers, authors, reality TV stars, doctors, lawyers, farmers, and even HIV counselors. We face a host of dangers and challenges every day for existing in a world that treats us as less than human and would rather that we just fade away. Yet we do it all in pursuit of what many of you take for granted every day -- a sense of sovereignty over our body, gender, and identity -- and we aren't going to disappear anytime soon.

To my transgender brothers and sisters reading this, I want to say: we have to stop thinking that any representation of us in the media is better than none. We need more than a line in a Lady Gaga song and a jitterbugging child of a gay icon. We need to start making our own voices heard. Grab a mic, write a blog, write a poem or novel, make art, make a scene, hold a protest, fight back, take up space, start a movement! Our future depends on it.
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Jayne Henson is HIV counselor and outreach worker in the GMHC Center for HIV Prevention.  Her article was originally published in The Huffington Post on December 5, 2011.

A Thanksgiving Story

By Felix Lopez

On November 10, a homeless family was referred to GMHC. The family consisted of a mother and six children. Two of the children were pregnant. The family had lived in a one bedroom apartment until October, when the landlord, aware that the father had died of AIDS in September and fearful that the remaining family members couldn’t afford to pay rent, put the family on the street. The family eventually sought shelter in a church basement, which is where they were living when they were referred to us. Deborah Welch, Assistant Director, and her team immediately went to work to help the family enroll in our Sustainable Living Fund program which provides rental assistance to eligible New York City residents who have symptomatic HIV/AIDS. The Sustainable Living Fund works in partnership with community based organizations that provide services to individuals with HIV/AIDS and their families.

Within five days, Deborah and her team had processed the enrollments and secured the money to pay for a new apartment for the family. On November 15, the family left the church basement they had been occupying and moved into a four-bedroom apartment. The family’s ongoing rent will be paid by the Sustainable Living Fund.

There is a sad note to the story. Earlier today we learned that one of the pregnant daughters has lapsed into a coma and lost her baby.

As a member of the GMHC staff, I am very proud that we were able to help this family get into stable housing, especially with winter around the corner. I am also very proud of the work of the SLF team: Deborah, Theodura, Yesenia, and Elizabeth.

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Felix Lopez is the Director of Legal Services at GMHC.