Quick News Round-Up

Just wanted to cover a couple of quick bullet points this morning:

• Washington State's "everything but marriage" law was signed by Gov. Gregoire, giving same-sex couples all the rights of marriage except for the word. It is considered the most sweeping DP law in the country. Per the Governor: “Despite the sameness, the absolute sameness of straight couples and gay and lesbian couples, nonetheless here in the state of Washington we saw discrimination. We saw inequality that had to be addressed.” The law will go into effect in July, though a referendum may occur in November.
• Rochelle Hamilton should win the awesomest teenager of the year. She took on Vallejo City School District over harassment after she came out... and won in a settlement. In the suit, Hamilton states that she was forced to attend a group therapy session that taught kids how not to be LGBT. The settlement includes a requirement for the district to make a more stringent anti-harassment rule, come up with a way to deal with complaints, and provide training for staff and administration. Well done.
• The Assembly of that state Nevada passed a DP law 26-14, will likely pass the Senate, but Gov. Gibbons states he will veto it (unfortunately, we do not have the votes to override). I think I also heard Nevada will be passing a sexual orientation protection bill (no gender), but I can't find the newssource.
• Obama's pick for the head of the CDC, New York's Health Commissioner Dr. Thomas Friedan is drawing some heat from AIDS activist. Per Housing Works: "Frieden has simultaneously employed an authoritarian, my-way-or-the-highway approach and an unabashed secretiveness undignified of a public servant. He has excluded AIDS groups wherever possible from having input into life-and-death AIDS funding, testing, and care policymaking decisions."
• More ongoing weirdness in the Florida gay adoption ban: you still can't adopt if you're gay in Florida, but the state must recognize out of state adoptions to same-sex couples.
• And in pop culture, Sex and the City star Cynthia Nixon plans to marry long-time girlfriend Christine Marinoni; and Fergie comes out as bisexual.

I know, I know, not a lot and it's real quick. Bad, bad homosexual blogger.

We're Here! We're Queer! And we know how to email!

Lots and lots of opportunities these days for you to make your voice heard on a whole host of issues around the country, even if they don't apply to you directly!*

*In the end, everything applies to everyone.

The National Health Interview Survey is a division of the National Center for Health Statistics, based out of the CDC. It is the public health census, essentially, that monitors health related behaviors and conditions. The National Coalition for LGBT Health is pressing (via email, their website is not updated to reflect this) to add questions about sexual orientation and gender identity to the NHIS, and has met with some success ... garnering the support of 46 additional representatives and the personal interest of Rep. Whitehouse (D-RI), who is pressing for a $2million allotment in the budget to make this happen. Their recommendation is that you call the Senate switchboard (202-224-3121), ask for your Senator, and then request (once you get their office) the staff person in charge of Health and Human Services appropriations. Tell them that you are a constituent who supports appropriating an additional $2 million for the National Health Interview Survey and that you would like them to sign on. In order to sign on, they need to contact Jordanna Davis in Senator White house’s office by close of business on Tuesday, April 28th. (Means you guys have to contact your Senators on Monday).

*****

JoinTheImpact.com and the HRC is asking you to contact your Represenatives to support the passing of the Local Law Enforcement Hate Crimes Prevention Act (HR 1913 -- the Matthew Shepard Act). The vote could come as early as this week after the Judiciary Committee gave it to the full house with a passage there of 15-12. JTI put out an email asking for national call-in days on April 27th, 28th, and 29th (before 5pm EST). From the email:

Most likely, one of the Members interns will answer and ask where you're calling from and why. You're calling to urge the Representative to vote for the Matthew Shepard Act (H.R. 1913). Most calls end right there. But if you like, you can add:

· Hate crimes against lesbian, gay, bisexual and transgender people are on the rise. One out of every six hate crimes is because of the victim's sexual orientation.

· Hate crimes have more than one victim. They are intended to create an atmosphere of fear and terrorize entire communities.

· The Matthew Shepard Act targets only violent acts – not speech. It does not tell any clergy member what he or she can or can't preach.

· Mention that Rep. 's vote on this bill will affect your future support.

Make sure you contact JoinTheImpact to let them know that you've done it -- if you click on the HRC link above, they will track via their website.

*****

The HRC is asking NH folks to contact the New Hampshire legislature -- not for marriage anymore -- but for something probably a little more important: gender protections. That's right, kids, the state was nearly the next one to legalize equal marriage, but they do not yet protect people based on their gender identity and expression... but neither does Massachusetts, shockingly. The bill is HB 415 and would add gender in anti-discrimination and hate crimes statutes already in place. (The link above mentions also HB 436, the now defunct bill that would have extended marriage protections for same-sex couples.)

*****

Maine's equal marriage bill will shortly be voted on by the joint Judiciary Committee, and Equality Maine is asking residents to email their representatives to get this bill to a vote (and then vote it through the entire legislature). Gov. Baldacci, at this point, may event vote it up, as well. I think for non-Mainers, it may be valid to email as well, especially if you bring up that marriage, in other states, has led to an increase in tourism.

*****

Tennessee, also, will be taking up a hate crimes bill that adds gender to the protected groups -- HB0335, one of the two bills pushed by the Tennessee Transgender Political Coalition in this legislative session. The bill is being sponsored by Jeanne Richardson (D-Memphis), and I can't seem to find any indication as to whether it will pass or not. Regardless, it's an opportunity for people from Tennessee to make their voices heard. On a related note, does Ohio have a TransPAC?

*****

And, finally, Texas has an anti-bullying law, entitled "Corinne's Law" that will be hitting the floor of their legislature this week. Texans are urged to contact their representatives and let them know their support. The law will expand current statutes by including electronic harassment, as well as harassment that does not occur on school property.

You know, this took an awful long time.

HIV/AIDS Updates

A few little tidbits for you this morning:

• In an effort to make HIV drugs more profitable (strange, I know, but keep reading), GlaxoSmithKline and Pfizer are creating a new company solely to handle their HIV sales. Because of the expense, the field is actually not that profitable because people who need the drugs are, on average, poorer and would not be able to pay the exorbitant prices required for the R&D of each drug. Combining their resources will, they believe, reduce the overhead cost and increase their profits without having to charge more.
• In related news, the Clinton Foundation and an international HIV drug purchasing consortium -- Unitaid -- have struck a deal with drug manufacturers to cut prices for improverished nations. The average annual cost of the first line treatment falls to $210; second line treatments fall from $700 to $590 per annum.
• Two releases out of ScienceDaily have breakthrough news about the virus itself -- in one, HIV actually deactivates the cell's proteins that help protect itself from viral infection; in the other, HIV actually harms itself to dodge the current immune system from detection.
• Based on changes in the level of CD4 count -- a test for the body's immune function against HIV -- of newly diagnosed HIV+ individuals, there is reason to believe that HIV is becoming more virulent over time. The research is based both on newly diagnosed patient CD4 counts, as well as the CD4 count of newly diagnosed patients six months after diagnosis.
• Early estimates of New Jersey's needle exchange program indicate that more than 130,000 used and dirty needles could be taken off the streets this year. New Jersey's HIV rate amongst intravenous drug users is one of the highest in the nation -- at nearly 40% of all infections.
• Prisons in the US are not the only breeding grounds for HIV -- the UN reports prisons around the world are serving to spread the disease, as well. Officials are concerned predominately with the possible release of the world's 30million detained individuals that could create an HIV "time bomb." Statistics are focused primarily on drug use within prisons, rather than sexual activity.
• New clinical guidelines have been produced by the NIH and the CDC for the treatment and prevention of opportunistic infections in HIV+ individuals (opportunistic infections are diseases that generally attack immunosuppressed individuals, taking advantage of a reduced immune system to cause potentially fatal results). Previous guidelines were separated into two documents: one for prevention and one for treatment. Officials also changed the diagnostic testing procedures, as well as including new diseases like malaria as an OI.
• And finally, Michigan may be one of the few states to remove the consent requirement for an HIV test. I'll let you talk about it, but... honestly, I support the move.

And that's all folks!

Pre-Exposure Prophylaxis: Failure :-(

News of the great white hope, Pre-Exposure Prophylaxis, for the prevention of HIV:

A new mathematical model of PrEP use in U.S. populations at high risk for HIV infection takes these and other questions into account and predicts the prevention strategy could substantially reduce the lifetime risk of HIV infection. According to the model, the cost-effectiveness of PrEP could vary substantially depending on the age of the target population, their risk behaviors, the annual rate of new HIV infections in the target population, and the efficacy and cost of antiretroviral PrEP drugs. These findings are reported by a team of scientists led by A. David Paltiel, Ph.D., of Yale University, and supported by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health and the National Institute on Drug Abuse, all part of the National Institutes of Health.

Dr. Paltiel says his team's model is the first to establish performance benchmarks that clarify the clinical, epidemiologic and economic circumstances under which PrEP would represent good patient care, good public health and good value.

To create their model, the researchers made several conservative assumptions: 1) PrEP is 50 percent effective; 2) the target population is American men who have sex with men who average 34 years of age; 3) 1.6 percent of this population becomes newly infected with HIV annually; and 4) the antiretroviral drugs (tenofovir and emtricitabine) cost $9,000 per year. With these parameters, the model predicts PrEP would cut the lifetime risk of HIV infection from 44 percent to 25 percent.

However, the life expectancy of the target population from the time after beginning PrEP would increase by less than a year (from 39.9 years to 40.7 years) and PrEP would not be cost-effective by current U.S. standards. Yet with modest improvements in the efficacy of antiretrovirals used preventively, more realistic estimates of their cost (potentially as low as $900 per year), or a target population that is younger and at higher risk, the model predicts PrEP might be as cost-effective as other widely recommended public health and medical interventions in the United States. With large improvements in these parameters, the potential benefits of PrEP could be substantial, according to the model. For example, assuming PrEP will be 90 percent effective leads the predicted lifetime risk of HIV infection to fall from 44 percent to 6 percent.

First take: a couple of notable things: we are assuming only a 50% effectiveness rate (first). Second, we are looking at a price of $900-$9000 a year, to only add (third) an average of less than one year of lifespan to the target population while only (fourth) decreasing the risk of infection by 19%.

So... tell me about those crazy new things called "condoms" again???

What's disappointing is that I thought the news would be more positive -- that is, I was sure that there would be greater effectiveness (I've heard numbers as high as 80%), and I was sure that models would indicate a dramatic shift in infection.

The problem, of course, at this point, is that since HIV/AIDS has become somewhat of a manageable -- if still awful -- disease in this country, that these numbers don't look cost effective for funding PrEP -- even research! Who's going to fund something that, in the end, gives absolutely no return on their investment? The CDC could, I suppose, under the guise of "for use in foreign countries" or "gauge the true efficacy," but I'm going to bet that they will still have difficulty justifying it.

I'm more upset about the background data, and not so much about the mathematical model they created.

I thought it would be better.

I wonder what happened to all those people that Canada handed Truvada to at the Gay Games last summer as a PrEP.

Best HIV studies ever...

In two huge studies happening right now, we have two of the biggest hopes for HIV prevention and treatment.

Pre-Exposure Prophylaxis

The CDC has begun a massive 3 continent (actually, four, but those are not CDC run) study of the effectiveness of a single pill in blocking the transmission of HIV if taken before risky sex or drug behavior occurs. 

From ABC News:

In a massive medical trial on three continents, doctors are testing a controversial pill that could temporarily boost immunity against HIV before a person is even exposed to the virus. If the pill works safely, doctors must then address whether such a drug, if made widely available, could actually worsen the AIDS epidemic.

The pre-exposure pill undergoing testing seems promising, since HIV drugs taken within days after exposure to the virus have been shown to reduce the risk of infection by 80 percent. But public health officials debate whether people at high risk for the virus, such as men who have sex with men, would be more likely to set aside the use of condoms to instead rely on a drug regimen that doesn't provide full protection against the disease, which is spread by contact with the blood or semen of an infected person.

The other risk, of course, is the possible increase in other STD's -- syphilis, specifically, which has recently seeing a rise in new cases. The other concern are those 25% of people who don't know they have HIV -- who cause between 40-50% of new cases. In all likelihood, those people are not aware of their risk, and neither are their partners, which means they are less likely to take the pill.

And then the question of access of healthcare comes up... if we can't even control teenage pregnancy, how can we control HIV?

Translation: gay men might see drastic reductions in their HIV rates, but guess who's left? Hm. A population currently at risk (with increasing numbers), limited access to healthcare, low conceptions of risk, and high incidence of other indicators of unsafe sex practices (STD's, pregnancy)...

Black women are fucked.

Hemopurification

This sounds like a really strange "cure" out of the 1980s, but it's getting a little popular attention.

From the Hindu News:

A new device could open up a new way to treat HIV, hepatitis and cancers by filtering out infectious viruses in real time.

The device, called Hemopurifier, is being tried out for the first time in a 30-day case study on HIV, at the Jattinder Gambhir Hospital in Ludhiana, Punjab.

The goal of the study is to demonstrate that Hemopurifier can safely and effectively reduce viral load and trigger replenishment of CD4 immune cells in the absence of drug therapy.

The fieldwork, which calls for the administration of up to 12 Hemopurifier treatments, is scheduled for completion by Friday.

Hemopurifier targets all circulating strains of infectious HIV, including those varieties that cause patients to fail antiviral drug regimens.

I know, source source source.

But check this out from Popular Science. It's a possibility. And it's exciting, because it can help with more than just HIV.

WEARING *WHAT* WEDNESDAY: Kellen Winslow

I know, a little early, but this picture caught my eye on CNN...

And I thought, DAMN, check out those arms! And then I read the story...

The problem came to the forefront last week with Cleveland Browns player Kellen Winslow, who recently had his second staph infection. He is reportedly the sixth player to acquire staph among the Browns in five years.

Peyton Manning of the Indianapolis Colts was revealed to have a staph infection, the Indianapolis Star reported Friday. University of North Carolina-Asheville fans also recently learned that Kenny George, the 7-foot-7 center on the basketball team, had a staph infection complication that led to part of his foot being amputated.

It's unclear how these high-profile athletes acquired their infections, but locker rooms have been found to habor staph bacteria in previous outbreaks. The topic is generating buzz throughout the sports world as more players' staph cases are revealed. Hospitals have long been known to be hot spots for transmitting staph, but recently cases have cropped up in other community settings. Regardless of where these players got their infections, the close quarters of a locker room raise questions about overall risks.

About 30 percent of people carry staph in their noses without exhibiting symptoms, according to the Centers for Disease Control and Prevention...

Experts say Methicillin-resistant Staphylococcus aureus, or MRSA, a form of staph resistant to common antibiotics, has become a more prevalent problem in settings such as contact sports that involve skin-to-skin touching.

Most MRSA infections acquired in community settings present themselves as sores or boils and often appear red, swollen, painful or with drainage such as pus, the CDC says. Infections often occur in cuts and abrasions but also on body parts covered in hair, such as the back of the neck, armpit or groin.

They have a link on the page to the CDC's Fact Sheet on MRSA and athletes (although I think it's funny and sad that they don't actually distinguish between MRSA and staph, but you know...). What is also interesting as, earlier this year, the CDC came close (but not quite) to labeling MRSA as an STI that has started to be found in men who have sex with men:

The strains of MRSA described in the recent Annals of Internal Medicine have mostly been identified in certain groups of men who have sex with men (MSM), but have also been found in some persons who are not MSM. It is important to note that the groups of MSM in which these isolates have been described are not representative of all MSM, so conclusions can not be drawn about the prevalence of these strains among all MSM. The groups studied in this report may share other characteristics or behaviors that facilitate spread of MRSA, such as frequent skin-to-skin contact.

MRSA is typically transmitted through skin-to-skin contact, which occurs during a variety of activities, including sex. There is no evidence at this time to suggest that it MRSA is a sexually-transmitted infection in the classical sense.

Anyways, I am not making any implications about what's his face... right, Kellen Winslow. I just thought people who read my blog might be interested to know more about MRSA.

They might also be interested in his amazing body...

And, of course, the piece de resistance...
Unlike what my family will tell you...

...sometimes, I do like football.

PS There is also the strange and interesting case of the Turkish wrestlers who appeared to have transmitted and contracted Hepatitis B through sweat/skin-to-skin contact. So STDs in athletics are neither new nor unusual...

HIV/AIDS: New Numbers Released

The CDC now estimates the new HIV infection rate is about 56,000 people a year, up 16,000 from the 40,000 that has been estimated for years.

Ouch.

New technology and methodology developed by CDC show that the incidence of HIV in the United States is higher than was previously known. However, the incidence has been stable at that higher level for most of this decade. HIV incidence is the number of new HIV infections occurring during a certain time period, in this case, the year 2006.

These findings, published by in a special HIV/AIDS issue of the Journal of the American Medical Association (JAMA) that was released August 3, 2008, show that in 2006, an estimated 56,300 new HIV infections occurred – a number that is substantially higher than the previous estimate of 40,000 annual new infections. It should be noted that the new incidence estimate does not represent an actual increase in the numbers of HIV infections. Rather, a separate CDC historical trend analysis published as part of this study suggests that the annual number of new infections was never as low as 40,000 and that it has been roughly stable since the late 1990s (with estimates ranging between 55,000 and 58,500 during the three most recent time periods analyzed).

(from the CDC announcement)

And the breakdown by risk factor:

Thanks to the LifeLube blog for the heads up -- and don't forget to read the excellent press release the AIDS Foundation of Chicago put out.

HIV/AIDS: National HIV Testing Day -- June 27th, 2008

It's funny that it took lesbians (over at Juliet and Juliette) to remind me that tomorrow... 40 minutes from now... is National HIV Testing Day!!!

That's right, folks, it is the annual event organized by the National Association of People with AIDS (NAPWA -- main site, event site) where the CDC (information from the CDC -- there are a lot of really great videos on this site) and hundreds of local organizations are encouraging you to get tested for HIV, regardless of your risk. Hell, even if you are suburban housewife with only one sex partner in your life and no history of drug use, I'll bet you have one risk factor...

Unprotected sex.

It doesn't matter who it's with; if it's sex, it's still risky. A lot of people blow off risk as something other people have -- after all, I've been with my husband for years, and we only have sex with each other. Oh yea? When was your last HIV test? When was his last HIV test? Is this a monogamous relationship... are you sure? It's an awful truth of the world, but just because you are monogamous does not mean they are.

Even condoms are not 100%, as there is such a thing as "imperfect use" -- condoms breaking, not being put on properly, etc. etc. etc.

There is no such thing as safe sex, only safer sex. All sex has its risk, as even the best forms of protection cannot safeguard against everything. Herpes and warts, for example, only require skin-to-skin contact for transmission.

And, it's a sad truth, that those are the two most common STD's. It is estimated that upwards of 25-30% of people have genital herpes; most of them have just never shown a symptom.

But I digress.

The point of this blog is to let you know that tomorrow, June 27th, you should get tested. There are a host of options out there to get tested at (listed below), and some of them offer the 20-minute oral swab (there is a slight caveat on this, right now, though), some the 20-minute finger stick, and some of them the more traditional 5-7 day oral swab or venipuncture (blood draw). I have personal and professional relationships with people at each one of these agencies, and I would not be posting any of them unless I was 100% sure that you would be treated with the kind of dignity and respect that you should have when you decide to be tested.

1) STOP AIDS -- 513-421-AIDS (2437)
My former employer and one of the largest testing sites in the city, offering the free 20-minute oral swab OraSure. In the past, though I have not received confirmation on this for this year, they offered all day walk-in testing on National HIV Testing Day. On Fridays, too, they offered walk-in testing from 9a-1p. I'm guessing it will not be much different tomorrow. Regardless, show up at 9a, they are always, always busy, and I've been informed that the entire testing staff will be available to test that day.

2) Cincinnati Health Department
Ambrose Clement/Burnet Ave 513-357-7350
Northside Clinic 513-357-7600
Price Hill Clinic 513-357-2700
Offering the free 20-minute finger stick test. I don't have much information on their program, and I've not heard of anything specific they are doing. But, if you go to the Burnet Avenue location, see if you can get Johnnie or Chuck -- they are both fantastic people and just wonderful, compassionate testers.

3) Northern Kentucky Independent District Health Department (NKIDHD)
Boone County -- 859-363-2060
Campbell County -- 859-431-1704
Grant County -- 859-824-5074
Kenton County/Covington -- 859-431-3345
Kenton County/Ft. Mitchell (main testing site) -- 859-578-7660
Testing process varies based on location, some do venipuncture and some do the 20-minute test. They put out a great press release and are on Cincinnati.com with their schedule. They are offering special times tomorrow, so check it out here.

4) Planned Parenthood
Sites include: Hamilton, Middletown, Auburn Ave, Western Hills, Springdale, and Clermont County -- 800-230-7526
Offers the 7 day venipuncture, but it does charge a nominal fee for an HIV test. Last I heard it was under $20, but I can't be sure. The great thing is that they are everywhere and there is likely one close to you.

5) University Hospital Emergency Department -- 513-584-0720
Though free, they offer the 20-minute venipuncture, but you have to call while their nurse is working and you have to be medically cleared and sign a waiver before you can do a walk-in test. It's a little bit more paperwork, as the program is more designed for patients of the ER.

Other programs I know little about:

• 4CHARIS/SARA IRP -- 513-542-9730 -- Religious organization
• Hamilton City Health Department -- 513-785-7080
• Warren County Health Department -- 513-695-2428

Likely, there is a testing site near you that you should go to.

As for me, well.

I haven't been tested in two years. And tomorrow... I will be getting tested at STOP AIDS bright and early at 9am. Come out, check it out, I'll be there. Even for me, folks, this freaks me out. It's hard, I know, but it's worth your time.