Researchers from the Rollins School of Public Health at Emory University unveiled a new website, www.preplocator.org, that will allow users to locate a medical provider or clinic that can prescribe Pre-exposure Prophylaxis (PrEP) to prevent HIV infection. If taken daily, PrEP helps prevent the transmission of HIV.
According to Damon L. Jacobs who founded the Facebook Group: PrEP Facts: Rethinking HIV Prevention and Sex, “We have been doing this on a grass-roots peer-to-peer level since July 1, 2013. The creators of this database used a lot of these conversations to find providers. New providers can easily be added to the database, and information for existing providers can be corrected by clicking on the provider, and clicking on the link to update provider info. Corrections/additions will go into a holding pen for Emory staff to verify and update as appropriate.”“PrEP has the potential to substantially reduce the number of new HIV infections in the United States but only if people know how and where to get it,” says Aaron Siegler, PhD, research assistant professor in the Department of Epidemiology at Emory University’s Rollins School of Public Health. “Importantly, the tool features a search function that allows users to search for PrEP providers who would prescribe to individuals without insurance.”
The CDC has estimated that more than one million people in the United States are eligible for PrEP.
For many gay and bi men, it’s a perennial point of contention: Are “minor” sexually transmitted infections—like chlamydia or gonorrhea—a cause for serious concern or major behavior modification? They’re no fun, to be sure, and left untreated, they can cause problems more severe than a bit of burning or discharge. But then again, like many maladies we don’t rrationally stigmatize, they’re curable with a course of antibiotics, right?
For the most part they are. But a recent study by the Centers for Disease Control and Prevention, featured in its Morbidity and Mortality Weekly Report, found a significant rise in resistance to one of the drugs used to treat gonorrhea: azithromycin. Among the 5,093 samples taken from men who have sex with men (MSM), men who have sex with men and women (MSMW), and men who have sex with women (MSW), across 24 state and city health departments, the resistance to this drug has increased by more than 300 percent between 2013 and 2014. To be clear, resistance starts out low; in practical terms, its risen from 0.6 percent of cases to 2.5 percent of cases. But it’s important to note that the report shows antibiotic-resistant strains of gonorrhea are more prevalent among men who have sex with men than other demographics. Is 2.5 percent something that gay and bi men should be worried about? I spoke to Dr. Robert D. Kirkcaldy at the CDC, who has spent the last six years researching gonorrhea resistance, to find out.
“This is not a new phenomenon, because since penicillin was introduced, this bug has mutated so rapidly that it’s developed this remarkable ability to develop resistance to each of the drugs that we’ve thrown at it,” Kirkcaldy explained. “What’s changing is that … we’re running out of new drugs. The antibiotic pipeline is dwindling, and the bug is developing resistance to the last line of treatment.”
The dual therapy used to treat gonorrhea, which has been recommended for use by the CDC since 2010, includes azithromycin and ceftriaxone. (Resistance to ceftriaxone is about 1 percent.) If an infection is resistant to one of these drugs, the other will work, though both drugs used in combination is the best way to combat the STI.
“Dual therapy is still highly effective,” Kirkcaldy assures, “but we’re starting to see trends that it’s quite possible in the next few years that if resistance of these two drugs emerges, then that could jeopardize our last recommended treatment for gonorrhea, and we could be left with treatments that don’t work for everybody.”
Drug resistance aside, STI infection rates, including for syphilis and chlamydia, have been increasing since 2006. With gonorrhea, there are more than 300,000 reported cases each year, and likely many more that are undetected or not reported. Between 2013 and 2014 alone, there was a 5.1 percent increase in transmission. Bugs spread quickly. So does resistance.
“A lot of these things that we’re seeing now in increasing rates and also resistance are the warning signs—they’re sort of the clouds that are starting to come together on the horizon, telling us that there is a perfect storm brewing,” Kirkcaldy said. “The question is what can be done and what are people willing to do now to prevent this brewing crisis?”
Screening is no doubt a crucial part of preventing a true crisis, and it’s important for sexually active gay and bi men, particularly those who are having condomless or “bareback” anal sex, to be tested for all STIs every three to six months. We also know that many STIs can be asymptomatic, so it’s possible to be infected and not know it. And it’s necessary to ask for the right kind of tests, namely throat and rectal swabs. A urine test alone may come out negative for gonorrhea because it’s living in the throat or rectum. Some health care providers may not include these additional tests unless requested, so it’s important to actively request the right care.
Kirkcaldy has a few more recommendations, even if they’re ones that some sexually active gay and bi men may not want to hear: condom use, abstinence, and reducing the number of one’s sexual partners. This flies in the face of the pleasure movement that we’re seeing, particularly among users of the HIV prevention strategy PrEP who choose to bareback. After dealing with HIV for 35 years, many gay and bi men associate sex with death, so such a movement can feel like something that we both need and deserve in spite of the other STIs.
Kirkcaldy also understands that there’s more to sex than fearing these infections, but he’s still practical when it comes to prevention and public health. “It’s important for people to have healthy sex lives and to enjoy their sex lives,” he explained, adding:
Obviously there’s a lot more to it than the absence of disease. There’s emotional, physical, and spiritual well-being. But I think a part of sexual health, both emotional and physical, is also being free of disease. So being cognizant of the infections that can impact your sexual health and those of your partners still is important. Continuing to screen is an important component because at least that can catch it and prevent it from future partners, but what it doesn’t do is prevent people from getting it in the first place.
There’s a lot of truth to that, especially if one happens to run into an antibiotic-resistant strain. Unlike HIV in the 1980s and ’90s, though, gonorrhea is not a death sentence, which could account for the lack of worry within certain parts of the gay community. But what are the real health implications if an infection occurs? And are they severe enough to alter our sex lives?
Since gonorrhea can be silent, particularly in the throat or rectum, one may not experience symptoms—which to the selfish, may seem like good news. Still, it can be spread to other partners who may not be as lucky, particularly if they acquire a genital infection, where pain and discharge could be significant. Untreated, it can cause damage in the testicles and, in some cases, sterility. In rare instances, it can get into the blood stream and cause life-threatening infections in the joints, heart, or in very extreme instances, the brain. Untreated gonorrhea is also thought to help facilitate HIV transmission. In any case, it’s more severe than one might realize and shouldn’t be taken lightly.
Although we don’t have any drugs to fall back on if the dual therapy becomes ineffective, several drug companies have stepped up and started clinical trials for new ones. However, it takes time for these to come to market, and it’s unclear if they’re even going to work. That’s why it’s important that we keep the current drugs as effective as possible for as long as possible. “These drugs are still effective,” Kirkcaldy said. “The sky is not falling right now, but there are a lot of warning signs both from the data about emerging resistance and the historical perspective—what we know about this bug.”
So if resistance in 2.5 percent of cases seems low, it is. But the speed and size of increase—again, about 300 percent in one year—is cause for concern. For comparsion, ciprofloxacin, a drug that was used to treat gonorrhea in the 2000s, saw an increase in resistance that grew from less than a one percent of cases to ten percent in under five years. “All we have to do is look back at history and see that for each of the drugs that have been used [for gonorrhea], it was only a matter of time before resistance to those drugs emerged. And it sometimes emerged really quickly,” Kirkcaldy says. “This bug is so unpredictable that it can happen within a few years.”
As LGBT elders, maintaining a positive attitude toward aging and finding ways to continue enjoying a satisfying quality of life is said to have great potential for extending our lifespans … some studies say as much as 7-1/2 years!
Like breathing in and out, Life is constantly seeking to engage us through enjoyment and expression, regardless of our age. Our interests and our passions are “what floats our cork” as the saying goes. Each of us is drawn to activities that connect us to ourselves and to our surroundings. However the way we express and enjoy ourselves may change over time. The activities we were drawn to in our youth may no longer be as enjoyable or as fulfilling. We may also have to adapt our activities to reflect anticipated and unexpected age-related changes. The key is to focus our creativity on finding ways to make sure our interests and passions are adequately satisfied. Ray and Gloria are inspiring examples.
Ray has always enjoyed nature and in his younger years loved to go tent camping with a group of his gay friends. Their plans often included strenuous hikes in isolated wilderness areas. Now in his 70’s, Ray has a heart condition that severely limits his capacity for physical exertion. While Ray initially found it hard to accept this limitation, he has since found he can continue to fulfill his need to enjoy the outdoors by taking shorter walks with friends on easily accessed trails in nearby nature preserves. At home Ray is surrounded by the beautiful nature photos he took in his youth and also enjoys watching televised nature programs of all kinds.
Gloria and her lesbian partner used to have a sizable ranch where they enjoyed keeping horses and they often went riding together. When Gloria’s partner died, she discovered she was no longer able to maintain the ranch on her own and moved to a senior apartment complex closer to the services she now needs. However Gloria still loves to ride when she feels up to it, so she maintains a horse named Jenny in a stable on the outskirts of town. Even when she isn’t up to riding, Gloria still enjoys just visiting and grooming Jenny and intends to continue keeping her as she feels this connection to her passion is important to her enjoyment of life.
How are you creating ways to maintain the quality of your life as you age?
Buz Hermes is co-facilitator of the Sonoma Valley LGBT Seniors Group and a former staff member of Spectrum’s Senior Outreach Program. He is currently a consultant on LGBT aging and can be reached at GaryDHermes@comcast.net or (707) 227-6935.
Tuesday, the Human Rights Campaign (HRC) Foundation and Whitman-Walker Health, a community health center with special expertise in LGBTQ and HIV-related care, released Safer Sex for Trans Bodies, a comprehensive sexual health guide for transgender and gender expansive people and their partners. The guide fills a significant gap in inclusive, publicly-available sexual health resources for transgender and gender expansive people.
“Transgender people are too often denied crucial and relevant guidance around sexual health that everyone needs to live healthy, safe and whole lives” said HRC Communications Director Jay Brown. “Transgender health issues, especially those related to sexual health, are all too often stigmatized or completely ignored. Safer Sex for Trans Bodies provides essential information that will help minimize health risks that can develop because of a lack of knowledge.”
This first-of-its kind resource was drafted by HRC and Whitman-Walker Health in consultation with Casa Ruby, Trans United Fund, and TransLatin@ Coalition. It was made possible with support from the Elton John AIDS Foundation.
“We are thrilled to continue our partnership with HRC in creating this important resource for the community,” said Josh Riley, Director of Community Commitment at Whitman-Walker Health. “Too often in healthcare settings, if there is a focus on sexual health at all, it is only explored through the lens of pathology or dysfunction. Sexual health for trans bodies is even less recognized, rendered invisible because of ignorance or stigma. This new guide emphasizes sexual health, wellness, and exploration, in addition to risk reduction, and will be a valuable tool for trans-identified individuals across the spectrum, as well as their healthcare providers and other allies.”
The guide is written by and for members of the transgender community and offers them a long-overdue resource on potentially life-saving and affirming practices, from respectful terminology and definitions to helpful practices for sexual health following transition-related care. It will be available online and at Whitman-Walker Health’s locations in Washington, D.C. A Spanish-language will be released in the coming months. HRC and Whitman-Walker Health will also host a Facebook Live conversation about transgender health on Wednesday, August 24th at 1 PM Eastern on the HRC Facebook page.
Ruby Corado of Casa Ruby, a bilingual, multicultural organization providing life-saving services and programs to LGBT people in the DC-area, offered her support of the guide. “This publication is critical to support informed decision-making in trans communities that lack access to many resources. Through this guide, providers will have ready access to culturally competent guidance,” Corado said.
Transgender people frequently experience significant barriers to inclusive and competent care. Last year, the HRC Foundation released a guide for transgender people navigating insurance plans, which often exclude coverage for medically necessary transition-related care. The annual Healthcare Equality Index (HEI), the HRC Foundation’s national benchmarking tool that evaluates health care facilities’ LGBTQ-inclusive policies and practices, measures services and treatment of transgender patients.
One of my favorite memories growing up was piling in the car and heading down to Chicago. When you’re five, that hour drive seems an eternity, but it was always worth it. Chicago was always a big world to me, full of great food, fun and family. A place where you could always find something exciting around the corner. As I grew older I realized that it had even more to offer then hot dogs, skyscrapers and Cubs games.
On Chicago’s greatness…
I love Chicago because it’s so unapologetically Midwestern. As someone who grew up in the Midwest, but has lived on the East and West coasts (DC & LA), I have some insight as to how people see the world and approach life. Chicagoans combine that earnest Midwestern essence with big city know-how. You’re just as likely to stumble into a conversation about architecture or a fight about baseball. Guys are easy to talk to, friendly, unpretentious, and usually up for a good time. Oh, and there’s a ton of bears (and I don’t mean the football team). Everywhere. So I like that. A lot.
On Market Days…
It’s hard to ignore the sheer force of Market Days. The largest street festival in the Midwest, it boasts over 300,000 attendees over two days. It’s non-stop fun with drinks, music, food, and shopping. And street food is one of my most favorite things in the world. So that makes me happy. But on any given day, there’s little that beats hanging with friends at Hollywood Beach (the un-official gay beach), people watching and pretending that the water is warm enough to swim in.
On the queer ‘hoods…
I start in Andersonville. Although traditionally Chicago’s gay epicenter is Boystown (next to Wrigley Field), I like people watching. Andersonville is a hotbed of gay folks, just living their everyday life. To get started, I’d stroll down Clark Street in the middle of the day and just take it in. It’s very casual — folks in Andersonville love their neighborhood — so they walk a little slower, and are open to whatever may come their way. You’ll find plenty of options to eat and drink (including the popular gay burger chain Hamburger Mary’s), as well as a plethora of eligible, handsome Midwesterners willing to strike up a conversation.
On nightlife...
When night falls, there’s no place better than Boystown. Head to Halstead and see what all the fuss is about. Here’s where you’ll find the nightlife really hopping. Sidetrack and Roscoe’s are staples of Chicago gay life, so check them out. You’ll have no trouble finding fun, friendly people willing to show you a good time. Of course, the music scene is great. I’ve played a variety of venues, from rock clubs to coffeehouses to gay bars. My following tends to be primarily gay. I love playing at Jackhammer, a dance/dive bar on Clark Street, a little bit north of where you’d expect the gay action to be. Friendly staff, fun patrons and even a basement fetish bar (The Hole) where things are, how do I say this, get a little more jacked…
On celebrity…
Usually people come up to me and tell me that they love my work. I’m very humbled by that. Then it’s sometimes followed by a lean in and a “you’re much cuter in person”… Or is it “shorter?” My hearing isn’t so great sometimes…
On causes…
There’s an amazing nonprofit Broadway Youth Center at the Howard Brown Clinic that provides medical care and social services. Many of its clients are homeless, and in addition to providing HIV/STI tests and health services, they provide a safe space in order to help connect kids with housing, employment and other everyday needs that many of us take for granted.
On celebrating…
I love Greek town. So if it were up to me, I’d head over to The Parthenon. I love the Parthenon because it’s got that typical Chicago vibe, it’s tasty, REALLY filling, and super reasonably priced. My favorite is the Flaming Saganaki. The waiter brings out a flaming block of cheese over to your table — it’s quite a production. They serve family style as well, so it’s great for big parties. Afterwards I’d walk on over to little Italy and get an Italian Ice at Mario’s Italian Lemonade (only open in the summer).
On carefree moments…
I’m the kind of guy that would most prefer hosting a bunch of people over at the house to celebrate. There is not much that makes me happier than having people over and making sure they have plenty to drink, plenty to eat, and a lot to laugh about. That’s probably because I come from a big Italian Chicago family. And for that kind of celebration, you need some great, cheap, unhealthy food in large quantities. Luckily, Chicago has a wealth of that.
On the perfect night out…
My night would start with music. You can usually catch an awesome rock/songwriter show at Metro, but if you want a taste of some old school Chicago blues, hop on over to Buddy Guy’s Legends. Now there’s always going to be arguments as to who makes the best Chicago deep dish pizza, but I love Giordano’s. After the show I’ll order a small cheese deep dish. For some reason, I prefer the proportion of cheese in the small — once the pie gets larger, it starts to lose it for me. Same with toppings: They just get in the way of the massive quantities of cheese I want so badly to enjoy. After all that cheese settles I’d head up to Boystown for some dancing and socializing at Sidetrack or Jackhammer. When at last my legs get tired, I love to head over to Lake Michigan and unwind. It’s really relaxing just talking with friends while the waves crash at your feet.
On the perfect Sunday afternoon…
I was raised a die-hard Cubs fan, so I’d start with a day game at Wrigley. It’s one of those things that’s a must in Chicago. Nothing beats sitting at the Cubs game, eating, drinking a beer, and watching the Cubs lose (less often this year!), but knowing that everyone around you still loves them just the same. Afterwards I’d hop up to Andersonville and tape a podcast with the guys at Feast of Fun. There’s few people that can make me laugh more than Marc and Fausto. Now that I have my homies in tow, we can head over to the uber gay Cheetah Gym (essentially a gay bar with workout equipment) for a quick workout, before grabbing some sandwiches and drinks and heading to Millennium Park for a picnic, then a stroll along the lake.
Now I know what you’re going to say. There’s no way you can do that in one Sunday afternoon. Sure, maybe, but my perfect Sunday afternoon in Chicago would last a very long time…
Tom Goss is an unabashed romantic, known for his expressive and personal songs about love and longing. A self-taught musician and songwriter, Tom has performed to tens of thousands in the United States and Europe, and has been heard on ABC, HBO and several independent films. Tom has performed over 1,000 shows, in 100 cities and 5 countries.
His newest single and music video, “Son of a Preacher Man,” garnered world-wide attention, generating over 130,000 views in it’s first week of release. His previous videos have accumulated over 5 million views.
As the 2016 presidential race transitions to the general election, Entrepreneurs for Hillary, a national group of volunteers committed to mobilizing entrepreneurs and their networks in support of Hillary for America, has secured endorsements from more than a dozen industry-leading entrepreneurs. On the opening night of the Democratic National Convention, these innovators will be featured on the newly launched Entrepreneurs Wall of the Entrepreneurs for Hillary website, discussing why Hillary Clinton is their choice for President of the United States.
The Entrepreneurs Wall highlights leaders in multiple fields, from high tech firms to e-commerce and social ventures. Among those featured are Alexandra Wilkis, co-founder of Gilt Groupe; Robert Rodriguez, award-winning director and founder of Troublemaker Studios; Kimbal Musk, co-founder of Zip2 and Kitchen Community, and board member of Tesla and SpaceX; Nancy Pfund, founder of DBL Partners, one of the largest impact investing venture capital firms; and Chris Larsen, founder of Ripple, the global leader in real-time financial settlement. The full list can be seen at EntrepreneursforHillary.com/Entrepreneurs-Wall.
“Hillary Clinton has been a long-standing friend and advocate for innovators both at home and abroad,” said Nancy Pfund, founder and managing partner of DBL Partners. “Entrepreneurs are chronically busy and may not always follow the political process. Entrepreneurs for Hillary provides a platform which is both informative and collaborative, allowing those interested in entrepreneurship to start to engage in the politics which affect and interest them.”
“Entrepreneurs have the greatest impact when they bring their collective skills to bear on an opportunity,” said Chris Larsen, founder and CEO of Ripple. “I’m proud to support Hillary Clinton for President, and look forward to contributing my ideas to the larger Entrepreneurs for Hillary community.”
Entrepreneurs for Hillary co-founders Laetitia Garriott de Cayeux, Lisa Diaz Nash, Maura O’Neill, Jo Ousterhout and Shelly Porges will be at the Democratic National Convention, building support and spreading awareness of Hillary Clinton’s platform for entrepreneurship as a force for broad-based growth and American leadership on the global stage.
“Propelling economic development in emerging and high-growth sectors is of primary importance amongst entrepreneurs who support Hillary,” said Lisa Diaz Nash, co-founder of Entrepreneurs for Hillary. “We created the Entrepreneurs Wall to showcase some of these entrepreneurs, their impact and why they believe Hillary Clinton is the candidate to create inclusive economic growth in America in the 21st century.”
Empowerment may be an overused word, but it is what got us older LGBT adults through some tough times as we courageously faced a largely homophobic and transphobic culture and creatively carved out a niche for ourselves. LGBT aging is now our new frontier and empowerment comes from being prepared for any “potholes” we may encounter as we continue our life journey, and of course from fearlessly facing our mortality and preparing for our death.
As Atul Gawande amply illustrates in his best seller Being Mortal, the downside of not being proactive in preparing for health crises and our dying can be prolonged distress and suffering both for ourselves and those we love. While we may have no control over the when or why of illnesses, accidents and death, we can begin to address the who, where, and how aspects. The planning process involves many decisions and is not something you just do once; it needs to be revisited periodically as our preferences and circumstances evolve. Of course, it also involves substantial “paperwork” as our choices need to be recorded to be legal. The Council on Aging can assist with healthcare and estate planning.
The decisions about how you wish to be treated and under what conditions are complex and it helps to explore the options with someone with whom you are comfortable. Likewise you may want to share your thoughts about death and how you might wish your assets distributed and your body and your life honored.
The other important decisions, of course, involve choosing those we trust to implement our wishes. We need someone willing to carry out our health care instructions in the event we are incapable of articulating them ourselves. We may also wish to have someone appointed to have power of attorney for our finances in the event we are incapacitated so that our bills will continue to get paid. We also need an estate executor to make sure our after-death instructions are implemented. If we can’t identify anyone to assume these roles, there are professional fiduciaries who can assume them.
Last but not least, we need to make sure all these people know our wishes and have a copy of our legal planning documents and that someone knows where we keep all of our important papers. Of course, the list of those records and their locations needs to be updated periodically. Once these decisions are made and documents are in place, we can enjoy peace of mind knowing that we have acted as empowered LGBT elders.
Buz Hermes is co-facilitator of the Sonoma Valley LGBT Seniors Group and a former staff member of Spectrum’s Senior Outreach Program. He is currently offering 8-week “Aging Together With Pride” workshops sponsored by Adult and Aging Services for LGBT seniors. He can be reached at GaryDHermes@comcast.net or (707) 227-6935
The hotel that had become a symbol of support for Ted Cruz’s antigay policies is now closing.
The Out Hotel in New York City faced a heated boycott last year after its gay owners held a fundraising dinner party at their home for the Texas senator and Republican presidential hopeful. Ian Reisner and his business partner at Parkview Developers, Mati Weiderpass, came up with a lot of reasons for that party, but none flew.
Numerous groups canceled events in outrage, including the New York Gay Men’s Chorus, AIDS Walk, Broadway Bares, Urban Bear, and more. When the boycott began spreading to the Fire Island Pines commercial district, the management there publicly distanced themselves from their chief investor. A Facebook group launched in the hopes of exacting a punishment, though exactly what that should be was always unclear.
Things had recently calmed down, with that Facebook group disbanding, but business remained slow. The Real Deal, a real estate blog, reports Out NYC was just sold for $40 million to Merchants Hospitality. Its hotel, restaurant and nightclub will no longer cater to a gay clientele.
Cruz, booed by his own party during the Republican convention, was named The Advocate’s Phobie of the Year at the end of 2014. Along with a table of high-dollar guests, he’d met with Reisner and Weiderpass in April 2015. The two had first claimed it wasn’t a fundraising dinner but later admitted donating $2,700 — the maximum allowed — as a show of “support for his work on behalf of Israel.”
The owners have been alternately contrite and angry during the boycott. They feigned ignorance about Cruz’s anti-LGBT policies and asked for forgiveness. Nothing seemed to work.
It wasn’t a win for Cruz either. When asked about the dinner party on the campaign trail, he called himself a “big tent Republican” and simultaneously announced he’d push for two new anti-LGBT bills in the Senate. The first would amend the Constitution to allow states to define marriage as only between one man and one woman, and the second would ban federal courts from ruling on marriage. Amping up his anti-LGBT rhetoric, though, didn’t stop the meeting from coming up here and there in attacks against him as weak on LGBT issues.
The hotel might never have made money, even before the boycott began. In an interview in May 2015 with New York magazine intended to smooth things over — but that actually insulted LGBT consumers — Reisner said it hadn’t turned a profit.
“You know, it’s so ironic — I wanted to build kind of a community center in the gateway to Hell’s Kitchen, which in 2008–2009 was already a gay place and now it’s even gayer,” Reisner said. “Very close to Broadway. We decided there’d be so many different ways to give back to the community. We show gay artists there. For gay performers, we have let this cabaret club go on for three and a half years. And you don’t make money when you let drag queens in on Tuesday night and 30 people drink at $10 a drink and you have to pay five people to watch over the place. You don’t make money. … My only point is, this has not been a profitable venture. Gays are cheap. They’re frugal; gays are frugal. Let me retract that … gays are entitled … Do you know how challenging it is to make a penny off a gay person? I’m gay, I don’t pay cover. I’m gay, where’s my comp drink? [Everyone laughs.] No, I’m being serious! The Out NYC has not shown a profit yet.”
The Office of Minority Health at the Centers for Medicare and Medicaid Services (CMS OMH) posted online national data – for the first time ever – exploring differences in 15 health characteristics between adults 65 years of age or older (older adults) who self-identify as lesbian, gay, or bisexual (sexual minority), and older adults who identify as heterosexual or straight (sexual majority).
This data present estimates using data from two years of the National Health Interview Survey (NHIS 2013-2014) conducted by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS) showing statistically significant differences for several health characteristics between sexual minority and sexual majority respondents.
Key Findings:
Among persons aged 65 and older, 62.7% of sexual minority respondents reported that they are in excellent or very good health compared to 45.9% of sexual majority respondents.
Nearly 80% of older sexual minority respondents reported that they received an influenza vaccine during the past year compared to nearly 70% of older sexual majority respondents.
More than half (51.3%) of the older sexual minority respondents reported that they had been tested for HIV compared to only 15.8% of the older sexual majority respondents.
Nearly twice as many older sexual minority respondents (14.5%) had five or more alcoholic drinks in one day – at least once in the past year – compared to older sexual majority respondents (6.7%).
Data Source: 2013 and 2014 National Health Interview Survey, conducted by the Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS)
The Office of Minority Health at the Centers for Medicare and Medicaid Services is committed to supporting the departments’ goals and to advancing sexual orientation and gender minority data collection and research.
The ultimate impediment to a cure for HIV infection is the presence of latent, HIV-infected cells, which can reawaken and produce new virus when antiretroviral drug therapy is stopped. These latent, HIV-infected cells are untouched by antiretroviral therapy and are unseen by the immune system. Moving medicine closer to a cure for HIV, scientists at Blood Systems Research Institute (BSRI), the University of California at San Francisco (UCSF), and the University of Hawaii have discovered that the human sugar-binding protein galectin-9 potently forces latent HIV out of hiding, and poisons the virus on its way out.
Building off of their earlier studies that identified key human genes involved in maintaining the latent, hidden state of HIV-infected cells, the paper’s lead author, Dr. Mohamed Abdel-Mohsen, Scientist at BSRI and UCSF School of Medicine, and colleagues used cutting-edge technologies to demonstrate that galectin-9, a beta-galactoside-binding lectin, reactivates latent HIV and renders infected cells visible to the immune system. This concept of therapeutically forcing latent HIV out of hiding as a curative approach is known as the “shock and kill” HIV eradication strategy.
Dr. Satish Pillai, lead researcher on the study, Associate Investigator at BSRI and Associate Director of the UCSF-Gladstone Institute of Virology & Immunology Center for AIDS Research, explains, “For nearly two decades, antiretroviral therapy has demonstrated efficacy in suppressing HIV replication, but these drugs do not completely clear viral infection or fully restore health. We need a means to draw out the virus from its hidden reservoirs within the body and allow the body’s own immune system to eliminate it.”
Beyond subjecting latent HIV-infected cells to destruction by the immune system, the team found that galectin-9 strongly increases levels of an antiviral protein called “APOBEC3G” in infected cells. APOBEC3G is a lethal mutagen that destroys the genetic code of viruses including HIV. This ensures that virus that comes out of hiding at the hands of galectin-9 will be sterilized on its way out of the cell, preventing any further infection. These findings reveal that galectin-9 is a new weapon in the HIV cure arsenal, promoting eradication of the latent HIV reservoir in infected individuals on antiretroviral therapy.
The research was published in PLoS Pathogens and is an open access manuscript.
An additional revelation in the authors’ study is that galectin-9 works by manipulating sugars on the surface of HIV-infected cells to deliver the signals that force latent HIV out of hiding. “Galectin-9 binds to certain classes of sugars on the surface of cells to start a chain reaction that forces HIV out of hiding. There’s been very little attention paid to how the sugar coating on the surface of human cells affects the fate of the virus that lies inside. This sugar coating may hold the key to new therapeutics that can be harnessed to cure HIV and possibly a range of other infectious diseases.” says Abdel-Mohsen.
Pillai and Abdel-Mohsen also see the potential for galectin-9 to alter the current course of treatment for HIV, which involves life-long adherence to antiretroviral therapies to prevent latent stores of the virus in the body from reactivating and infecting new cells. “Our findings make us optimistic that future HIV treatments can eliminate all traces of the virus from the body,” says Pillai. “Ultimately, we hope that galectin-9 gets us one big step closer to a cure.” says Abdel-Mohsen.
The study was funded in large part by the amfAR Institute for HIV Cure Research and by the National Institutes of Health (NIH), with additional support from the University of California and the San Francisco-Gladstone Institute of Virology & Immunology Center for AIDS Research. The findings are among the first to be generated by researchers supported by the amfAR Institute, which was announced in December 2015. The centerpiece of amfAR’s Countdown to a Cure for AIDS initiative, the Institute brings together leading HIV researchers working collaboratively to address the scientific challenges that stand in the way of a cure.
