Features

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Court blocks Trump’s Military Trans Ban

A federal court in Washington has blocked President Donald Trump changing the governmental policy to bar transgender individuals from serving in the military, according to an Associated Press report published by Time.com.

U.S. District Judge Colleen Kollar-Kotelly wrote today (Monday, Oct. 30) that transgender members of the military who had sued over the change were likely to win their lawsuit and barred the Trump administration from banning them from the military.

Trump announced his intention to change the policy, established by President Obama in 2016, that would allowed trans people to serve openly. Even military leaders balked at the idea of the ban.

In her ruling, Kollar-Kotelly wrote, “There is absolutely no support for the claim that the ongoing service of transgender people would have any negative effect on the military at all. In fact, there is considerable evidence that it is the discharge and banning of such individuals that would have such effects.”

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ACLU Takes Legal Action Defending Rights of Maryland transgender Students

The American Civil Liberties Union filed a motion today to defend a Maryland school board’s policies that prevent discrimination, harassment, and stigmatization of transgender and gender nonconforming students in the school system. The policies ensure that transgender students can, among other things, use school facilities in accordance with their gender identity.

A federal lawsuit against the Frederick County School Board was filed anonymously by a non-transgender student and her mother, who claim that allowing transgender students restroom and locker room access infringes upon student privacy rights. However, the only privacy violation alleged in the plaintiff’s complaint was an incident that did not even involve any students that are transgender. The lawsuit also seeks to invalidate policies preventing harassment, and protecting the confidentiality and privacy of transgender students.

The motion to intervene in the pending lawsuit was filed by the ACLU, ACLU of Maryland, and Free State Justice on behalf of James van Kuilenburg, an honor student at Governor Thomas High School who is transgender.

The school board’s policies, adopted in June 2017, were welcomed by community members from all over Frederick County. Van Kuilenburg says that the policies “gave me the ability to finally be myself and access all parts of my education.”

In the wake of the lawsuit, the Frederick County group “Support FCPS Trans Students” has started a social media campaign called #IAmFrederick to show support for their transgender classmates.

According to van Kuilenburg, reversal of the policies would be “devastating.”

“There is an epidemic of trans students feeling unsafe, depressed, and suicidal,” he explained, and a removal of the policies in place to protect them would “create a culture of fear and misunderstanding.”

“It’s important that trans students are given the opportunity to defend themselves against these shameful attempts to isolate and stigmatize them,” said Gabriel Arkles, senior staff attorney at the ACLU LGBT & HIV Project. He added, “Schools can and should provide extra privacy protections or private restroom or changing areas for any student who requests it. But no student has a right to demand that transgender students be segregated from their peers.”

“The Frederick County School Board did the right thing: they created policies that affirm and respect their students’ gender identity,” said Jennifer Kent, managing attorney of FreeState Justice. “We intend to vigorously defend these policies in the interests of our client and affected students in Frederick County Public Schools.”

Counsel on the motion to intervene also includes Leslie Cooper and Arkles of the ACLU; David Rocah and Nick Steiner of the ACLU of Maryland; and John Hayes, Brian Whittaker, and Kenneth Nichols of the law firm Nixon Peabody.

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2 in 5 LGBT Workers Feel Bullied at Work, According to Recent Survey

New research indicates that LGBT workers are facing bullying in an area that should be a safe place – their workplace. Two in five LGBT workers (40 percent) report feeling bullied at work, 11 percentage points higher than the national average of all workers combined. Fifty-six percent of bullied LGBT workers report being bullied repeatedly.

The nationwide survey was conducted by Harris Poll on behalf of CareerBuilder from February 16 to March 9, 2017 among a representative sample of 3,420 full-time workers across industries and company sizes in the U.S, including 238 LGBT workers and 3,215 workers in the private sector.

“Bullying of any kind or of anyone has no place in the workplace – period,” said Michael Erwin, director of corporate communications and social media at CareerBuilder. “Employers have a responsibility to create a safe working environment for all employees. They can minimize this destructive behavior by offering sensitivity training and enforcing anti-bullying policies across their organizations.”

Bullying Takes Many Forms
What does bullying look like in today’s workplace? Fifty-three percent of bullied LGBT workers say they were bullied by one person, and 13 percent say it happened in a group setting. Fourteen percent of LGBT bullied workers say they were bullied by someone younger, and 61 percent say they were bullied by someone older.

Among the most common examples of bullying given by LGBT workers who were bullied at work were:

  • Falsely accused of mistakes you didn’t make (61 percent)
  • Ignored – comments were dismissed or not acknowledged (50 percent)
  • Used different standards/policies for you than other workers (49 percent)
  • You were gossiped about (47 percent)
  • Picked on for personal attributes (race, gender, appearance) (42 percent)
  • Constantly criticized by boss or co-workers (40 percent)
  • Someone didn’t perform certain duties, which negatively impacted your work (40 percent)
  • Purposely excluded from projects or meetings (31 percent)
  • Belittling comments were made about your work during meetings (28 percent)

Consequences of Bullying
Being bullied can have many effects, many long-lasting, and LGBT workers are feeling the consequences. Of those LGBT workers who were bullied at work, 19 percent have suffered from health-related problems as a result of being bullied at work, and 15 percent have called in sick because of feeling bullied.

Forty-one percent of LGBT workers who have been bullied at work have left a job because they have felt bullied.

Dealing with Workplace Bullying
Erwin shared the below tips for workers dealing with office bullies.

  • Take notes. Document interactions with the bully. Keep these notes in a private place, and use them if you need to show the bullying pattern to a third party, such as your company’s HR department.
  • Rise above, but don’t be afraid to confront. At first, try to minimize time spent around the bully, and ignore any bullying behavior. But sometimes, enough is enough, and you need to confront them. Explain how the negative treatment makes you feel, and ask them to stop. Sometimes perpetrators are not aware of the effect their actions have. Fifty-three percent of workers who were bullied at work confronted their bully, and 20 percent said the bullying stopped.
  • Bring in the experts. Seventy-two percent of workers who were bullied at work do not report it to HR. Your HR team is trained in dealing with workplace conflict, and can step in to help you solve the issue.

Survey Methodology
This survey was conducted online within the U.S. by Harris Poll on behalf of CareerBuilder among 3,420 employees (employed full-time, not self-employed, non-government including 3,215 in the private sector and 238 LGBT workers) between February 16 and March 9, 2017 (percentages for some questions are based on a subset, based on their responses to certain questions). With a pure probability sample of 3,420, one could say with a 95 percent probability that the overall results have a sampling error of +/- 1.68 percentage points. Sampling error for data from sub-samples is higher and varies.

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LGBTQ Seniors Meetings Info and Support

All LGBTQ seniors are welcome to attend the “Aging Gayfully” classes at Finley Senior Center in Santa Rosa (Wednesdays 10 am – noon) and Sebastopol Area Senior Center (Wednesdays 2:30-4:30 pm).  While SRJC classes are officially cancelled this week, I am still meeting with those who feel the need to connect with their peers and be supported during this challenging time.

Vintage House in Sonoma is “closed until further notice” (probably due to power outages) so I may not be able to hold my “Aging Gayfully” class there this Thursday morning and we are still waiting to see if the Sonoma Valley LGBT Seniors Group can have our scheduled monthly discussion group there on Friday morning at 10 am.  If we can, we invite LGBTQ seniors in our area who have been affected by the fire to join us.  If not, we will be meeting in the banquet room of the Palms Grill (Sonoma Highway at El Vernano Blvd.) at noon for lunch and discussion.

Also I would encourage use of the LGBTQI Elder Resource Center (http://www.sebastopolseniorcenter.org/lgbtqi-elder-resource-center) and for LGBTQI seniors to feel comfortable contacting our Sonoma County Adult and Aging Services as their staff have received multiple LGBTQ cultural competency trainings and are eager to make sure LGBTQ seniors are not lacking in services, especially during this critical time.

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Bipartisan Legislation Introduced to Protect Transgender Service Members

Friday, bipartisan legislation was introduced in the U.S. House of Representatives to protect currently-serving transgender service members from being discharged due to President Trump’s transgender military ban. The legislation was introduced by Representatives Jackie Speier (D-CA), Charlie Dent (R-PA), Susan Davis (D-CA), Ileana Ros-Lehtinen (R-FL), Adam Smith (D-WA), and Kyrsten Sinema (D-AZ).

“Transgender troops serve this nation with distinction and honor, and President Trump’s unpatriotic attack on their service is unconscionable,” said Stephen Peters, HRC National Press Secretary and Marine Corps veteran. “Qualified Americans who are willing to put their lives on the line for their fellow citizens should be allowed to do so — regardless of their gender identity. We thank Representatives Jackie Speier, Charlie Dent, Susan Davis, Ileana Ro-Lehtinen, Adam Smith, and Kyrsten Sinema for their leadership in defending transgender service members.”

The Senate version of the legislation was introduced last month by Senators Kirsten Gillibrand (D-NY), Susan Collins (R-ME), John McCain (R-AZ), and Jack Reed (D-RI). The legislation is based on an amendment to the National Defense Authorization Act introduced by Senators Gillibrand and Collins that was blocked by Senate Majority Leader Mitch McConnell (R-KY) — despite the likelihood of majority, bipartisan support in the chamber.

Ian Thompson, legislative representative with the American Civil Liberties Union, had the following reaction:

“The introduction of this legislation provides still more evidence that bipartisan opposition in Congress to President Trump’s discriminatory and unconstitutional ban on military service by transgender individuals is growing by the day. Reps. Speier, Dent, Davis, Ros-Lehtinen, Smith, and Sinema are to be commended for standing up for transgender service members, like those represented by the ACLU in our legal challenge, who have repeatedly proven that they have the courage and capacity to serve in our nation’s armed forces.

“We have seen one sweeping anti-LGBT action after another from this administration. The commitment of the Trump administration to discrimination is now crystal clear. Members of Congress who support equality under the law for LGBT people must use every tool at their disposal to fight back.”

The legislation would protect transgender service members currently serving from being discharged because of their gender identity and express the sense of Congress that individuals who are qualified and can meet the standards to serve in the military should be eligible to serve.

After Trump in July unexpectedly and callously announced via Twitter that he would impose a discriminatory ban on transgender military service, members of Congress from both sides of the aisle spoke out forcefully against it. A clear majority of Americans believe anyone who is willing and able to serve in our nation’s military should be allowed to do so.

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Florida Keys Reopens to Visitors After Hurricane Irma

The Florida Keys have reopened to visitors, exactly three weeks after Hurricane Irma impacted the island chain Sept. 10.

Local officials chose Sunday, Oct. 1, as the official reopening date based on the speedy completion of significant infrastructure repairs, almost total restoration of utilities, and necessity of resuming the tourism-driven economy that employs about 50 percent of the Keys workforce.

“By welcoming visitors to the destination, it will provide the jobs and the hope that our residents are looking for so they can begin to rebuild their lives,” said Stacey Mitchell, director of marketing for the Florida Keys tourism council.

While Key Largo and Key West were least affected by Irma, a number of lodging properties and other tourism facilities in the Keys haven’t yet resumed normal operations. Recovery efforts are ongoing, especially in the Lower Keys and parts of Marathon that were hardest hit by the storm.

“It’s been a road of recovery and continues to be so, but we’ve made enough progress where the infrastructure is ready to accept visitors,” said Mitchell. “By the visitor coming down, they’re helping in the recovery and being part of that process.”

Visitors will find the Key West and Marathon airports open as usual, and the Port of Key West hosting cruise ships again. The Florida Keys Overseas Highway has passed inspection and is easily drivable throughout the 125-mile island chain.

Even Key West’s Southernmost Point marker, an iconic photo stop that designates the continental United States’ southernmost land mass, is being repainted after damage from Irma.

A number of Keys special events scheduled for mid to late October — including Key West’s Fantasy Fest, Marathon’s Stone Crab Eating Contest and Key Largo’s Humphrey Bogart Film Festival — are to take place as planned, according to organizers.

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36 Hours in Sonoma County

Robust zinfandels. Floral chardonnays. Crowd-pleasing pinot noirs. Sonoma County is known for its many varietals and the oenophiles who flock there to sip and swill. More than double the size of its more popular neighbor, Napa, Sonoma is a sprawling, diverse locale that offers much more than what’s under the cork. From 300-foot tall trees to manicured tea gardens to farm-to-table dining, it’s easy to fall under its spell.

  1. 36 Hours in Sonoma County, Calif.

  • Frriday

    1) 3 P.M. Go Fish

    Start what will inevitably be a decadent weekend with Sonoma’s purer draws: the spectacular landscape and outdoor activities. Lake Sonoma, formed in 1983 by the construction of a 319-foot-high, 3,000-foot-long dam, offers a surface area of more than 2,700 acres for swimming, boating and fishing. Rent a modest aluminum rowboat or double-decker patio boat ($45 to $110 for one hour) at the Lake Sonoma Marina and angle for rainbow trout, black bass and redear sunfish, all of which are plentiful in the lake. For land-loving mountain bikers, hikers and horseback riders, there are 40 miles of trails through grassy slopes, rugged hills and mixed forests. And if archery is your game, bring your bow and arrows — there’s also a 14-target archery range.

    2) 5 P.M. Plaza Shopping

    Just southeast of the lake, the landscape is considerably different but no less inspiring. Healdsburg, a well-heeled town anchored by a central square that is surrounded by restaurants, shops, art galleries and, of course, wine stores and tasting bars, is the perfect place to transition into evening. Start at Shed, a cavernous culinary market and cafe devoted to local farming culture that features everything from butter churns and herb shears to umami salt and kombucha on tap. At Lime Stone, Lisa Palmer, the wife of the well-known chef Charlie Palmer, stocks the housewares store with cheeky-chic items: Sonoma wine label decoupage platters, shatterproof wine glasses and serving trays plastered with words to live by: “There’s always time for a glass of wine.”

    image for BarndivaThe king salmon, with fried green tomatoes and caviar crème fraîche, at Barndiva. Drew Kelly for The New York Times

    3) 6:30 P.M. Cocktail Kickoff

    Wine country is not immune to the cocktail craze that has swept the country, as evidenced at Healdsburg’s Bravas Bar de Tapas, a lively Spanish restaurant that opened five years ago and remains a local favorite. The fenced-in patio, strewn with fairy lights, has a small bar tucked under an overhang and a cocktail menu where gin plays the starring role. Try the Primavera, a gin and tonic made with locally distilled D. George Benham’s gin, fennel fronds, lemon and cucumber bitters, or the Levante, a gin cocktail accented with orange, saffron and cardamom ($11 each).

    4) 8 P.M. Dine With The Locals

    On the other side of the town square is another residents’ favorite: Barndiva. The large barnlike structure, designed and built from the ground up by the owners, Jil and Geoffrey Hales, offers an urbane country-meets-industrial chic interior filled with art and antiques, as well as a picturesque patio beneath arching mulberry trees. Ryan Fancher helms the kitchen, marrying French technique with California ingredients, many coming from the Barndiva Farm in Philo, to deliver crowd-pleasing dishes like goat cheese croquettes drizzled with wild lavender honey, duck leg confit with gnocchi and caramelized endive, and local petrale sole with lobster risotto and pickled fennel. Dinner for two with wine is about $120.

  • The Dry Creek General Store is a historic landmark. Drew Kelly for The New York Times
    Saturday

    5) 9:30 A.M. Go West

    Wend your way west on Route 116, through light-barring redwoods, past glowing green dairy farms and alongside the placid Russian River. Don’t blink as you near the Pacific or you might miss Duncans Mills (population: 175) and Gold Coast Coffee & Bakery. Inside the single-story strip mall storefront, you’ll have to wait your turn at the self-serve cabinet filled with turkey pesto croissants, blueberry lemon scones and generously frosted cinnamon rolls. Of all the tempting pastries, don’t miss the gigantic butterhorn ($4), which is made with swirls of cinnamon-saturated dough and topped with crumbled sugar bits. Pair it with the Rocket Dog ($3), a bracing mix of espresso and coffee.

    6) 11 A.M. Ocean Views

    Goat Rock Beach, located in Jenner just past Duncans Mills, is part of the Sonoma Coast State Park’s rugged expanse. Park at the top and hike the narrow path through the grassy bluffs and listen to the ocean roar, or drive down to the expansive sandy stretch of beach that sits at the mouth of the Russian River. While the currents make it too treacherous for swimming, it’s the perfect place for beachcombing, contemplating the grandeur of the jagged headlands and flat-topped rock formations, and potentially spotting wildlife — migrating whales are often seen from December to April, while a local colony of Pacific Harbor seals and their pups can be spotted from late spring through summer.

    7) 2 P.M. Pick Up A Picnic

    Established in 1881, the Dry Creek General Store is a historic landmark but has all the modern fixings for a picnic lunch. Go up the creaky front porch, through the swinging doors, and head to the deli counter, where an array of snackable goodies — deviled eggs! peppered beef jerky! — are the accompaniments you didn’t know you needed to go with your pressed turkey sandwich topped with homemade cranberry sauce and slaw ($12.95) or prosciutto tucked into a crunchy baguette ($7.95). As you wait for your sandwiches, do some time-traveling: The bar tucked in the rear has antiquated suitcases, cowboy boots, water jugs and other relics from yesteryears suspended from the ceiling.

    image for QuiviraA wine tasting in the gardens at Quivira. Drew Kelly for The New York Times

    8) 3 P.M. Time to Taste

    Of course you can’t visit Sonoma without sampling some wines. With over 400 wineries across 17 appellations, it’s best to focus on one or two regions and maximize your tasting journey. If you fancy zinfandels, sip in Dry Creek Valley. Quivira offers biodynamic gardens and electric car-charging stations outside — this is California, after all — and flights of elegant Rhone varietals inside its cool-as-clay tasting room, while Truett Hurst bustles with lolling couples, groups of friends and multigenerational families picnicking and sipping the bright, fruity zinfandels on the terrace’s comfortable couches and cherry-red Adirondack chairs. Just southwest, the Russian River and Green Valleys are forested, lower in elevation and cool — ideal conditions for pinot noir and chardonnay. The tasting room at Iron Horse Vineyards happens to be an outdoor bar made of reclaimed redwood planks and oak barrels. Take in the views of the undulating hills stitched with rows of grapevines and Mount St. Helena’s double peaks in the distance as you sample the silky Estate Pinot.

    9) 7 P.M. Farmhouse Dining

    Despite being one of the most refined dining spots in Sonoma, the Michelin-starred restaurant at Farmhouse Inn in Forestville manages to keep a comfortable, cool vibe. Located in a restored 1873 farmhouse, the soothing neutral shades in the dining room are given added character by the raw wood chandeliers and quirky mural that depicts scenes from the family albums of the siblings and owners, Joe and Catherine Bartolomei. The tasting menu ($99 for three courses, $115 for four) teems with local ingredients such as the ricotta from Bellwether Farms, an artisan creamery in Petaluma, that fills the delicate rainbow chard raviolis; fresh asparagus from Salinas; and hon shimeji mushrooms from Sebastopol that artfully encircle a filet of Alaskan halibut. Whether you opt for a modest half glass or splurge on the wine pairing ($74 and $84 for the three and four courses, respectively), wine service, led by Jennifer Jespersen, is as wonderfully unsnobbish as you can get.

    10) 10 A.M. Heaven

    Not many original redwood groves survived the West Coast’s 19th-century logging boom, but one of them, happily, is in Sonoma. Armstrong Redwoods State Natural Reserve, in the backyard of the thriving foodie scene along Guerneville’s Main Street, is a magical 805-acre oasis of old growth trees. Pick up the 1.7-mile Pioneer Nature Trail just inside the park entrance and meander past the tallest specimen in the grove (the Parson Jones Tree, at more than 310 feet) as well as the oldest (the Colonel Armstrong Tree, estimated to be over 1,400 years old). Educational placards along the flat, well-marked path relay biological and historic facts on the remarkable natural spectacle.

    11) 12 P.M. Brunch Alfresco

    After the cool, enveloping silence of the redwoods, the sunny energy at Canneti Roadhouse Italiana will be welcome. Created in the spirit of a Tuscan trattoria, the restaurant’s interior is painted a neutral Mediterranean palette, and a garden patio sits draped in wisteria. Have another glass of wine — perhaps a crisp pinot gris from the local Moshin Vineyards — with the creamy scrambled eggs with endive, served in a bowl of toasted brioche and saffron hollandaise sauce, or go for the gusto with pennette carbonara. Brunch for two with wine, about $70.

    12) 2:30 P.M. Detox

    Because it’s been so exhausting, finish your weekend at Osmosis Day Spa Sanctuary in the historic village of Freestone. The grounds have been magnificently landscaped to include a Japanese meditation and tea garden, pagodas and hammocks, but the real reason to visit is for the Cedar Enzyme Bath ($109). A ritual in Japan, these baths are warm from the natural fermentation of finely ground evergreens and rice bran. The 20 minutes you spend immersed — with visits from an attendant who offers sips of water and cold compresses — are said to draw out impurities, relax joints and muscles and activate your metabolism. Finish with a shower and meditative lie-down in the spa.

  • Lodging

    With its 60-foot outdoor pool and Jacuzzi and in-house Charlie Palmer restaurant, Dry Creek Kitchen, the 56-room (including six suites) Hotel Healdsburg has been a hot spot since opening in 2001. Located on the main square in Healdsburg, it’s perfectly situated for eating, drinking and exploring. Rooms in peak season start at $549.

    For a more eclectic experience, check in at Boon in Guerneville. Tucked between Main Street and the redwoods, the 12 rooms and two suites (rates start at $225 on weekdays) are minimally appointed, but cozy, featuring organic linens, platform beds and custom reclaimed redwood furniture.

 

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UNAIDS Calls to Quicken the Pace of Action to End AIDS

The President of Uganda, Yoweri Museveni, in collaboration with UNAIDS, brought together six heads of state or government to accelerate action and get countries on the Fast-Track to end AIDS. World leaders joined around 500 partners from government, the private sector and civil society on the sidelines of the United Nations General Assembly to reinvigorate political leadership around HIV.

The Fast-Track approach is saving more and more lives. In 2016, 19.5 million people—more than half the 36.7 million people living with HIV—were accessing life-saving treatment. The number of people who died from AIDS-related illnesses has been reduced by nearly half since 2005, and the global number of new HIV infections has been reduced by 11% since 2010.

However, the pace of action is still not enough to end the AIDS epidemic as a public health threat by 2030. In order to step up progress and achieve the global targets adopted in the 2016 United Nations Political Declaration on Ending AIDS, all partners need to fully implement their country Fast-Track strategy. Ending AIDS requires steadfast political leadership, commitment to action and accountability towards shared responsibility and reaffirmed global solidarity. Increased effective and efficient investments are, and will continue to be, an essential prerequisite for success. Elimination of stigma and discrimination and full recognition of human rights are cornerstones of sustainable progress.

“Leadership, partnership and innovation will transform the epidemic,” said UNAIDS Executive Director Michel Sidibé.

President Museveni was the first head of state in Africa to launch a presidential Fast-Track initiative on ending AIDS as a public health threat, known as “Kisanja Hakuna Mchezo”, or “no time for playing games”.

“I am confident that working together with you all, we shall attain an AIDS-free Africa. It is possible to end AIDS in our generation!” said President Museveni.

During the event, the speakers outlined the positive impact that the Fast-Track approach to ending AIDS is having on people, health systems and the broader Sustainable Development Goals in Africa and beyond. They noted that addressing HIV within the Sustainable Development Goals will pave the foundation of the AIDS response.

“We must build on the Fast-Track commitments. We cannot stop before we have reached the finish line,” said Jacquelyne Alesi, a civil society representative from Uganda.

Speakers made a strong call for political leadership, global solidarity and shared responsibility to build momentum and deliver on the goal of ending AIDS by 2030, highlighting the role that supporting strengthened health systems plays, not just in making progress towards the Fast-Track Targets, but also in addressing stigma and discrimination.

“I am not speaking of a vague hope, but of a willingness of the heart. I do not say “we could defeat AIDS,” but rather “we will end AIDS,” said Line Renaud, singer and AIDS activist.

Momentum is building, but has not yet reached a critical mass. When the United Nations General Assembly adopted the Political Declaration on Ending AIDS in June 2016, Member States committed to achieve global and regional Fast-Track Targets by 2020.

In 2016, UNAIDS estimated:

19.5 million people were accessing antiretroviral therapy

36.7 million [30.8 million–42.9 million] people globally were living with HIV

1.8 million [1.6 million–2.1 million] people became newly infected with HIV

1.0 million [830 000–1.2 million] people died from AIDS-related illnesses

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IAS 2017: Progress on PrEP, treatment as prevention, and HIV cure science

While the world’s top HIV experts reported no earth shattering progress in preventing, treating or curing HIV at the 9th IAS Conference on HIV Science (IAS 2017), which took place in July in Paris, it did serve as an important marker of progress. HIV researchers revealed new data that further strengthened the case for PrEP and HIV treatment as prevention — and issued a resounding declaration that a person with full viral suppression is essentially incapable of passing on HIV to their sex partners.

On the other hand, a joint meeting of HIV and cancer scientists, just before IAS 2017, ended on a more somber note. Though noting the rapid progress in our knowledge of the underlying mechanisms that make both HIV-infected cells and cancerous cells so hard for the body to get rid of, experts there also acknowledged that while long-term viral remission — with HIV still present in the body — can likely be achieved in many people, completely eliminating the virus will remain rare.

Here are some key highlights from the conference.

HIV Treatment Scale-up, Treatment as Prevention, and U=U

Two presentations and one issuance of a declaration statement, when combined, demonstrated just how much progress we are making at simultaneously improving the physical, mental and social health of people with HIV and substantially reducing the number of new HIV infections around the globe.

In terms of the societal impact of HIV treatment scale up and viral suppression, a new study out of Swaziland in the Kwazulu-Natal province in South Africa found that doubling the number of people with HIV who had full viral suppression was accompanied by a 50% drop in new infections. Though previous studies in multiple countries and cities had demonstrated less directly that increasing the number of people with HIV on ART was associated with significant drops in new HIV cases, this study represents the most direct correlation between viral suppression and HIV incidence to date.

A second presentation took these data to a very personal level. The previously reported PARTNER study, which predominantly enrolled heterosexual mixed HIV status couples, found zero cases of HIV transmission between people with HIV who had fully suppressed virus and their HIV-negative primary partner, despite thousands of condomless sex acts. The PARTNER study did enroll couples where both partners were male and where condomless anal sex was the primary risk, but the numbers were so small it was not possible to derive firm conclusions other than that lower HIV levels did offer good protection.

The Opposites Atract study focused solely on male-male mixed HIV status couples, and also found zero new infections between positive and negative partners despite nearly 17,000 condomless sex acts, a fair number of them occurring when the HIV-positive partner also had a sexually transmitted infection. Combined with the original PARTNER study, the top experts who convened the IAS 2017 conference, and high level officials from the U.S. government issued a strong declaration in support of the Undetectable = Untransmittable (U=U) campaign from the Prevention Action Campaign, which stresses the critical importance for people with HIV and the communities they live in to be aware of the fact that when a person living with HIV is on ART with a persistently undetectable viral load there is a negligible risk that they can transmit HIV to their sex partners. Growing consensus around this statement, and gaining buy-in and support from medical societies and various branches of government could considerably improve the physical, emotional and social well-being not only of people with HIV, but others in their communities.

PrEP

Perhaps the most helpful presentation on pre-exposure prophylaxis (PrEP) came from a second look at data from the IPERGAY study, which took place in France and Canada a couple of years ago, and which studied intermittent rather than continuous daily PrEP. Though efficacy rates were very high in IPERGAY — an 86% reduction in new HIV infections overall, but zero new infections in people who actually took their medication as directed — a critical uncertainty remained. Since the protocol recommended PrEP just before, during and after sex, and because so many participants had a lot of sex, a lot of the guys in the study were essentially taking daily PrEP.

The re-analysis of data on the subset of people who did go for longer stretches between sexual encounters, and who therefore could be considered as truly taking intermittent PrEP, showed that they also had high levels of protection against HIV transmission. It thus seems pretty clear that intermittent PrEP is a reasonable approach for those who go for longer periods between having condomless anal sex (provided that it is taken similarly to the protocol used in IPERGAY). It also lends further weight to the argument that even daily oral PrEP is likely to be incredibly forgiving of missed doses in those whose HIV risk is from condomless anal sex.

Pathway to a Cure

Since approximately 2010, when the world’s top scientists and government agencies began openly using the word “cure” as an achievable goal in the fight against HIV, we have gone from an initial burst of exuberance to an attitude of more sober optimism — the result of repeated experiments documenting the stubborn persistence of the virus and its ability to surge back to life when ART is stopped, even when the most sensitive tests seeking a trace of it come up blank over months or years.

Interestingly, as the consensus among scientists is that total elimination of the virus from a person’s body is highly unlikely, but that a long-lasting remission free of ART might be, we are now most intensively utilizing drugs designed for another condition where the word remission is the key: cancer.

Because both HIV-infected and cancerous cells hijack the biological machinery that protects the immune cells from attack by most viral infections, the IAS 2017 organizers convened a small pre-conference devoted to exploring the commonalities and the ways that some of the newest cancer drugs might also be promising as part of a combination approach to achieving long-lasting suppression of HIV when people stop taking ART.

Predominantly, those drugs are focused on the molecular markers on the outside of CD4 and CD8 cells that communicate with other immune cells. These checkpoint markers can affect whether a cell that has been activated by the presence of a virus essentially goes to sleep and becomes invisible to the rest of the immune system. While this is a desirable ability if we want to retain cells that can immediately mount strong immune response if we are exposed to a virus a second time, it is a total liability if those cells harbor reproducible portions of genetic material that can lead to the reemergence of HIV disease or cancer.

The good news is that several of the immune check-point blockers are so much more potent against some cancers than previous drugs, also appear to enhance the immune system to recognize and eliminate cells that are latently infected with HIV. Unfortunately, the drugs approved so far stop or reverse tumor growth in only about half of people with cancer, and the drugs almost always lose potency over time. This is leading researchers to believe that immune-checkpoint blocker therapy for cancer is possibly going to look a lot more like modern ART — combinations of drugs used together over the course of a person’s life.

Though sobered by these realities, however, the two-day pre-conference ended on a note of determination to succeed with the same zeal that delivered the medications that are making ending the epidemic a plausible reality for many parts of the globe.

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Planned Parenthood and Black AIDS Institute Announces Program to Expand HIV Services

 Planned Parenthood has announced a multi-phase pilot program to build and expand its comprehensive HIV prevention and education efforts. Gilead Sciences, Inc, a research-based biopharmaceutical company, awarded the $900,000 grant to support and expand efforts of HIV prevention and education, including the integration of Pre-Exposure Prophylaxis (PrEP) awareness, at Planned Parenthood affiliate health centers across the country over the next 18 months. It is the first significant corporate grant of its kind awarded to Planned Parenthood, and will focus critical prevention efforts in communities hardest hit by the epidemic.

The grant work will be carried out in partnership with The Black AIDS Institute, the only national HIV/AIDS think tank in the United States focused exclusively on Black people.

“Planned Parenthood is thrilled to be launching this incredibly exciting project. Although this country has made progress toward greater health care equity, disparities in HIV rates remain a serious issue for too many people and too many communities,” said Dr. Raegan McDonald-Mosley, chief medical officer at Planned Parenthood Federation of America. “Rates of new HIV cases, along with barriers to treatment and health care access, continue to more greatly impact marginalized communities.  With this grant, Planned Parenthood can implement life-saving awareness and care not otherwise funded at this scale. It furthers our mission to provide all people, especially those already facing barriers to accessing quality health care, with comprehensive and cutting-edge HIV prevention methods, including PrEP”.

PrEP is the medical practice of prescribing antiretroviral medication to prevent against HIV infection.

“The Black AIDS Institute is proud to partner with Planned Parenthood to expand comprehensive HIV prevention services to Black Women”, Phill Wilson, President and CEO of the Black AIDS Institute. “Given the disproportionate impact HIV is having on Black women and the new tools we have at our disposal, this is the right thing to do at the right time.”

The majority of the grant will directly support the efforts of Planned Parenthood affiliates to develop training and resources aimed at delivering a comprehensive program of HIV prevention, including PrEP and other methods, in health centers across the country. It will also go toward the creation of patient education materials to reach populations most at-risk for HIV, as well as capacity-building sustainable learning modules across affiliates.

“Scientific innovation has greatly improved our ability to address the HIV epidemic,” said Gregg Alton, Executive Vice President, Corporate and Medical Affairs for Gilead Sciences, Inc. “Alongside that innovation, diverse programs and partnerships are helping to ensure we can reach those most in need of treatment and prevention options.  Prevention strategies, including PrEP and other methods, can have a meaningful impact on public health, offering an unparalleled opportunity to avert new infections and reduce long term costs to the healthcare system.”

Planned Parenthood provides high-quality, compassionate care in health centers across the country, including nearly 700,000 HIV tests each year. Planned Parenthood health centers are uniquely positioned to deliver HIV prevention services and education to disproportionately impacted communities, including Black women, Latinas, transgender people, young adults of all backgrounds, and men who have sex with men, especially people of color.

Dr. McDonald-Mosley added, “Training and resourcing more medical providers to provide HIV and PrEP education, with a particular focus on prevention in underserved communities, is a job for which Planned Parenthood is uniquely suited. For over 100 years, we’ve been fighting to ensure that people — no matter where they live — can access accurate, nonjudgmental preventive care and education so they can keep themselves and their families healthy.”

Despite the life-saving advances in highly active antiretroviral therapy (HAART) for treatment and prevention, HIV remains an urgent public health crisis, especially for certain marginalized communities who face barriers to affordable, quality health care. According to a 2014 Centers for Disease Control and Prevention (CDC) surveillance report, women of color, particularly Black women, are disproportionately affected by HIV, accounting for the majority of the HIV infections, women living with HIV, and HIV-related deaths among women in the U.S.

“Over 40% of people living with HIV in the U.S are Black.  Nearly 50% of new HIV infections in this country are Black. and 1 in 32 black women, 1 in 16 black men, and 1 and 2 Black Gay men will be diagnosed with HIV infection in their lifetime. Yet 85% of current PrEP users are white men. What’s wrong with this picture”, says Leisha McKinley Beach, technical assistance consultant, Black AIDS Institute.

While awareness of antiretroviral medication as pre-exposure prophylaxis (PrEP) among men who have sex with men (MSM) has risen significantly, women at risk for HIV still face several challenges in getting the services and information they need, including structural and cultural barriers such as poverty, HIV stigma, and a relative lack of access to healthcare professionals trained to offer comprehensive HIV prevention, including PrEP and other methods.

As part of our mission to help people live healthy lives, Planned Parenthood works every day in communities across the country and with partners around the world so that everyone — no matter who they are or where they live — can access accurate, high-quality, compassionate sexual and reproductive health care.

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