More than 20 Republican attorneys general filed a lawsuit Tuesday against President Joe Biden’s administration over a Department of Agriculture school meal program that prohibits discrimination based on sexual orientation and gender identity.
The challenge, led by Tennessee Attorney General Herbert Slatery, claims that the federal government is attempting to force states and schools to follow anti-discrimination requirements that “misconstrue the law.”
The coalition of attorneys general are hoping for a similar result to a separate challenge from earlier this month when a Tennessee judge temporarily barred two federal agencies from enforcing directives issued by Biden’s administration that extended protections for LGBTQ people in schools and workplaces.
The judge sided with the attorneys general, ruling that the directives infringed on states’ right to enact laws, such as banning students from participating in sports based on their gender identity or requiring schools and businesses to provide bathrooms and showers to accommodate transgender people.
“This case is, yet again, about a federal agency trying to change law, which is Congress’ exclusive prerogative,” Slatery said in a statement. “The USDA simply does not have that authority. We have successfully challenged the Biden Administration’s other attempts to rewrite law and we will challenge this as well.”
In May, the USDA announced that it would include discrimination based on sexual orientation and gender identity as a violation of Title IX, the sweeping 1972 law that bars sex-based discrimination in “any education program or activity receiving Federal financial assistance.” The directive requires states to review allegations of discrimination based on gender identity and sexual orientation, as well as update their policies and signage.
The agency warned that states and schools that receive federal funds, which include the national school lunch program overseen by the USDA, have agreed to follow civil rights laws. Although the agency says it wants voluntary compliance, it also has promised to refer violations to the Department of Justice. It is not clear whether the federal government would hold back funding for school meal programs as part of its enforcement.
The directive followed a landmark civil rights decision by the U.S. Supreme Court in 2020 that, under a provision called Title VII, protects gay, lesbian and transgender people from discrimination in the workplace.
According to the lawsuit, the attorneys general allege that the USDA’s new directive is based on a “misreading” of the Supreme Court’s ruling and did not provide states and other groups the opportunity to provide public comment.
The attorneys general involved in the lawsuit filed Tuesday are from Alabama, Alaska, Arizona, Arkansas, Georgia, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia and West Virginia.
A spokesperson for the USDA did not immediately return a request for comment.
Either America is a country where fundamental rights are guaranteed, or we are a nation where your rights depend on who you are and your zip code. Those are the stakes right now, as an emboldened far-right political movement attacks federal protections for the rights to vote, access abortion care, marry the person you love, and more.
It’s a critical step forward, then, to see the U.S. House’s strongly bipartisan passage of the Respect for Marriage Act. The bill, which heads to the Senate, would ensure federal recognition of marriages between same-sex couples and interracial couples.
The bill’s passage comes after Justice Clarence Thomas’s chilling sentences declaring not just the Obergefell ruling ensuring the freedom to marry but also Griswold’s guarantee of contraception and Lawrence’s right to consensual same-sex relationships to be “demonstrably erroneous decisions.” He all but invited challenges to these historic precedents.
The Respect for Marriage Act evokes an earlier time in the long fight to win marriage equality. I have been replaying vivid memories of traveling the South a decade ago with our team at the Campaign for Southern Equality, standing with hundreds of same-sex couples who courageously requested marriage licenses in their hometowns to call for marriage equality, knowing they’d be denied. We worked with families in small towns like Morristown, Tenn., and cities like Mobile, Ala. I think about those who were plaintiffs in lawsuits striking down marriage bans in state after state. Those brave efforts worked — changing hearts, minds, laws, and our nation. Public support for the freedom to marry has grown steadily to now-historic levels, with polling tracking support at 71 percent. So many Americans have a close friend or family member who is LGBTQ+ and show their support everywhere from the kitchen table to the voting booth.
Despite this resounding public support, the LGBTQ+ community has been subject to a ceaseless assault from a far-right, Christian nationalist movement that exerts tremendous political power at every level of the American government. This movement has, through a mix of methodical strategy and deliberate chaos, seized the reins of the U.S. Supreme Court and almost every state legislature in the South. If they prevail in having Obergefell or other landmark precedents revisited or overturned, so many families and marriages would be at risk.
We must all be clear-eyed that we are entering a new chapter in the movement for LGBTQ+ equality. We’re already seeing the damage, especially in the South, which has been and will likely continue to be the epicenter for these attacks. Nearly every Southern state has passed laws targeting transgender youth for discrimination and exclusion. Parents who advocate for their trans children are being investigated as “child abusers.” The Texas attorney general has vowed to defend a 50-year-old law criminalizing homosexuality. A South Carolina congressional candidate called for LGBTQ+ people to be charged with treason. Even simple civic affirmations of LGBTQ+ people, such as Pride Month proclamations, are being censored.
We must harness the power of the supermajority of Americans who support LGBTQ+ equality. A record number of communities in the South have passed nondiscrimination ordinances, there is strong bipartisan support for LGBTQ+ protections, and countless Southern families are responding with love when a child comes out. For me, this is a source of very real hope.
The variety of hope I feel is not the buoyant stuff made of easy promises of what can be. It is, rather, hope that’s like a muscle you train until it’s strong enough for the work ahead, the kind made of prayer, grit, and crystal-clear resolve.
The stakes for our country could not be higher. Now is the time for us to take swift action in every part of our lives:
Individuals should take legal steps to protect themselves and their families and make concrete, detailed plans around access to health care, including transgender health care and reproductive health care.
Communities should mobilize funding, volunteers, and infrastructure for frontline work to support communities under attack.
At the state level, we should focus efforts on repealing “latent” laws, from so-called sodomy laws to marriage bans, that could be revived to challenge LGBTQ+ people.
Nationally, we must demand that Congress codify in federal law the freedom to marry who you love, abortion access for all, and the right to contraception — including urging the Senate to pass the Respect for Marriage Act.
We know what is possible if we prevail — and we also know what happens if we do not. This work is our charge. It is the work of our lifetimes. And it will take all of us.
Rev. Jasmine Beach-Ferrara is the executive director of the Campaign for Southern Equality. She and her family live in Asheville, N.C.
Republican governor Ron DeSantis has filed a complaint against a Miami restaurant after a video showed kids at a drag brunch event.
The Florida governor spoke about the video – which sees a child walking with a drag artist – at a Wednesday (27 July) news conference, saying that an investigation by the Florida Department of Business and Professional Regulation was conducted.
“They actually had agents going to this place and effectively just gathering information, getting intelligence, seeing what’s going on,” he said. “And what they found was not only were there minors there, the bar had a children’s menu. And you think to yourself, ‘Give me a break, what’s going on?’”
An administrative complaint accusing the restaurant of disorderly conduct was filed by the department on Tuesday (26 July), with reports that NBC Newshad obtained the complaint on Thursday (28 July). According to a tweet by activist Erin Reed, the complaint referenced a 1947 ruling that “men impersonating women in a suggestive fashion” is against the law.
“They are building the framework to go after all drag, and likely all trans people,” Erin continues in her tweet.
Clinical instructor Alejandra Caraballo also tweeted saying that the complaint was “setting the stage” for the revitalisation of “anti-‘crossdressing’ laws”.
“This is the foundation to target all visibly trans and queer people in Florida and use the state to enforce rigid gender norms,” she continued.
The complaint reportedly says that the video shows “what appears to be a transgender dancer” walking with a young girl around the restaurant while wearing a “‘g-string’-style bikini bottom”. The complaint also uses he/him pronouns despite saying that the dancer was “female in appearance”.
The original clip was posted on TikTok but had been shared by the notorious Twitter account LibsofTikTok which often shares videos ridiculing LGBTQ+ teachers and other marginalised groups. Those who are targeted by the account often receive an influx of death threats and harassment.
The Washington Post released an exposé on 19 April revealing the account owner to be Chaya Raichik, who attended the Capitol insurrection in January 2021. Reports later in the month suggested that Raichik had a long-running online friendship with Desantis’ press secretary Christina Pushaw around a month after he signed Florida state’s hateful ‘Don’t Say Gay’ legislation.
Since then, Ron DeSantis has turned his sights onto drag performances after Texas lawmakers planned to ban kids from attending drag shows on 6 June. The Florida politician then proposed a similar bill and also suggested that parents who take their kids to drag shows could be investigated.
During an 8 June news conference, he said that he had asked staff to look into a proposal, characterising drag as “really, really disturbing” and “inappropriate” for children to be at the show.
“We’re going to look to see what can be done under existing statutes, but I do think targeting these kids with all this stuff,” he said. “It used to be kids would be off-limits, used to be everybody agreed with that. And now, it just seems like there’s a concerted effort to be exposing kids more and more to things that are not age-appropriate. I think our state, Florida, we need to be a family-friendly state.”
San Francisco has declared a state of emergency, with the city in “desperate need of vaccines” as monkeypox cases skyrocket.
The US has seen around 4,600 confirmed cases of monkeypox across the country. Of these cases, 261 have been detected in San Francisco, representing around 30 per cent of all cases in California.
On Thursday (28 July), San Francisco mayor London Breed said: “We are at a very scary place. And we don’t want to be ignored by the federal government in our need. So many leaders of the LGBT community have also, weeks ago, asked for additional help and support and assistance.”
By declaring a state of emergency, San Francisco will be able to allocate more resources to fight the virus. Breed added that the city was in “desperate need of vaccines”.
San Francisco’s emergency declaration comes as earlier this week World Health Organization (WHO) said the accelerating monkeypox outbreak was a global health emergency, the health agency’s highest level of alert.
Monkeypox has spread around the world in recent months, however the outbreak is concentrated in Europe, and gay and bisexual men are disproportionately affected.
The health department of San Francisco, arguably the LGBTQ+ capital of America, has faced criticism for its response to the monkeypox outbreak because of a lack of public messaging and vaccine information.
The queer community and LGBTQ+ organisations have had to pick up the slack, with the San Francisco AIDS Foundation setting up a monkeypox advice hotline, and creating a vaccine waiting list, rather than forcing those at risk to queue for hours.
But state senator Scott Wiener, who represents the city, said: “San Francisco was at the forefront of the public health responses to HIV and COVID-19, and we will be at the forefront when it comes to monkeypox. We can’t and won’t leave the LGBTQ community out to dry.”
The most visible monkeypox symptom is a red rash with flat marks, with lesions soon rising and filling with puss, before falling off.
According to the NHS, other symptoms include a fever, body aches, chills and swollen glands. Symptoms can take between 5 and 21 days to show and bouts of monkeypox can last for weeks.
The Spahr Center is committed to keeping our community safe, including from the Monkeypox virus. That’s why we’re teaming up with Marin County Health and Human Services to host an LGBTQ+ Monkeypox Vaccination Clinic on August 6th. Due to vaccine shortages across California, we have only 48 vaccines available. To be eligible, you must be a Marin County resident age 18 years or older who also meets one of the following criteria:Gay or bisexual men and transgender people who have had multiple sexual partners in the last 14 days Sex workers of any genderAnyone with known exposure to someone who has monkeypox
Questions about Monkeypox?Equality California has lots of information on the virus, who is at risk, and what LGBTQ+ organizations and public health leaders are doing to keep our community safe. If you want to speak with someone at The Spahr Center about monkeypox (or HIV prevention), reach out to Romario, our HIV prevention navigator, at rconrado@thespahrcenter.org.
The head of the World Health Organization on Wednesday advised men at risk of catching monkeypox to consider reducing their sexual partners “for the moment” following the U.N. health agency declaring the escalating outbreaks in multiple countries to be a global emergency.
WHO Director-General Tedros Adhanom Ghebreyesus said 98% of the monkeypox cases detected since the outbreaks emerged in May have been among gay, bisexual and other men who have sex with men. He called for those at risk to take steps to protect themselves.
“That means making safe choices for yourself and others, for men who have sex with men,” Tedros said. “This includes, for the moment, reducing your number of sexual partners.”
Infectious individuals should isolate and avoid gatherings involving close, physical contact, while people should get contact details for any new sexual partners in case they need to follow up later, the WHO chief said.
The U.S. Centers for Disease Control and Prevention has not suggested that men who have sex with men reduce their sexual partners, only that they avoid skin-to-skin contact with people who have a rash that could be monkeypox.
WHO officials emphasized that monkeypox can infect anyone in close contact with a patient or their contaminated clothing or bedsheets. The U.N. health agency has warned that the disease could be more severe in vulnerable populations like children or pregnant women.
To date, more than 19,000 cases have been reported in more than 75 countries; deaths have only been reported in Africa.
“We know very clearly that one of the main modes of exposure for this particular illness is through direct contact, close contact, skin to skin contact, possibly even face to face contact, exposure to droplets or virus that may be in the mouth,” Dr. Rosamund Lewis, WHO’s technical lead for monkeypox, said.
Andy Seale, a WHO adviser on HIV, hepatitis and sexually transmitted infections, said experts have determined the current monkeypox outbreak is “clearly transmitted during sex,” but he said they have not yet concluded whether it’s a sexually transmitted infection.
Dr. Hugh Adler, who treats monkeypox patients in the U.K., said monkeypox was being transmitted during sex and that sexual networks and anonymous sex with untraceable partners were facilitating its spread.
“It’s just as likely that monkeypox was always capable of transmitting and presenting like this, but it hadn’t been formally reported or so widespread before,” he said.
Last week, British authorities issued new guidance advising doctors that people with just one or two lesions might be infectious with monkeypox, potentially complicating efforts to stop transmission.
The European Union’s health commissioner urged the bloc’s 27 member nations Wednesday to step up their efforts to tackle outbreaks in the EU, which she called “the epicenter of detected cases.”
In a letter to European health ministers obtained by The Associated Press, EU Health Commissioner Stella Kyriakides called for a “reinforced, concerted and coordinated action.”
“There is no time for complacency and we need to continue working together to control the outbreak,” she wrote.
There is still hope that Democrats can convince ten Republican senators to join them in codifying marriage equality, even though two Republicans once considered amenable to voting for it have come out against it.
Four Republicans have so far said they will support the measure: sponsors Susan Collins of Maine and Ohio’s Rob Portman; Sen. Thom Tillis from North Carolina, who said he’s a probable vote; and Sen. Ron Johnson of Wisconsin.
Johnson said in a statement Thursday, “Even though I feel the Respect for Marriage Act is unnecessary, should it come before the Senate, I see no reason to oppose it,” according to CNN.
In addition, Alaska’s Sen. Lisa Murkowski says she generally supports the measure but is reviewing the proposed bill. “I have long made known public my support for marriage equality,” she said, the Hill reports.
Eight to 10 Republicans are also possible yes votes, according to the Hill.
The two GOP senators who were once seen as possible supporters of the legislation, Sens. John Cornyn of Texas and Lindsey Graham of South Carolina, announced Wednesday they would not support it.
Graham said he’d defend the Defense of Marriage Act, which defines marriage as the union between one man and one woman. “I’m going to support the Defense of Marriage Act,” he said.
Graham’s remarks on marriage sparked concern among many, according to The Advocate‘s sibling publication Out.
During his tenure in Congress, Graham has long been one of the most anti-LGBTQ+ members and has refuted rumors of being gay.
Cornyn, on his part, said the bill wasn’t anything but a stunt by Democrats to shift concerns over inflation, the outlet reports. “This is a contrived controversy in pursuit of a political narrative that somehow that decision by the Supreme Court is in jeopardy. I don’t believe it is, and this is an effort to try to stoke the fires of political activists and scare them with a narrative that I think is a false narrative,” Cornyn said.
He added that Supreme Court’s 2015 Obergefell v. Hodges ruling upholds the 14th Amendment’s protection of same-sex marriages, which he said probably wouldn’t change.
Sen. Mitt Romney of Utah, who has sided with Democrats in the past, agrees with Cornyn’s position.
“We all know what the law is. I haven’t given consideration to that legislation, in part because the law isn’t changing and there’s no indication that it will,” he said, according to Insider. “And clearly, the legislation from the House is unnecessary, given the fact that the law is the same, and we’ll take a look at it as it comes our way.”
As of a few weeks ago, Roe v. Wade was also the law of the land. In arguing for the legislation, Democrats raise the concurring opinion of Justice Clarence Thomas in Dobbs v. Jackson Women’s Health Organization, which overturned Americans’ right to abortion access. According to Thomas, the court should review its rulings protecting marriage equality and contraception.
Senate Republican Conference members and voters across the country changing their opinions on marriage equality, the Hill reports Portman, whose son is gay, saying.
“You look at the shifting sentiment about this issue throughout the country. I think this is an issue that many Americans regardless of political affiliation feel has been resolved,” he said.
“My own personal views on this haven’t changed from several years ago when I said people ought to have the opportunity to marry who they want,” Portman said. “I think its time has come.”
A coalition of 83 conservative groups sent a letter to Senate Minority Leader Mitch McConnell (R-KY) on Tuesday urging him to block the Respect for Marriage Act.
“H.R. 8404 would require federal recognition of any one state’s definition of marriage without any parameters whatsoever. This would include plural marriages, time-bound marriages, open marriages, marriages involving a minor or relative, platonic marriages, or any other new marriage definition that a state chooses to adopt, including through undemocratic imposition by a state Supreme Court,” the group, led by the Alliance Defending Freedom, claims.
“We call on you to reject H.R. 8404 and to urge your colleagues to thoroughly abandon this harmful and unnecessary legislation,” the letter, signed by Family Research Council president Tony Perkins, Focus on the Family president Jim Daly, and others, concludes.
In a separate letter, the Conservative Action Project claims that the Supreme Court’s decision in Obergefell v. Hodges, the 2015 case that established the constitutional right to same-sex marriage in the U.S., “unleashed religious freedom violations across the land, launching a new era of harassment and coercion of millions of Americans who hold a sincere religious belief or moral conviction that marriage is, or ought to be, between one man and one woman.”
McConnell has yet to take a stance on the Respect for Marriage Act, which House Democrats passed last week with the support of 47 Republicans. The bill is intended to enshrine the right to same-sex as well as interracial marriage into law following the Supreme Court’s decision striking down Roe v. Wade and Justice Clarence Thomas’s call for the court to reconsider Obergefell v. Hodges.
Senate Democrats need to pick up 10 Republican votes in order to pass the law, and several key GOP lawmakers have signaled their support for the bill. Sens. Susan Collins (R-ME) and Rob Portman (R-OH) have said they will vote for it, while Sens. Thom Tillis (R-NC), Lisa Murkowski (R-AK), and Ron Johnson (R-WI) have all signaled that they will likely vote for the bill. Along with McConnell, Sen. Mitt Romney (R-UT) hasn’t said whether or not he will vote for it.
The letters to McConnell are aimed at countering efforts on the part of progressive and LGBTQ organizations to sway Republican senators.
Proponents of the legislation are hopeful that they stand a chance of securing 10 Republican votes, due in part to the strong support for marriage equality across party lines. According to a 2022 Gallup poll, 71% of Americans support the right to same-sex marriage. A 2021 poll found that 55% of Republicans are in favor of marriage equality.
The tasteless, anti-LGBTQI+ comic Dave Chappelle performed five shows at Luther Burbank Center for the Arts in Santa Rosa. It is difficult to believe the LBC staff and board were unaware of Chappelle’s numerous anti-LGBTQI+ comments that are well-documented and for which he has offered no apologies. Chappelle identifies as a so-called “TERF (Trans Exclusionary Radical Feminist)” joining author J. K Rawlings in such dangerous hate speech. These people refuse to accept that we are in the position to declare our gender or lack thereof.
Netflix came under fire for producing and airing two Chappelle shows that feature anti-Trans comments. LGBTQI+ Netflix employees protested – some even quit. Days before the LBC shows comenced, a Minneapolis Chappelle show switched locations as a direct result of a protest organized after Chappelle referred to Monkeypox as “a gay disease.” Chappelle mocked the members of the local LGBTQI+ Community who brought about the move. The original venue apologized to the local LGBTQI+ Community for once welcoming Chappelle and his hate. Chappelle has never backed down, apologized or even reached out to better understand the concerns of he LGBTQI+ Community. Instead, he continues to mock our Community.
The Press Democrat revealed that mere weeks before the five July shows, Live Nation approached LBC with an offer LBC appears to have found unable to refuse. The LBC staff and board claim there was considerable conversation – considerable, but certainly brief and misguided. Did they notice how few dates Live Nation had booked for Chappelle? None in San Francisco or Oakland or Los Angeles. LBC thought they could sneak this past our Community. No doubt comedy venues in big cities find Chappalle as toxic as the LBC staff and board should have.
Luther Burbank Center for the Arts found it necessary to confiscate all audience cell phones before the Chappelle shows. I have attended too many LBC concerts to count but have never had my cell phone taken away before a show. They must have done this so no footage of his anti-LGBTQI+ vitriol would find its way onto social media identifying LBC as the location. Sorry, LBC, you are now forever linked to anti-LGBTQI+ comments.
Should the North Bay’s LGBTQI+ Community allow hate speech and inflammatory comments to be staged in our backyard? Make no mistake – this is not an attack on free speech or about censorship. This is about making LBC aware that Trans people are harmed and even killed as a result of such despicable comments. 2021 saw a record number of Trans-folks murdered. So far this year 57 have been murdered in the United States alone. We once valued this venue, but it’s decision to allow Chapelle a forum for his hate is unacceptable. The LGBTQI+ Community finds Dave Chappelle comments offensive, inflammatory and even deadly.
Let’s stand up to Hate Speech and inform those in power at Luther Burbank Center for the Arts we will boycott the venue. Some shy away from boycotts. If you are amongst them, at least express your opinion by contacting the people listed below.
Let the Staff and Board of Luther Burbank Center for the Arts, its sponsors, those who share the Center’s campus, and elected officials know that such Hate results in harm to members of the LGBTQI+ Community. Email and call, as many as possible and as often as possible.
Call to Action: BOYCOTT Luther Burbank Center for the Arts for Bringing Anti-LGBTQI+ Hate to Sonoma County
The tasteless, anti-LGBTQI+ comic Dave Chappelle performed no less than five shows at Luther Burbank Center for the Arts in Santa Rosa. It is difficult to believe the LBC staff and board are unaware of Chappelle’s numerous anti-Trans comments that are well-documented and for which he has offered no apologies. Chappelle identifies as a so-called “TERF (Trans Exclusionary Radical Feminist)” joining author J. K Rawlings in such dangerous hate speech. These people refuse to accept that we are in the position to declare our gender or lack thereof.
Netflix came under fire for producing and airing two recent Chappelle shows that feature anti-Trans comments. LGBTQI+ Netflix employees protested – some even quit. Recently, a Minneapolis Chappelle show switched locations as a direct result of a protest organized after Chappelle referred to Monkeypox as “a gay disease.” Chappelle mocked the members of the local LGBTQI+ Community who brought about the move. The original venue apologized to the local LGBTQWI+ Community for once welcoming Chappelle and his hate. Chappelle has never backed down, apologized or even reached out. Instead, he continues to mock our Community.
The Press Democrat revealed that mere weeks before the five shows, Live Nation approached LBC with an offer they seen unable to refuse. The LBC staff and board claim there was considerable conversation – considerable, but perhaps, but certainly misguiged. Did they notice how few dates Live Nation had booked for Chappelle. None in San Francisco or Oakland or Los Angeles. LBC thought they could sneak this past our Community. No doubt comedy venues in big cities find Chappalle as toxic as the LBC staff should have.
Imagine, Luther Burbank Center for the Arts confiscated cell phones at the Chappelle shows. I have attended too many LBC concerts to count but have never had my cell phone taken away before a show. They must have done this so no footage of his anti-LGBTQI+ vitriol would find its way onto social media identifying LBC as the location. Sorry, LBC, you are now forever linked to anti-LGBTQI+ comments. Did you think this community could be so easily duped?
Should the North Bay’s LGBTQI+ Community allow hate speech and inflammatory comments to be staged in our backyard? Make no mistake – this is not an attack on free speech or about censorship. This is about making LBC aware that Trans people are harmed and even killed as a result of such despicable comments. 2021 saw a record number of Trans-folks murdered. So far this year 57 have been murdered in the United States alone. We once valued this venue, but it’s decision to allow Chapelle a forum for his hate is unacceptable. The LGBTQI+ Community finds Dave Chappelle comments offensive, inflammatory and even deadly.
Let’s stand up to Hate Speech and inform those in power at Luther Burbank Center for the Arts we will boycott the venue. Some shy away from boycotts. If you are amongst them, at least express your opinion by contacting the people listed below.
Let the Staff and Board of Luther Burbank Center for the Arts, its sponsors, those who share the Center’s campus, and elected officials know that such Hate results in harm to members of the LGBTQI+ Community. Email and call, as many as possible and as often as possible.
Two new cases presented Wednesday at the International AIDS Conference in Montreal have advanced the field of HIV cure science, demonstrating yet again that ridding the body of all copies of viable virus is indeed possible, and that prompting lasting viral remission also might be attainable.
In one case, scientists reported that a 66-year-old American man with HIV has possibly been cured of the virus through a stem cell transplant to treat blood cancer. The approach — which has demonstrated success or apparent success in four other cases — uses stem cells from a donor with a specific rare genetic abnormality that gives rise to immune cells naturally resistant to the virus.
In another case, Spanish researchers determined that a woman who received an immune-boosting regimen in 2006 is in a state of what they characterize as viral remission, meaning she still harbors viable HIV but her immune system has controlled the virus’s replication for over 15 years.
Experts stress, however, that it is not ethical to attempt to cure HIV through a stem cell transplant — a highly toxic and potentially fatal treatment — in anyone who is not already facing a potentially fatal blood cancer or other health condition that would make them a candidate for such a treatment.
“While a transplant is not an option for most people with HIV, these cases are still interesting, still inspiring and illuminate the search for a cure,” Dr. Sharon Lewin, an infectious disease specialist at the Peter Doherty Institute for Infection and Immunity at the University of Melbourne, told reporters on a call last week ahead of the conference.
There are also no guarantees of success through the stem cell transplant method. Researchers have failed to cure HIV using this approach in a slew of other people with the virus.
Nor is it clear that the immune-enhancing approach used in the Spanish patient will work in additional people with HIV. The scientists involved in that case told NBC News that much more research is needed to understand why the therapy appears to have worked so well in the woman — it failed in all participants in the clinical trial but her — and how to identify others in whom it might have a similar impact. They are trying to determine, for example, if specific facets of her genetics might favor a viral remission from the treatment and whether they could identify such a genetic profile in other people.
The ultimate goal of the HIV cure research field is to develop safe, effective, tolerable and, importantly, scalable therapies that could be made available to wide swaths of the global HIV population of some 38 million people. Experts in the field tend to think in terms of decades rather than years when hoping to achieve such a goal against a foe as complex as this virus.
The new cure case
Diagnosed with HIV in 1988, the man who received the stem cell transplant is both the oldest person to date — 63 years old at the time of the treatment — and the one living with HIV for the longest to achieve an apparent success from a stem cell transplant cure treatment.
The white male — dubbed the “City of Hope patient” after the Los Angeles cancer center where he received his transplant 3½ years ago — has been off of antiretroviral treatment for HIV for 17 months.
“We monitored him very closely, and to date we cannot find any evidence of HIV replicating in his system,” said Dr. Jana Dickter, an associate clinical professor in the Division of Infectious Diseases at City of Hope. Dickter is on the patient’s treatment team and presented his case at this week’s conference.
This means the man has experienced no viral rebound. And even through ultra-sensitive tests, including biopsies of the man’s intestines, researchers couldn’t find any signs of viable virus.
The man was at one time diagnosed with AIDS, meaning his immune system was critically suppressed. After taking some of the early antiretroviral therapies, such as AZT, that were once prescribed as individual agents and failed to treat HIV effectively, the man started a highly effective combination antiretroviral treatment in the 1990s.
In 2018, the man was diagnosed with acute myeloid leukemia, or AML. Even when HIV is well treated, people with the virus are still at greater risk of a host of cancers that are associated with aging, including AML and other blood cancers. Thanks to effective HIV treatment, the population of people living with the virus in the U.S. is steadily aging;themajority of people diagnosed with HIV is now older than 50.
He was treated with chemotherapy to send his leukemia into remission prior to his transplant. Because of his older age, he received a reduced intensity chemotherapy to prepare him for his stem cell transplant — a modified therapy that older people with blood cancers are better able to tolerate and that reduces the potential for transplant-related complications.
Next, the man received the stem cell transplant from the donor with an HIV-resistant genetic abnormality. This abnormality is seen largely among people with northern European ancestry, occurring at a rate of about 1% among those native to the region.
According to Dr. Joseph Alvarnas, a City of Hope hematologist and a co-author of the report, the new immune system from the donor gradually overtook the old one — a typical phenomenon.
Some two years after the stem cell transplant, the man and his physicians decided to interrupt his antiretroviral treatment. He has remained apparently viable-virus free ever since. Nevertheless, the study authors intend to monitor him for longer and to conduct further tests before they are ready to declare that he is definitely cured.
The viral remission case
A second report presented at the Montreal conference detailed the case of a 59-year-old woman in Spain who is considered to be in a state of viral remission.
The woman was enrolled in a clinical trial in Barcelona in 2006 of people receiving standard antiretroviral treatment. She was randomized to also receive 11 months of four therapies meant to prime the immune system to better fight the virus, according to Núria Climent, a biologist at the University of Barcelona Hospital Clinic, who presented the findings.
Then Climent and the research team decided to take the woman off her antiretrovirals, per the study’s planned protocol. She has now maintained a fully suppressed viral load for over 15 years. Unlike the handful of people either cured or possibly cured by stem cell transplants, however, she still harbors virus that is capable of producing viable new copies of itself.
Her body has actually controlled the virus more efficiently with the passing years, according to Dr. Juan Ambrosioni, an HIV physician in the Barcelona clinic.
Ambrosioni, Climent and their collaborators said they waited so long to present this woman’s case because it wasn’t until more recently that technological advances have allowed them to peer deeply into her immune system and determine how it is controlling HIV on its own.
“It’s great to have such a gaze,” Ambrosioni said, noting that “the point is to understand what is going on and to see if this can be replicated in other people.”
In particular, it appears that what are known as her memory-like NK cells and CD8 gamma-delta T cells are leading this effective immunological army.
The research team noted that they do not believe that the woman would have controlled HIV on her own without the immune-boosting treatment, because the mechanisms by which her immune cells appear to control HIV are different from those seen in “elite controllers,” the approximately 1 in 200 people with HIV whose immune systems can greatly suppress the virus without treatment.
Lewin, of Australia’s Peter Doherty Institute, told reporters last week that it is still difficult to judge whether the immune-boosting treatment the woman received actually caused her state of remission. Much more research is needed to answer that question and to determine if others might also benefit from the therapy she received, she said.
Four decades of HIV, a handful of cures
Over four decades, just five people have been cured or possibly cured of HIV.
The virus remains so vexingly difficult to cure because shortly after entering the body it infects types of long-lived immune cells that enter a resting, or latent, state. Because antiretroviral treatment only attacks HIV when infected cells are actively churning out new viral copies, these resting cells, which are known collectively as the viral reservoir and can stay latent for years, remain under the radar of standard treatment. These cells can return to an active state at any time. So if antiretrovirals are interrupted, they can quickly repopulate the body with virus.
The first person cured of HIV was the American Timothy Ray Brown, who, like the City of Hope patient, was diagnosed with AML. His case was announced in 2008 and then published in 2009. Two subsequent cases were announced at a conference in 2019, known as the Düsseldorf and London patients, who had AML and Hodgkin lymphoma, respectively. The London patient, Adam Castillejo, went public in 2020.
Compared with the City of Hope patient, Brown nearly died after the two rounds of full-dose chemotherapy and the full-body radiation he received. Both he and Castillejo had a devastating inflammatory reaction to their treatment called graft-versus-host disease.
Dr. Björn Jensen, of Düsseldorf University Hospital, the author of the German case study — one typically overlooked by HIV cure researchers and in media reports about cure science — said that with 44 months passed since his patient has been viral rebound-free and off of antiretrovirals, the man is “almost definitely” cured.
“We are very confident there will be no rebound of HIV in the future,” said Jensen, who noted that he is in the process of getting the case study published in a peer-reviewed journal.
For the first time, University of Cambridge’s Ravindra Gupta, the author of the London case study stated, in an email to NBC News, that with nearly five years passed since Castillejo has been off of HIV treatment with no viral rebound, he is “definitely” cured.
In February, a research team announced the first case of a woman and the first in a person of mixed race possibly being cured of the virus through a stem cell transplant. The case of this woman, who had leukemia and is known as the New York patient, represented a substantial advance in the HIV cure field because she was treated with a cutting-edge technique that uses an additional transplant of umbilical cord blood prior to providing the transplant of adult stem cells.
The combination of the two transplants, the study authors told NBC News in February, helps compensate for both the adult and infant donors being less of a close genetic match with the recipient. What’s more, the infant donor pool is much easier than the adult pool to scan for the key HIV-resistance genetic abnormality. These factors, the authors of the woman’s case study said, likely expand the potential number of people with HIV who would qualify for this treatment to about 50 per year
Asked about the New York patient’s health status, Dr. Koen van Besien, of the stem cell transplant program at Weill Cornell Medicine and New York-Presbyterian in New York City, said, “She continues to do well without detectable HIV.”
Over the past two years, investigators have announced the cases oftwo women who are elite controllers of HIV and who have vanquished the virus entirely through natural immunity. They are considered likely cured.
Scientists have also reported several cases over the past decade of people who began antiretroviral treatment very soon after contracting HIV and after later discontinuing the medications have remained in a state of viral remission for years without experiencing viral rebound.
Speaking of the reaction of the City of Hope patient, who prefers to remain anonymous, to his new HIV status, Dickter said: “He’s thrilled. He’s really excited to be in that situation where he doesn’t have to take these medications. This has just been life-changing.”
The man has lived through several dramatically different eras of the HIV epidemic, she noted.
“In the early days of HIV, he saw many of his friends and loved ones get sick and ultimately die from the disease,” Dickter said. “He also experienced so much stigma at that time.”
As for her own feelings about the case, Dickter said, “As an infectious disease doctor, I’d always hoped to be able to tell my HIV patients that there’s no evidence of virus remaining in their system.”
