Health

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Spain to Test if PrEP Can Prevent COVID-19 Infection in Medical Workers

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A new clinical trial is underway in Spain that will assess whether Truvada, a drug commonly used as PrEP for HIV prevention, can stave off COVID-19 infection among medical practitioners seeking to treat patients amid the pandemic.

If successful, the trial may have broader implications for the general public and not just health workers. But the next step would be awaiting the result of the trials before the drug is determined to be effective.

The study, which began April 1 and is expected to run through the summer, is being conducted at Ramón y Cajal University Hospital in Madrid and sponsored by the Spanish National AIDS Plan, an arm of the Spanish government. 

An estimated 4,000 participants will participate in the study, each of whom are medical workers age 18 to 65 working in areas of Spain heavily afflicted with the coronavirus.

Dr. Jose Arribas, research director of HIV and infectious diseases at La Paz Hospital in Madrid, said in Spanish via email to the Washington Blade one underlying basis for testing Truvada against COVID-19 is his findings that relatively few HIV-positive people have the disease.

“We are seeing few cases of HIV-positive people with severe COVID-19,” Arribas said. “This is surprising because the immune system of an HIV-positive person has similarities to that of older people who do have severe cases of COVID-19. Furthermore, there is evidence from in vitro studies support that Truvada can have an immunomodulatory effect.”

Asked whether Truvada could be used for everyone, not just health care workers, if shown to have a positive impact in the study, Arribas replied, “You have to wait for the results of the study before we can answer this question.”

The National Institutes of Health in the United States posted a notice Monday about the test on the agency’s website, which lists ongoing or upcoming clinical trials across the globe.

According to the abstract, the study will seek to assess whether the components of Truvada — as well as hydroxychloroquine, a drug with well publicized potential use against COVID-19 — are effective in preventing coronavirus infection among medical practitioners because “healthcare workers are particularly at risk of SARS-CoV-2.”

“In the absence of a vaccine, other strategies aiming to reduce the development of COVID-19 in the population, more specifically in healthcare workers is being sought,” the abstract says. “Administration of effective drugs to people at risk of developing an infectious disease is well accepted and is part of clinical practice.”

The choice of Truvada for the study, according to the abstract, is the result of anecdotal evidence the medicine may be effective against COVID-19.

“Existing recent and scarce literature shows that RNA synthesis nucleos(t)ide analogue inhibitors, acting as viral RNA chain terminators, like TDF, abacavir or lamivudine, amongst others, could have an effect against SARS-CoV-2 infection,” the abstract says.

Over the course of the 12-week study, administrators will provide daily doses of Tenofovir Disoproxil Fumarate and Emtricitabine, the components of Truvada, Hydroxychloroquine and placebos to study participants.

One group will receive a daily dose of Truvada and a hydroxychloroquine placebo; another will receive hydroxychloroquine and a Truvada placebo; another will receive both drugs; and another will receive a placebo of both drugs.

The trial will assess confirmed infections of COVID-19 as a primary outcome measure, then the severity of disease, including its duration, among confirmed infected participants as a secondary outcome measure.

The initial results of the study are expected to be compiled by June 30, but the study won’t be completed until July 31, the abstract says.

Overseeing the test will be Dr. Rosa Polo of the Spanish National AIDS Plan and Miguel Hernan, an epidemiologist at the Harvard School of Public Health, according to the abstract.

Ramón y Cajal University Hospital in Madrid and the Spanish National AIDS Plan didn’t respond to a request for comment.

Truvada has been brought up as a potential drug to test against COVID-19 among many other medications being assessed for use against the epidemic. Also in the mix is Remdesivir, an antiviral drug the medical experts have said may hold the best chance against COVID-19.

Dr. Sarah Henn, chief health officer of the D.C-based Whitman-Walker Health, welcomed news of the trial in an email responding to the Washington Blade’s request to comment on the study.

“We are happy to see trials focusing on both prevention and treatment of COVID-19 infections and look forward to learning from these results,” Henn said.

Dr. David Hardy, adjunct professor of medicine for the Division of Infectious Diseases at Johns Hopkins University School of Medicine, on expressed skepticism about study because it makes “a big jump” on the use of Truvada for HIV prevention to its use for COVID-19 prevention.

“Truvada for PrEP was created as a new option for trying to prevent
those who aren’t infected with HIV,” Hardy said. “If we can use that analogy with COVID-19, we don’t have a treatment that we can easily extrapolate into prevention yet.”

Based on that, Hardy said he’d be more supportive of a study that strictly tested hydroxychloroquine as a means to prevent COVID-19, and not the combination of the drug with Truvada.

“That’s simply because of the fact that we list up some laboratory information that says that hydroxychloroquine does in fact have some anti SARS-CoV-2 antiviral activity,” Hardy said. “We know that it works against the virus, at least in a test tube.”

Gilead Sciences, the manufacturer of Truvada, has told the Blade it would conduct an in vitro test of the components of Truvada against the coronavirus, but has low expectations for the drug’s effectiveness. The company hasn’t responded to requests from the Blade for an update.

The Spain study appears strictly to be a project of the Spanish government; U.S. government health officials aren’t involved even though NIH posted an abstract of the study online.

Kathy Stover, a spokesperson for the National Institutes of Health, told the Washington Blade NIH doesn’t have any involvement in the study.

“The study you highlighted is actually not being funded or conducted by the NIH,” Stover said. “It’s being led by the Plan Nacional sobre el Sida (PNS) in Spain.”

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FDA Eases Ban on Gay Blood Donations amid Coronavirus Crisis

Faced with tremendous pressure during the coronavirus crisis to lift its policy barring gay men from donating blood, the Food & Drug Administration announced on Thursday it has eased the restrictions.

While the previous policy, established in 2015, barred men who have had sex with men in the 12 months from making a donation, the new policy would shorten the deferral period, requiring abstinence for only three months.

The FDA indicated it would make a change in a notice to stakeholders on Thursday, indicating the decision was based on “evaluation of the totality of the scientific evidence available.”

“To help address this critical need and increase the number of donations, the FDA is announcing today that based on recently completed studies and epidemiologic data, we have concluded that the current policies regarding the eligibility of certain donors can be modified without compromising the safety of the blood supply,” the notice says.

In addition changing the recommended deferral period for men who have had sex with men from 12 months to 3 months, the FDA informs stakeholders of other changes.

Among them are easing ban on donations for women who have had sex with men who, in turn, previously have had sex with a man. For these women the deferral period has similarly been changed from 12 months to 3 months.

Further, the new policy eases recommended 12 month deferral for individuals with recent tattoos and piercings to three months, and eases from an indefinite ban to a three month ban for donations from people who have a past history of sex in exchange for money, or injection drug use.

Other changes are implemented easing policy related to blood donors who have travelled to malaria-endemic areas, such as countries in Africa, or to European countries where the donors faces potential risk of transmission of Creutzfeldt-Jakob Disease or Variant Creutzfeldt-Jakob Disease.

The FDA issued the notice to stakeholders at the same time it published on its website a 17-page official memo outlining the changes, declaring they were made to address the shortage in the blood supply amid the COVID-19 crisis and therefore would not wait for a public comment period.

“As a result of this public health emergency, there is a significant shortage in the supply of blood in the United States, which early implementation of the recommendations in this guidance may help to address (even though the recommendations in this guidance are broadly applicable beyond the COVID-19 public health emergency),” the memo says.

The three month deferral period is consistent with recommendations from the American Red Cross, which before the coronavirus had called on the FDA to shorten the deferral period.

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Burning or Pain when you Pee? It Might be the STI Mycoplasma Genitalium

Without causing alarm, we’d like you to know about a sexually transmitted infection (STI) you probably haven’t heard about but that we’re seeing in people who visit our sexual health clinic Magnet at San Francisco AIDS Foundation. Although the infection Mycoplasma genitalium itself isn’t new, awareness about and testing for this infection is recently on our radar. Here’s what to know.  

What is Mycoplasma Genitalium?  

Mycoplasma genitalium (we’ll shorten it to MG) is a bacterial infection that can cause symptoms similar to chlamydia. You can get an MG infection in your urethra (penis), vagina and front hole, rectum (butt), and likely in your throat–although there is only testing available for urethral or vaginal infections.  

What are symptoms of MG? 

Many people don’t get symptoms from an MG infection. If you do have symptoms, they might include burning, stinging or pain when you pee or discharge from your penis. For people with a vagina or front hole, symptoms might include pain or bleeding during sex, pain in your pelvic area, bleeding between periods, and discharge from your vagina or front hole.  

How is MG diagnosed? 

We diagnose MG by talking to you about your symptoms and sexual history, doing a physical exam, and testing your urine or doing a vaginal swab.  

Should you get tested for MG?  

If you still have symptoms mentioned above after treatment for gonorrhea and chlamydia, testing of MG may be appropriate. At this time, we are not recommending that people without symptoms get tested for MG. As always, we recommend regular testing for other STIs (gonorrhea, chlamydia and syphilis) even if you don’t have symptoms.  

Health care providers might not consider or test for MG infection. So the important thing to know is that if you have symptoms of an STI in your penis, vagina, or front hole, get tested and treated. If you still have symptoms after treatment you might have MG. 

If you think you have an MG infection, ask your provider if testing is available for MG, or make an appointment at Magnet if you are in the San Francisco Bay Area.  

About MG testing  

Testing for MG is done through a urine sample or swab. Once a sample is taken, it is analyzed by a lab for the presence of MG bacteria using the same type of DNA tests that we use for gonorrhea and chlamydia. Usually, it takes 3-5 days for you to find out your result from an MG test.  

What is the treatment for MG? 

The antibiotic azithromycin can treat MG. About 50% of cases are resistant to azithromycin, which means that the medication won’t cure the infection and you would still have symptoms. In these cases, we use a second type of antibiotic (Moxifloxacin) which requires 7 – 10 days of medication.  

Should my partner(s) get tested for MG?  

If your partner(s) are experiencing any symptoms, it’s a good idea for them to get tested for STIs. At this time, we don’t recommend that people without symptoms get tested for MG.  

Resources 

SYMPTOMS OF AN STI?

If you have symptoms of a suspected STI, call our sexual health clinic in the Castro at 415-437-1600.

TELL YOUR PARTNER 

 It takes less than 2 minutes to notify your partners that they may have been exposed to an STI. Find out more about Tell Your Partners, explore the Tell Your Partner website to notify sex partners, find a local free clinic and get tips on talking to sex partners in person.  

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Groups Say LGBTQ People more Vulnerable to Coronavirus

More than 100 LGBTQ or LGBTQ supportive organizations on March 11 released a joint open letter to health care providers and media outlets urging them to be aware that LGBTQ people may be at greater risk for the Coronavirus than the general public. 

D.C.’s Whitman-Walker Health is part of a coalition of six organizations that initiated the letter, according to a statement released by the groups. 

Other groups making up the coalition include the National LGBT Cancer Network, Health Professionals Advancing LGBTQ Equality; the LGBTQ senior’s advocacy group SAGE, the New York Transgender Advocacy Group, and the National Queer Asian Pacific Islander Alliance. 

“As the spread of the novel coronavirus a.k.a. COVID-19 increases, many LGBTQ+ people are understandably concerned about how this virus may affect us and our communities,” the letter states. 

“The undersigned want to remind all parties handling COVID-19 surveillance, response, treatment, and media coverage that LGBTQ+ communities are among those who are particularly vulnerable to the negative health effects of this virus,” the letter says. 

“Our increased vulnerability is a direct result of three factors,” the letter continues. “The LGBTQ+ population uses tobacco at rates that are 50 percent higher than the general population,” it says, adding, “COVID-19 is a respiratory illness that has proven particularly harmful to smokers.” 

The letter notes that the LGBTQ+ population also has higher rates of HIV and cancer, “which means a greater number of us may have compromised immune systems, leaving us more vulnerable to COVID-19 infections.” 

A third factor making LGBTQ people more vulnerable to the newly discovered virus, the letter claims, is LGBTQ people “continue to experience discrimination, unwelcoming attitudes, and lack of understanding from providers and staff in many health care settings.” As a result, the statement adds, “many are reluctant to seek medical care except in situations that feel urgent – and perhaps not even then.” 

The letter recommends that media outlets report on particular vulnerabilities of “any person” with a pre-existing respiratory illness, compromised immune system, or who uses tobacco products. It calls for providing LGBTQ+ individuals with “resource to find welcoming providers” if they are experiencing symptoms like a cough or fever and need to seek medical attention. 

The full text of the joint letter and additional information on how LGBTQ people may be impacted by the Coronavirus can be found at cancer-network.org/coronavirus.

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Queer and Sober: New Options Arise for Those Seeking Booze-free Fun

Arielle Clark, 28, grew up in a sober household in Louisville, Kentucky, and was never drawn to alcohol. But when as a teenager she began her process of coming out, alcohol suddenly became ubiquitous in her social life.

“When I was growing up and I was kind of figuring out my sexuality, all of a sudden I was inundated with alcohol,” Clark told NBC News.

Going to Kentuckiana Pride, her home state’s largest gay pride celebration, at 16 was Clark’s “LGBT puberty” moment, she said. While she witnessed the heavy presence of alcohol at the event, she felt accepted. Her next milestone, friends said at the time, would be turning 21 and being able to go to the gay bars.

Clark quickly realized that alcohol use — and, in many cases, dependence — were large parts of the LGBTQ social scene that she had been introduced to. She eventually decided gay bars were not for her, but she had a hard time finding a social alternative.

** one-time use, pls. contact photodesk to relicense **
Arielle Clark, a 28-year-old Kentucky native, is trying to find a brick-and-mortar for her tea shop, which would be the first sober, LGBTQ space of its kind in Louisville.Savannah Eadens / Louisville Courier Journal

That’s when she got the business idea for Sis Got Tea, a tea shop that she hopes will provide a safe, alcohol-free social space for Louisville’s black queer community that is accessible to people with disabilities. While she continues to fundraise for the shop’s brick-and-mortar space, she has been hosting pop-up events around the city that aren’t centered on alcohol.

“It took until my mid- to late-20s to finally find a group of black, queer women where I could finally relax my shoulders, and I really want to provide that for the community,” Clark said.

Sis Got Tea, which Clark hopes will open later this year, will be among a new wave of queer, alcohol-free social spaces and traveling events that have popped up over the last few years and serve as alternatives to gay bars. While sober social spaces and events have become popular among younger Americans more broadly, they are particularly noteworthy within the LGBTQ community — where substance abuse is disproportionately high and gay bars have long served as unofficial community centers and safe havens.

‘Third spaces’

Indiana resident Morgan Roddy has been making chocolate truffles and desserts for more than a decade. With the support and encouragement of her wife, Roddy opened the high-end chocolate shop Queer Chocolatier in Muncie, Indiana, in 2017.

She said she decided to make the name of her shop explicitly LGBTQ after the state’s governor, Mike Pence, was elected vice president. She feared his anti-gay track record would force some people to go deeper into the closet — so she wanted to come further out.

“I knew there would be a lot of people who would feel safer if they were quiet about their sexual orientation,” she explained. “I decided to take space and hold it for those who would be feeling vulnerable in these times.”

For Roddy, keeping Queer Chocolatier alcohol-free is a commitment to keeping the space accessible to patrons of all ages and those recovering from substance abuse. She also believes it will foster a better environment for political discourse and community activism.

“As a queer woman with a masters in sociology, ‘third spaces’ are places where ideas are shared and relationships are built,” Roddy said. “Without alcohol, there’s less pressure to engage in sex-centered conversations or hookup culture as well. Allowing for people to thrive and flourish in third spaces without alcohol has the potential to bring about some truly radical changes.”

Across the country in Portland, Oregon, Ori Gallery in 2018 launched a creative and community-organizing space for trans and queer artists of color. The gallery was founded by Maya Vivas, a ceramic and performance artist, and Leila Haile, a tattoo artist and community activist.

Aside from offering a rotating gallery space, Ori Gallery also offers free or low-cost workshops and organizes meetups for LGBTQ artists of color.

Ori Gallery was not originally intended to be a sober space — people are still allowed to consume alcohol at private events — but since the gallery’s organizers prioritize youth in their programming, alcohol is not provided at the venue’s regular events. Maintaining alcohol-free environments is often a way of ensuring that queer spaces are accessible to young people under 21.

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In Los Angeles, Cuties has become a popular destination for daytime socializing among the city’s LGBTQ community. Virginia Bauman, the venue’s queer owner, opened the café in 2017 after a successful IndieGogo fundraising campaign. Bauman said she wants Cuties to serve as a casual space that can reduce isolation and promote greater connectivity within the community.

“Having spaces that are accessible from an economic standpoint where people can just be for long periods of time … without having to justify their existence, or without having to justify why they’re there, is one of the biggest opportunities that I still see for queer communities,” she explained.

The absence of alcohol sales, which produce relatively high profit margins, can be a financial obstacle, according to Bauman. In order to compensate, Cuties started a fundraising campaign to bring in additional money to help keep the venue afloat.

‘We’re tapping into a need’

In a number of cities across the U.S. — and beyond — LGBTQ event organizers and online communities are bypassing the overhead of a physical space altogether and are focusing on intentionally alcohol-free social gatherings that are not dependent on a specific location.

Photographer and queer activist Cyrus Golestan is the co-founder of Trans in the Wild, a nonprofit that provides resources to New York’s LGBTQ community. Last month, he hosted his first alcohol-free party in an apartment building basement in Brooklyn. The idea was to “overcome winter gloom” with “sober fun,” according to the party’s promotional flyer.

“We used to have so much fun as kids without any type of substances,” Golestan, 29, said. “Why can’t we just get together and play?”

Image: Cyrus Golestan, second from left in the front row, at an alcohol-free social event he hosted in Brooklyn on Jan. 11, 2019.
Cyrus Golestan, second from left in the front row, at an alcohol-free social event he hosted in Brooklyn, New York, on Jan. 11, 2019.Courtesy of Cyrus Golestan

After posting the promotional flyer, Golestan said he received an influx of positive messages. Many of those who wrote to him expressing interest in the party told him they “do partake in alcohol sometimes” but were “excited that this is a healthier option,” he said.

Golestan said he does not identify as sober, but he recognizes how he has used alcohol in the past to cope, especially during his college years before coming out as trans.

“I was trying to be something that I wasn’t,” Golestan said. “Being closeted even from yourself is this really stressful thing that alcohol let me escape from.”

Golestan’s experience of using alcohol to cope with isolation is not unique. A study published last October in the journal Psychiatric Services found LGBTQ stressors, like discrimination and stigma due to one’s sexual orientation or gender identity, “contribute to the development of substance use disorders among some LGBTQ young adults” between 21 and 34.

Golestan’s first sober party attracted over 30 people, which he considered a success, so he is already in the planning stages for the next one on Feb. 22.

Last month, a new alcohol-free LGBTQ social meetup also debuted in Chicago. Aptly named the Chicago Queer Sober Social, the event was organized by Powerbabe, a sober queer community founded by two tech professionals, Phoebe Conybeare, 30, and Hollie Lambert, 28, who have both been sober and in recovery for two years.

The event, which is scheduled to take place monthly, is not part of a structured recovery program and is marketed simply as an alcohol-free social community. Conybeare said she and Lambert saw the need for a safe space for those who decided to abstain from alcohol for any number of reasons.

“Most sober spaces online and IRL catered to a cisgender, heterosexual and monogamous crowd or were program-based,” Chicago Queer Sober Social’s Facebook page says. “Most queer social events were focused on bars and parties where drugs and alcohol would be present.”

The group’s first event was held in a coffee shop and drew over 100 attendees. Given its success, the next Chicago Queer Sober Social, scheduled for Feb. 18, will be held in a larger venue.

“People were extremely grateful for the space — many were thanking us throughout the night and excited about attending future events and offering to help us organize,” Conybeare told NBC News. “We now have a small list of volunteers just from our first event. Response from the community has been incredibly supportive, and we’re so glad we’re tapping into a need.”

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In North Texas, KT Kershen, 27, who has been sober and in recovery for four years, said she started an alcohol-free social group last year due to a “personal need for connection and a sense of community.”

“The experience of intense loneliness that comes at the intersection of being both queer and sober drove me to create a space for myself and for others like me,” she said, noting that as a queer atheist woman she felt like “an outside” in the 12-step Alcoholics Anonymous program.

Kershen said Queer Sober Society initially started as an online group for North Texan LGBTQ people in recovery, but she said it has since morphed into an in-person meetup that connects at least once a month. The group organizes mocktail parties, game nights, bowling outings and other alcohol-free events.

“It is my hope, and I am going back to school to get a bachelors in psychology to prepare for it, that Queer Sober Society will one day be a nonprofit organization that provides a safe space for folks like me,” Kershen said.

The United Kingdom is also seeing queer sober parties pop up. Misery, a queer sober collective focused on mental health and healing, launched in 2019 and hosts events in London and Berlin. Queers Without Beers, which started in 2018, started as an online community and then started organizing sober meetups in different U.K. cities, including monthly pop-up “bars” in London, Bristol and Manchester.

“Everyone is welcome,” Laura Willoughby, the founder of Queers Without Beers, said. “We have people who are going through traditional recovery, the local muslim LGBT group, students who have never really drunk as well as people looking to cut down or just socialize without the pressure of needing to drink all evening.”

‘The possibilities are endless’

Arielle Clark, who in November exceeded her $10,000 fundraising goal for a physical Sis Got Tea space in Louisville, said she’s encouraged by the queer, alcohol-free events she has heard about popping up across the U.S. and abroad.

While she looks for a permanent home for Sis Got Tea, aiming for a 2020 debut, she said she plans to continue hosting pop-up events to provide options for those who don’t want their social life centered on alcohol.

“As we move further into creating these sober spaces, I think we’ll identify more needs within the LGBTQ+ community that intersect with sobriety,” Clark said. “The possibilities are endless.”

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Got an STI? Anonymously Tell Sex Partners to Get Tested

A new tool makes it even easier to let your sex partners know—anonymously—that they may have been exposed to a treatable sexually transmitted infection (STI) and that they might want to get tested. 

The free service, Tell Your Partner, is a fast, secure, easy-to-use notification system that doesn’t require you to share any of your personal information. Simply add phone numbers or email addresses for partners you’d like to notify and enter the infection(s) your partner(s) should get tested for. After you preview a sample message and confirm you’re not a robot, hit send.

How Tell Your Partner Works 

Many people keep up with regular STI testing and treatment as part of a proactive sexual health plan. But with rising STI rates across the U.S., and higher rates among gay, bisexual and other men who have sex with men, it’s clear that more tools are needed to slow the spread of STIs including gonorrhea, chlamydia and syphilis.

“Notifying sex partners about a recent infection makes it more likely that those partners will get tested, treated and not pass the infection along to anyone else,” said Jen Hecht, MPH, senior director of program strategy & evaluation at San Francisco AIDS Foundation and director and co-founder of Building Healthy Online Communities. “In that way, you’re also improving your own future health, by reducing the overall infection rate in the community.”

The site and mobile app were conceptualized and created by Building Healthy Online Communities(BHOC) in collaboration with YTH and the National Coalition of STD Directors (NCSD). Tell Your Partner is a modern version of inSPOT, the first online STI partner notification system developed by YTH, which sent e-cards anonymously to partners.

Tell Your Partner

It takes less than 2 minutes to notify your partners that they may have been exposed to an STI.Explore the Tell Your Partner website to notify sex partners, find a local free clinic and get tips on talking to sex partners in person.  

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Sexual Abuse Against Gay and Bi Men Brings Unique Stigma and Harm

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As trauma psychologists, we’re leading a team to help alleviate psychiatric distress in gay, bi and trans males who have been sexually abused or assaulted.

In collaboration with two nonprofit organisations, MaleSurvivor and Men Healing, we recruited and trained 20 men who have experienced sexual abuse to deliver evidence-based online mental health interventions for sexual and gender minority males – an umbrella term for individuals whose sexual identity, orientation or practices differ from the majority of society.

This study should help men in this group who have been sexually assaulted know that they are not alone, that they are not to blame for their abuse, and that healing is possible.

But, there are some things that trauma psychologists already know about these men, such as how prevalent sexual abuse of men is and ways to help men recover.

All too common, all too traumatic.

Boy holding his head in his hands
Sexual abuse of boys and young men is more common than many people might think. (Pexels)

At least 1 in 6 boys are sexually abused before their 18th birthday. This number rises to 1 in 4 men across their lifespan.

The rates of sexual abuse and assault are even higher in boys and men from sexual minority populations.

Sexual violation in gay, bisexual, transgender and intersex individuals often complicates their sense of self, and how they fit, or don’t fit, into LGBTQ+ culture and communities. Such abuse may even impact their reaching out for help or reporting traumatic events as they fear stigmatisation or victim-blaming.

Men and women who have experienced sexual abuse and assault are at risk for a wide range of medical, behavioural and sexual disorders. They have high rates of several psychiatric disorders, including post-traumatic stress disorder, substance abuse and dependence, depression and anxiety, as well as greater risk for suicide. They also have more educational, occupational and interpersonal difficulties than non-abused men. Further, sexual trauma is linked to medical illnesses, increased health care utilisation and poor quality of life.

But, sexual minority males who have experienced sexual trauma face even greater health disparities. Gay and bisexual men with histories of childhood and adult sexual victimisation are more likely to report greater numbers of sexually transmitted infections, increased sexual risk for human immunodeficiency virus, and higher sexual compulsivity than men with no history of sexual assault. In addition, sexual minority male survivors exhibit more negative psychological outcomes related to their sexual identities, such as lower self-esteem, distorted sense of self and difficulties forming healthy adult intimate relationships.

The cumulative impact of sexual abuse, in conjunction with individuals’ sexual minority status, also can result in higher rates of sexual re-victimisation, as well as anti-gay violence and discrimination.

Discrimination galore.

Gay and bisexual men are also exposed to significant minority stress, a term used to describe the sociopolitical stressors placed on individuals as a result of their minority status. Sexual orientation disparities start relatively early in development. LGBTQ+ individuals are disproportionately exposed to day-to-day discrimination, peer and parental rejection, unsupportive or hostile work or social environments, and unequal access to opportunities afforded to heterosexuals, including marriage, adoption and employment nondiscrimination.

Chronic expectations of rejection, internalised homophobia, alienation and lack of integration with the community can understandably lead to problems with self-acceptance. As a result, a sexual minority male who has experienced sexual abuse may feel deficient, inferior or impaired. Further, they may view themselves as shameful, undesirable, undeserving, or incapable of forming a loving relationship.

Many sexual minority males who have experienced sexual abuse internalise harmful beliefs that make it harder for them to heal. These myths include the false belief that men cannot be forced to have sex against their will; that men who become sexually aroused or have an erection when assaulted must have wanted or enjoyed it; and that real men should welcome any opportunity to have sex.

These men often bottle up additional detrimental myths, such as men become gay or bisexual because they were sexually abused, and sexual minority men are obsessed with sex, and that they molest children at higher rates than straight men. Sexual minority males who have been abused are not born with these beliefs. They learn them from their families, religion, society and the media. But, the more men hold these beliefs to be true, the harder it is for them to move forward in their psychological recovery.

Getting the help to heal from sexual abuse.

These men typically do not seek formal mental health treatment. Or they take, on average, decades to do so. This is consistent with research on predictors of engagement in mental health services in the larger population, as well as in those recovering from trauma. In general, men seek mental health assistance at lower rates than women. Similarly, in survivors of a broad range of traumatic events with post-traumatic stress disorder, decreased mental health service use was related to being male.

Additionally, despite similar rates of military sexual trauma in men and women, men are less likely to seek and utilise professional help. Men are even less prone to seeking counselling when they have been most severely assaulted through penetration.

There are many hurdles to male sexual abuse survivors receiving needed mental health care. When encountering perceived authority figures, such as health care providers, these men sometimes experience harsh judgment and distrust. In addition, when initiating psychological services, they may have difficulty finding knowledgeable and experienced health care providers who understand the nuances specific to male sexual abuse and, consequently, won’t disclose their sexual trauma.

Nondisclosure of sexual abuse may also be due to a male’s own lack of understanding of what abuse is. This is in line with research that found that the majority of men who endorsed survey items or behaviours indicating sexual abuse did not actually label themselves as sexual abuse survivors. Not disclosing one’s sexual trauma history is associated with increased emotional distress, while self-disclosure and seeking mental health services are related to psychological well-being.

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Nearly 2 Million LGBTQ Youths Contemplate Suicide each Year

Nearly 2 million LGBTQ youths ages 13 to 24 in the United States consider suicide each year, according to research released Thursday by the Trevor Project.

Using data from a variety of sources, including the U.S. Census Bureau, the Centers for Disease Control and Prevention and its own National Survey on LGBTQ Youth Mental Health, Trevor Project researchers determined that LGBTQ teens were particularly at risk. Those 13 to 18 were approximately twice as likely to contemplate suicide as those 19 to 24.

Amy E. Green, the nonprofit’s director of research, told NBC News that although these numbers are harrowing, they are “conservative estimates.”

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“These numbers are the bare minimum they could be because we used a conservative method to conclude our estimates,” Green said. “The fact that we still arrived at these huge astonishing numbers shows that this is a serious health problem.”

According to the mental health survey, released this month, there are multiple factors that can negatively affect the well-being of queer adolescents — the foremost being lack of acceptance.

More than 70 percent of respondents reported experiencing discrimination because of their sexual orientation or gender identity, and two-thirds of respondents stated that someone has tried to convince them to change those identities.

Though previous research has revealed that LGBTQ youth are more likely to experience thoughts of suicide, Green said these latest figures “provide additional context to just how widespread this problem is.”

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A separate research released by the Trevor Project on Thursday offered some positive news, however. LGBTQ youth who report having at least one accepting adult in their lives were 40 percent less likely to report a suicide attempt in the past year.

“I hope this research will inspire the country to come together to change policies on the state and federal levels that affect LGBTQ youth’s lives, like ending the harmful practice of conversion therapy, as well as inspire other researchers who are looking into this area to study the factors and find solutions,” Green said. “We also need to support organizations that are doing the work to launch anti-bullying and suicide prevention efforts.”

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Poppers Pose ‘Low Risk’ of Addiction or Negative Impact on LGBTI Lives

Alkyl nitrites, commonly known as poppers, pose very little chance of addiction, risky consumption habits or other psychosocial problems.

Many LGBTI people, but especially gay and bisexual men use poppers for recreational purposes or to enhance sex.

A new study found little evidence of typical dependency characteristics, including health, social, legal and financial problems. It also found no correlation between popper use and mental health or psychological stress.

Researchers at the University of Technology Sydney (UTS) surveyed more than 800 men aged 18 to 35. Lead researcher Dr Daniel Demant, welcomed the decision by the Therapeutic Goods Administration (TGA) to not ban poppers.

In 2018, the TGA issued a temporary ban on poppers. It put them onto Schedule 9 of the Poisons Standard – the same schedule as heroin.

But thanks to a vocal campaign from the LGBTI community and passionate submissions to the TGA, it backtracked on the ban. The TGA instead elected to classify them as a Schedule 3 drug. From February 2020, poppers will be available over the counter in pharmacies.

Poppers users will be made ‘overnight criminals’

Demant described the ban as creating ‘overnight criminals’ of the estimated more than 100,000 Australian users.

‘What we see with this research is that poppers are a very commonly used drug in the LGBT community, both recently and over their lifetime,’ Demant said.

‘Most of the users are already oppressed or marginalized based on their social identity as gay or bisexual men. This creates a question as to whether there would have been a discriminatory element in banning a substance with such a low risk profile.

Currently, poppers are available on prescription from pharmacies. But many people buy them illicitly at sex-on-premises venues or LGBTI bars. A vial for up to AU$50,(US$34.60/€30.63) despite costing a couple of cents to manufacture.

The new TGA decision to regulate poppers rather than banning them hopefully paves the way for some measure of quality control as well as the removal of the ‘extreme profit margin’ that exists now Demant said.

‘We could stop pretending that poppers are sold for anything other than getting people high,’ he said.

‘And once we do offer it in pharmacies, we would have something made to the highest standards for people to use.’

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Trans Activists Denounce Mental Health Assessments

Doctors should ditch the requirement for a mental health assessment of transgender teens and adults before prescribing them hormone treatment, argues an activist and bioethicist, drawing on their own personal experience in the Journal of Medical Ethics, MedicalXPress reports. 

The practice is dehumanizing, unjustified and turns the process of transformation into the treatment of a mental illness, says Florence Ashley of McGill University, Montreal, Canada.

It should instead be replaced with informed consent, which respects a patient’s lived experience and autonomy, they insist, MedicalXPress reports. 

The informed consent approach is becoming more common, they acknowledge. But many doctors still require an assessment and referral letter from a mental health professional in compliance with the World Professional Association of Transgender Health (WPATH) Standards of Care, MedicalXPress reports. 

The author says that their decision to take hormones was not made in haste, and they had socially transitioned months before opting for hormone treatment. Their university health clinic had adopted informed consent for transgender care, which allowed them to get a prescription for hormones without a referral letter, MedicalXPress reports. 

But “many others are not so lucky,” they point out, adding that their own luck ran out when they had to get two referral letters for genital surgery.

The assessment of gender dysphoria — discomfort or distress caused by the mismatch between a person’s gender identity and his/her sex assigned at birth — left them “feeling exposed, naked and dehumanized,” because it was viewed as a mental flaw that needed fixing, MedicalXPress reports. 

“Referral requirements for [hormone treatment] treat self-reports of gender dysphoria not as one would treat reports of normal mental experiences, but as one would treat reports of mental illnesses,” they write.

By requiring a mental health assessment instead of taking the transgender person’s word, doctors “deny the authority trans people have over their own mental health experiences,” they say.

“As being transgender is not a mental illness, treating gender dysphoria in this way is pathologizing and, because it pathologizes normal human variance, dehumanizing.”

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