Anti-transgender Facebook content shared by right-wing news sources generated more engagement than content from pro-transgender or neutral sources combined, according to a Media Matters for America study of 225 viral social media posts.
That means the majority of Facebook interactions with those viral posts — over 43 million of 66 million shares, comments and reactions over the span of a year — were on items posted by anti-trans websites like LifeSiteNews, Daily Wire and Daily Caller, according to the report.
“Facebook users are getting a totally biased and factually inaccurate understanding of the multitude of issues that impact trans people,” said Brennan Suen, Media Matters’ LGBTQ program director and one of the study’s authors. Suen pointed to an October Pew poll showing that a majority of Americans get news from Facebook.
In total, seven of the top 10 sources for interactions on popular transgender Facebook content were anti-trans sites. Just three LGBTQ-oriented sources appeared in the top 10: PinkNews, Gay Star News and NBC Out.
Trans activist and writer Raquel Willis said she was unsurprised by the finding that Facebook interactions about transgender issues are dominated by sources that oppose transgender rights and degrade transgender individuals.
“Narratives that further our demonization, that further confusion, are still the ones that often carry the most weight in our society,” Willis said. “Blood is on the hands of the Mark Zuckerbergs and the people who don’t want to hold these platforms to a humane standard.”
“Actual lives of marginalized people are at stake,” she added.
Suen said anti-transgender content that “lies about best practice medical care for trans youth” could “enable adults to do harm to their own children and deprive trans youth of affirmation and care that can be life saving.”
“Transphobic discourse online contributes to this dangerous rejection of trans children, real world harassment of trans peopleand harmful policies — and it contributes to a social and political culture that continues to demonize and fail the trans community,” Suen added.
Facebook did not respond to NBC News’ request for comment on Media Matters’ findings.
The Media Matters for America study examined 225 articles, blog posts and videos about transgender topics that had 100,000 or more Facebook interactions and were posted from February 2019 to this February. The liberal nonprofit used the social media analytics website BuzzSumo to identify the viral transgender-related content.
Fifty-six percent of these 225 primarily English-language articles, posts and videos were published by right-leaning sources, the report found. Conservative posts comprised the top five most-interacted-with pieces of trans content and 14 of the top 20.
LifeSiteNews, Daily Wire and Daily Caller dominated these interactions. Stories about transgender participation in sports and medical care were particularly high ranking, generating about 37 percent of all interactions, the report found.
Suen said right-wing and anti-trans content flourishes on Facebook, in part, because the network has failed to fully crack down on “coordinated, inauthentic behavior,” which Facebook’s head of cybersecurity policy, Nathaniel Gleicher, defined as “when groups of pages or people work together to mislead others about who they are or what they are doing.”
Last October, Judd Legum, founder of the liberal news site ThinkProgress, reported in Popular Information that 14 large Facebook pages, like Conservative News (which has nearly 500,000 followers), all of which had no apparent link to the Daily Wire, would “exclusively promote content from the Daily Wire in a coordinated fashion.”
Following Legum’s investigation, Facebook pages like Conservative News, which had allegedly promoted Daily Wire’s content in a coordinated fashion, now contain a disclaimer: “Confirmed Page Owner: DAILY WIRE.”
In an op-ed published this month titled “Facebook Does Not Benefit From Hate,” the company’s vice president of global affairs, Nick Clegg, wrote, “When content falls short of being classified as hate speech — or of our other policies aimed at preventing harm or voter suppression — we err on the side of free expression because, ultimately, the best way to counter hurtful, divisive, offensive speech, is more speech.”
“Exposing it to sunlight is better than hiding it in the shadows,” added Clegg, a former deputy prime minister in the U.K.
Sex education may be starting too late to help young gay men, according to new research.
A study from Rutgers University, published in the Journal of Sex Research, highlights a disparity between young gay men and the straight population when it comes to the age at which people first engage in sexual behaviours.
Queer men become sexually active at an earlier age, researchers find.
Based on a sample of 600 young men who have sex with men, researchers found that on average, same-sex sexual encounters first happen at 14.5 years of age – before straight teens are typically sexual active. Queer men have their first experiences of penetrative sex at age 16 on average – one year earlier than their straight peers.
The researchers wrote: “We found that the mean age of same-sex sexual debut was between 14 and 15 years old, with mutual masturbation occurring earliest on average among this sample, followed by oral sex performed and received occurring at approximately age 15.
“Notably, we found that the debut of same-sex anal intercourse was approximately age 16, which is younger than the national mean of 17 for vaginal intercourse among heterosexual men in the United States.”
Queer Black and Hispanic men are also more likely to report an earlier age for the start of sexual activity.
The study, which includes only “self-identified consensual behaviours,” also found that approximately 19 per cent of young men who have sex with men indicated that their first sexual intercourse before age 13 – more than double the upper range of national estimates.
Caleb LoSchiavo, doctoral student at the Rutgers School of Public Health, said: “As many schools are forced to redesign their classrooms and curricula to accommodate socially distanced or remote learning for COVID-19, this may be the perfect time to consider implementing comprehensive sex education programming to provide age-appropriate sexual health education for people of all genders and sexual orientations.”
The research also concludes that providers working with young gay men of all ages should consider beginning routine testing for HIV and other sexually transmitted diseases at earlier ages than previously indicated, particularly among youth of colour.
Perry N Halkitis, dean of the Rutgers School of Public Health, said: “Our results suggest that health care providers can play an active role in mitigating sexual and health behaviours that are associated with the early onset of same-sex sexual behaviours; to date the medical profession is ill equipped to address the needs of LGBT+ people.”
Ever since Perriviia “Black Butterfly” Brown moved into her Memphis, Tennessee, apartment in 2015, she has been afraid to sit on her front porch. A Black transgender woman who is partially blind, Brown said she doesn’t feel safe in her neighborhood. She said she often deals with transphobic abuse when she ventures to the nearby grocery store.
“I just stay in the house and mind my business,” Brown, 46, told NBC News. “If I have someone come over, they just have to come over on the inside. I would love to entertain on the outside, but it’s … so violent out here, and you don’t know who likes you and who don’t like you, and you don’t know if they got a hatred against trans women.”
Despite her fear, Brown considers herself lucky to have a home. A 2018 Human Rights Campaign report noted that 41 percent of Black transgender respondents reported experiencing homelessness at some point in their lives, a rate five time higher than the general U.S. population.
“If you are experiencing the intersection of racism and transphobia that leads to social and economic marginalization without access to some kind of permanent housing support, it’s going to be very difficult to fight to try and access that stability that a lot of people in our country take for granted.”
But thanks to a recent campaign that has raised over $250,000 to build a small neighborhood of 20 “tiny homes” for Black trans women and nonbinary people in the Memphis area, Brown may soon own her own home — one with a porch where she can sit outside unafraid.
“Tiny homes” are a rising trend made popular with reality TV shows like HGTV’s “Tiny House Hunters.” Seen by some as a path to affordable, minimalist living, tiny homes are pre-made studio structures, sometimes converted from sheds, that cost a fraction of the price of a traditional home.
The project is the brainchild of Memphis-based My Sistah’s House, which helps Black transgender women and nonbinary people access safe housing. The small nonprofit also helps individuals with bail assistance and the legal processes around transitioning.
In June, the group launched a GoFundMe page and quickly exceeded its $200,000 goal in a matter of weeks, according to My Sistah’s House cofounder Kayla Gore.
Since its founding in 2017, My Sistah’s House has provided temporary shelter to those in the Memphis area but has struggled to help them access permanent housing, Gore said. Many of the organization’s clients have been turned away from homeless shelters due to their transgender identity, she said, adding that long-term housing projects are necessary to lift the Black trans community out of an endless cycle of homelessness and poverty.
“It’s been super overwhelming to see the support that’s coming in so fast and so rapidly,” Gore said. She hopes the project will serve as a model for other advocacy organizations that want to help trans people own their own homes.
Homeownership is low among transgender people: The 2015 U.S. Transgender Survey, which included interviews with nearly 28,000 trans individuals across the U.S., found 16 percent of transgender respondents reported owning their homes, compared to 63 percent of the general public at the time.
My Sistah’s House is among a handful of trans-led, grassroots groups that are working to create long-term housing solutions for Black trans women and nonbinary people in the South.
In Atlanta, a campaign called the Homeless Black Trans Women Fund, organized by trans activist Jesse Pratt López, has so far raised over $2.7 million of its $3 million goal to create secure, long-term housing for Black transgender women. In Louisiana, Trans United Leading Intersectional Progress, or TULIP, is more than halfway to its goal of raising $400,000 to purchase and restore a six-bedroom house (to be named “House of Tulip”) that will provide a pathway to home ownership for trans and gender-nonconforming people in New Orleans.
“Housing really is this first thing that is such a necessity for people to be able to access all of these other things,” according to Dylan Waguespack, co-founder of TULIP and public policy director for True Colors United. “If you are experiencing the intersection of racism and transphobia that leads to social and economic marginalization without access to some kind of permanent housing support, it’s going to be very difficult to fight to try and access that stability that a lot of people in our country take for granted.”
‘There’s so many roadblocks’
The low rate of homeownership and high rate of homelessness for transgender Americans are connected to the disproportionate discrimination, unemployment and incarceration they face, which can all cascade into a cycle of poverty, according to advocates.
Rebeckah Hill, a Memphis-based rapper, is familiar with this cycle of poverty. A Black trans woman who has experienced homelessness on and off since her early 20s, she has been unable to get her name and gender updated on her government ID, find a stable job and secure housing, or even build the credit necessary to qualify for her own home.
“I can’t get into an apartment now,” she said. “I’m 31 years old. I’ve never had my own place to stay.”
Black trans people have an unemployment rate more than three times that of the general population, and half of these individuals reported “feeling forced to participate in underground economy for survival,” according to a 2018 American Psychological Association report. When people turn to the “underground economy,” which includes sex work and drug sales, they then risk going to jail or prison, and a criminal record is often another barrier to obtaining long-term housing. According to the U.S. Transgender Survey, the rate of Black trans women who were incarcerated in the course of a year was 10 times the rate of the general public.
In May, Hill was incarcerated on a pending drug case. After a week in jail, she was bailed out by the Official Black Lives Matter Memphis Chapter and My Sistah’s House, which also helped her find a room in a temporary rental. Having a felony on her record, she said, has made it difficult for her to qualify for public housing and climb out of the cycle of poverty.
“There’s so many roadblocks,” Hill said. “It makes my head hurt.”
A landmark Supreme Court ruling issued last month found that Title VII of the Civil Rights Act of 1964 prohibits workplace discriminationbased on sexual orientation and transgender identity. While the decision was welcome news to LGBTQ advocates, Gore noted that many Black trans women still lack access to quality education and job training that will help them begin a decent-paying career that would in turn allow them to qualify for an apartment or mortgage.
“A big portion of the folks that we serve participate in survival sex or sex work, therefore, they don’t have verifiable income,” Gore said. “So that’s the reason that they can’t get housing or they’re underemployed, in a sense that they don’t necessarily have access to equitable jobs that will provide them an income that is enough to obtain stable housing.”
Currently, federal law does not explicitly prohibit discrimination based on gender identity in private housing, and at least 25 states do not have state-level protections against such discrimination, according to Movement Advancement Project, an LGBTQ think tank. While an Obama-era rule protects transgender people from discrimination in federally funded housing, the Trump administration announced it intends to reverse this measure, which could result in trans women being assigned to men’s homeless shelters.
Trans women who cannot access stable housing often seek shelter in hotel rooms, according to Hill, who said hotel managers often turn them away “because we’re automatically assumed to be sex workers.”
Even when trans people meet the requirements to qualify for an apartment, they frequently report dealing with discrimination from housing providers, advocates say. According to the 2015 National Transgender Discrimination Survey, 19 percent of respondents reported being refused a home or apartment, and 11 percent reported being evicted due to their gender identity or gender expression. A 2017 Urban Institute study that relied on paired testing found that housing providers were less likely to tell transgender people about rentals. The study found that rental seekers in the Washington, D.C., metro area who told housing providers they were trans were less likely, on average, to be informed about available rentals than those who didn’t.
When Brown applied for her Memphis apartment five years ago, she said she presented as a man to avoid any potential discrimination.
“It made me feel nervous, it made me feel like I’m doing something wrong, and it made me feel like I was an outcast,” she said. “I had to play the role that they wanted me to play, the role to just give me a place to stay.”
Recent studies indicate that the lack of access to secure housing and employment often puts Black trans people at a dangerous crossroads where they are vulnerable to violence. Between January 2013 and July 2020, Human Rights Campaign, an LGBTQ advocacy group, has tracked at least 180 cases of trans and gender-nonconforming people being violently killed in the U.S., with trans Black women accounting for approximately 70 percent of the deaths.
The violence Black trans women endure is directly related to housing insecurity, Gore said, adding that the COVID-19 pandemicwill likely exacerbate the situation.
“That’s because we’re trying to maintain our housing, so we’re doing things that may be a little risky in order to survive and make sure that we do have housing,” she said.
Hill knows this violence firsthand. “I’ve been stabbed in my chest. … I have been shot. I have been through a lot,” she said.
At the end of June, Hill became homeless again after her landlord raised her rent. But through My Sistah’s House’s tiny-homes campaign, Hill hopes to soon have a house to call her own.
“I still have an opportunity to do what it is that I want to do,” said Hill, who hopes to build a career as a musician. “Stability right now would be overwhelming for me. I’m crying now, because it feels so good and sounds so good.”
Last year, the House of Representatives passed the Equality Act, a federal bill that would broadly modify existing civil rights legislation to ban discrimination against LGBTQ people in employment, housing, public accommodations, jury service, education, federal programs and credit, but the law has been held up in the Republican-controlled Senate.
In the absence of federal protections that would make it illegal for both private and federally funded housing providers to discriminate on the basis of gender identity, including homeless shelters, there is no universal safety net that protects Black trans people from the cycle of poverty, advocates say.
“We’ll never be able to eliminate discrimination; it will happen,” Waguespack said. “What we do need is recourse for people who experience it; we need access to justice for those folks, and we need federal, state and local dollars to be moving to folks who are actively working to make housing solutions available to communities that experience this kind of discrimination.”
‘We might have our own town’
My Sistah’s House is currently in negotiations to purchase a plot of land in the Memphis area, where the 20 tiny homes will be installed, according to Gore. The next step, she said, is to purchase the homes (at about $10,000 each) and work with a contractor to ensure they meet building codes. The group also plans to raise additional funds to complete the homes’ interiors and furnish them.
“If it’s successful, we might have our own town in a minute,” said Gore, who hopes to have the project complete by the end of 2020.
In the meantime, Brown imagines how her future tiny house will be adorned: pink and white siding with a black butterfly painted on the side, a rose bush and a swing where she can sit on her front porch with friends.
“Having my own key, just turning my own door into my own home,” Brown said of what she looks forward to the most, “and sitting outside on the porch enjoying the fresh air and the butterflies and just smelling fresh air and freshness and freedom that I can own my own home.”
Dr. Anthony Fauci on Friday said it remains unclear whether people with HIV are more vulnerable to the coronavirus.
“The story is not yet completely out in individuals with HIV,” he said during a panel that took place on the final day of the 2020 International AIDS Conference. “Those with HIV that’s not controlled in the sense of controlled viremia as opposed to those with good control. That knowledge store is still evolving.”
Fauci in his presentation also said there is a “significant issue” in the U.S. “with a disproportionate disparity or serious illness among our minority population” with Black people, Latinos and Native Americans most impacted. Dr. Deborah Birx, the coordinator of the White House’s coronavirus task force, echoed Fauci in her own remarks during the panel.
“This is like HIV and that there are specific vulnerable groups, either by race, ethnicity or their relationship in poverty,” she said.
Both Birx and Fauci said hypertension, diabetes and obesity are among the underlying health issues that make people more vulnerable to coronavirus.
Dr. Sarah Henn, chief medical officer at Whitman-Walker Health in D.C., told the Washington Blade in March that older people with underlying medical conditions and those who have chronic illnesses are most vulnerable to the pandemic. Immigration Equality and other advocacy groups have also said U.S. Immigration and Customs Enforcement detainees with HIV are also at risk.
“When I think of people who are at increased risk or high risk for coronavirus I think of people who are significantly immunosuppressed,” Henn told the Blade. “I think of people who are going through cancer chemotherapy, people who are immunosuppressed with medications with a history of organ transplants, and people with a very low CD4 count and uncontrolled HIV and AIDS.”
Fauci: U.S. in midst of ‘very serious problem’
The International AIDS Conference was to have taken place this week in San Francisco and Oakland, Calif., but it happened virtually because of the coronavirus pandemic.
Johns Hopkins University of Medicine’s Coronavirus Resource Center notes there are more than 3.2 million confirmed coronavirus cases in the U.S. Their statistics also indicate the pandemic has killed 134,729 people in this country.
The New York Times reported there were 68,241 new coronavirus cases reported in the U.S. on Friday.
Birx noted four states — Arizona, California, Florida and Texas — account for 50 percent of new coronavirus cases in the country. She also said positive test rates in Houston and Phoenix are higher than 20 percent.
“In the United States we have increased number of cases over the … particularly past three weeks,” said Birx. “We have not seen this result in increased mortality but that is expected as the disease continues to spread in some of our large metro areas where co-morbidities exist.”
Fauci also said upwards of 45 percent of people with confirmed coronavirus cases are asymptomatic.
“There is transmission by asymptomatic and pre-symptomatic individuals to unaffected individuals, which clearly complicates greatly attempts at contract tracing and isolation,” he said.
The Trump administration’s response to the pandemic has been widely criticized, but Birx stressed the U.S. has “worked hard to expand testing.” Birx also said efforts to combat the virus in this country remain largely focused on the state and local level.
Florida Gov. Ron DeSantis, a Republican who is a close Trump ally, is among the governors who continue to face sharp criticism over their response to the pandemic.
“The United States is a state-by-state, county-by-county and that’s the way we’ve made our response, very much looking at a very granular level and then working with the governors and the mayors to have a very specific and tailored response for each of these areas,” said Birx.
Fauci, like Birx, acknowledged the pandemic is far from under control in the U.S.
“My own country, the United States … is in the middle right now, even as we speak, of a very serious problem,” said Fauci.
At least four transgender people lost their lives in the space of a week, as trans homicides in the US reach the highest pace ever.
According to The Human Rights Campaign, at least 21 transgender or gender non-conforming people have been killed by violent means so far this year, nearly matching 2019’s total of 27.
The organisation says it has “never seen such a high number at this point in the year” since they began tracking this data in 2013, and other advocates across the US are horrified by the pace of “rampant and repeated” murders.
“It is ridiculous that we have to continue to hashtag our friends’ names and add them to a list of names to be memorialised every year, and that we expect it,” Carter Brown, executive director of National Black Trans Advocacy Coalition, told USA Today.
“We expect it because too many trans women of colour are continuously being murdered and beaten with minimum or no consequence being brought to the assailants.”
The deadly week began with the loss of Merci Mack, a 22-year-old Black transgender woman shot in the head in Dallas, Texas on June 30. She was initially misgendered and deadnamed by police and local media.
The fourth killing was that of Summer Taylor, a 24-year-old white non-binary person who was hit and killed by a car while participating in Seattle’s Black Femme March on July 4.
Transgender women of colour are known to suffer the highest levels of violence as they fall at the unfortunate intersection of transphobia and racism.
Systemic problems like homelessness, unemployment and lack of access to healthcare make trans people more susceptible to violence, but the actor and trans activist Laverne Cox believes the stigma around cis men’s sexual attraction to trans women is also a part of the problem.
In an interview with Buzzfeed last year, the Orange is the New Black star said: “I think the people who are attacking trans women, what I say to men, is that your attraction to me is not a reason to kill me.
“There’s this whole myth that trans women are out there tricking people and deserve to be murdered, and that’s not the case.
“There’s been a market for trans women in the realms of dating and sex work for a very long time, we don’t have to trick anyone.”
She encouraged cis women to have conversations with the men in their lives about trans people: “We have to lift the stigma around attraction to trans people, and we have to lift the stigma around trans people existing,” she said.
Non-binary people in Oregon will now be able to change the gender marker on their birth certificates to reflect their identity, an appeals court has ruled.
The verdict came when Oregon’s Court of Appeals overturned a 2019 decision that barred people from changing their legal gender to non-binary.
The appeals court sided with Eugene resident Jones Hollister, 53, who has been petitioning to have their gender legally recognised since 2017.
“I am thrilled,” Hollister said. “To have a ruling and to have a really affirming statement by the court, I’m speechless. I can barely talk because I keep crying every time I think about it. I’m just so excited.”
The appeals court said that a judge has the “authority to grant the requested change of legal sex”, without the need for a doctors note, and not restricted to just male or female.
“Rather, the new sex designation must affirm the petitioner’s gender identity whether that is male, female, or non-binary,” the appeals court ruled.
If you’re one of the more than 44 million people who have become recently unemployed thanks to the COVID-19 pandemic, you may be worried about what that might mean for your access to health care, HIV care, or PrEP.
“We have seen a lot of people in our PrEP program or who receive our HIV services–in addition to new clients who have recently lost their health insurance–who come in wondering how to afford their medications,” said Reina Hernandez, PrEP benefits and HIV linkage manager.
“Income from unemployment benefits might put you above the Medi-Cal threshold, meaning that you won’t be able to access full-scope Medi-Cal coverage. And then you’re left choosing whether to use your unemployment benefits to buy insurance or on other necessities like food and rent,” they said.
The good news is that there are a variety of free programs that can help people afford HIV and PrEP treatment and care even if they don’t have insurance, said Hernandez. Gilead’s medication assistance program covers PrEP and the HIV medications made by the company. ADAP, California’s AIDS Drug Assistance Program, can help cover medications, out-of-pocket lab and medical visit costs, in addition to insurance premiums. (You can find a full list of PrEP affordability programs at PleasePrEPMe.org.)
It can be difficult to figure out which programs you qualify for, and how to apply and use benefits, which is where benefits navigators can help.
“Call us, email us, leave us a voicemail, or come in to see us in person. We’ll make sure that you get onto some kind of assistance program, regardless of your immigration status,” said Hernandez. “Even if you’re just visiting the U.S. temporarily, or are living here long-term without residency, we can help.”
If you live outside the San Francisco Bay Area, and are interested in seeing a local benefits navigator, contact any local community health centers or AIDS service organizations in your area to find out if that service is offered. You can also use the PleasePrEPMe.org search tool, filtering results by “accepts uninsured.” If you call a PrEP or health care provider, ask if they have benefits managers, case managers, or social workers who can help you find and apply for assistance programs.
“What this epidemic has demonstrated is that we can’t rely on employer-provided health insurance,” said Hernandez. “COVID-19 has shown us the shortcomings of our current systems–health care in addition to financial, political and social. Since employment isn’t guaranteed, health insurance tied to employment just isn’t sustainable. We need to move to systems like single-payer universal health care, where regardless of your employment you have coverage.”
Although AIDS conferences have previously tackled the issue of racial disparities in HIV, conversations often stop with data and urgent calls to reach “key populations” or “those most at risk for HIV,” coded language oftentimes referring to Black, brown, Latinx and Indigenous people of color in the U.S.
Now, conversations about racism and racial justice in the wake of the murders of George Floyd, Breonna Taylor, Tony McDade, and others are permeating the largest international conference on HIV and AIDS–AIDS 2020–held virtually the week of July 6, 2020. Researchers, practitioners, and activists are discussing systemic bias in public health and our medical systems, and are providing ideas on how to incorporate anti-racist frameworks into the HIV response. Here’s some of what’s been shared.
In a presentation titled “Breathing is a human right” (Bridging Session 1), Darius Rucker, from Williams and Associates, shared his experience as a Black queer man living with HIV in order to name the racist policies and procedures that continue to place Black queer people at a disadvantage in HIV care and prevention.
“It took eight months between my [HIV] diagnosis and linkage to medication,” said Rucker. “In April 2011, my diagnosis was given to me. Months later, I was still not on medications, and was sick. December 2011, still no meds, sick, dying, AIDS. I didn’t have a doctor, a case manager, or support. I needed someone to walk with me. What could have been different? Access to equitable healthcare, and better conversations about healthcare. Racism, homophobia, stigma and HIV still continue.”
Wearing a Black Lives Matter shirt, Gregorio Millet, from amfAR, gave a comprehensive overview of some of the nuanced ways that historical legacies, policies, and other societal structures aggravate disparities experienced by Black Americans (Prime Session 1) in HIV and now COVID-19. He pointed to systemic biases which dictate who gets access to new technology, such as COVID-19 testing.
“COVID-19 testing centers are less likely to take place or to be located in African American or Latino communities. And we saw the exact same thing, unfortunately, with HIV, when antiretroviral therapy became available. We saw the disparity in mortality rates actually increased between African Americans and whites during the time when ART became available. And that’s because African Americans had less access to antiretroviral therapy and thus were more likely to die,” said Millet.
Access to pre-exposure prophylaxis (PrEP) is also an issue for many Black Americans.
People in the South, particularly people who are Black, experience the highest rates of HIV infection in the U.S., yet have the lowest rates of pre-exposure prophylaxis (PrEP) uptake, shared Jodie Guest, from Emory University (Oral Abstract Session C08). The “PrEP to need” ratio–the number of PrEP users divided by the number of people diagnosed with HIV–is highest in the West (over 25) and lowest in the South (less than 10), pointing to the stark need for increased PrEP access in the South among people of color. In addition to access issues experienced by people in the South, Guest pointed to startling low rates of PrEP awareness (11% in one study), and concluded by emphasizing that PrEP scale up must be equitable.
In San Francisco, Jonathan Volk shared continuum of care data from the Kaiser Permanente PrEP program, which found that African American clients were less likely to receive a PrEP prescription, less likely to begin PrEP, and more likely to discontinue PrEP (Oral Abstract Session C08).
“Given the pervasive effects of systemic racism and anti-blackness in our country, it is imperative that we implement an anti-racist approach to PrEP,” said Albert Liu, MD, MPH from San Francisco Department of Public Health, in a session about creating “person-centered” PrEP programs and reducing barriers to PrEP access and retention (Bridging Session 06).
Liu explained that, according to Ibram Kendi’s “How to be an Antiracist,” ideas and policies are either racist or anti-racist, and racist policies are the cause of racial inequities. This includes health inequities, such as those in HIV incidence and PrEP uptake, which means it’s critical for providers and those in power to upend and revise existing systems. Pointing to a “PrEP equity index” developed by Myers and colleagues, Liu said that PrEP use must increase by up to 300% in Black men who have sex with men (MSM) and 230% in Latino MSM to achieve equity with white MSM in New York City.”
“It’s critical that we examine all steps of the PrEP continuum to ensure PrEP delivery is anti-racist,” said Liu.
“Your HIV organization or health department probably has a racist history–all of ours do,” said Felipe Flores, from San Francisco AIDS Foundation (Satellite Session On-Demand). “Building bridges with BIPOC [Black, Indigenous, and people of color] organizations, offering resources and services to these community partners, begins to heal some of the failings that we have inherited or created.”
Flores said it is critical to dedicate time, appointments, and resources to communities that “we have collectively failed,” and to be “loud and unrelenting about it.”
“What holidays does your organization get time off for? What events does your outreach team go to? What languages are your materials in? Who is pictured on flyers? Integrate a racial justice framework into everything you do,” said Flores.
Carmarion Anderson, from Human Rights Campaign, shared her perspective as a Black trans woman working in HIV advocacy to drive home the importance of understanding of intersectionality in order to connect with (not “target”) people of color living with or at risk for HIV (Symposium SS21).
“You have to understand what barriers we face. Before you offer me an HIV test, before you offer me a biomedical intervention like PrEP, you have to understand the trauma I have gone through,” she said. “Some of these things [rejection, poverty, depression] influence how we show up as you are trying to aid us and implement the work of your organization.”
As Anderson spoke about advocacy, she gave an important recommendation for organizations who work with Black and trans communities.
“As a Black trans woman, I can speak up for who I am. And if I can speak up for myself, I can also sit at your table of decision. You understand what I’m saying. That means you can employ me, in order to have my voice, my narrative and my community working with you,” she said.
Carmen Logie, from University of Toronto, also used an intersectionality framework to present the experiences of Black, Caribbean, African and Indigenous women living with HIV in Canada (Bridging Session 12). Women of color are overrepresented in the number of HIV infections that happen among women in Canada, said Logie, and oftentimes experience the intersectional stigmas related to race, gender, HIV status and sex work.
“Ths intersecting stigma matters,” said Logie. “Racism, HIV stigma and gender discrimination are associated with ART [antiretroviral therapy] adherence issues, depression, and injection drug use. It shapes mental health. We need intersectional stigma interventions, and we need them now. We need them to be trauma-informed, and have a harm reduction approach.”
Monica McLemore, from University of California, San Francisco, shared her personal experience being born prematurely to a Black mother as she spoke about health inequities faced by Black Americans and the importance of movements like Black Lives Matter to HIV prevention and care (Symposium SS21).
“In New Jersey, where I was born, infant mortality was double the rate for mothers of color compared to white mothers. I am lucky and grateful to be alive.” said McLemore. “Now, we have to deal with two two pandemics at once: the novel coronavirus, and racism. We can do better, and we have to.”
McLemore urged the HIV community to consider, and incorporate, the principles of Black Lives Matter and the movement for Black lives into the HIV response. “If we place our asks in terms of a human rights frame, the health of everyone can, and will, and should improve.”
In a presentation about including community in the plan to end HIV (Symposium SS21), Venton Jones-Hill, from Southern Black Policy Advocacy Network advocated for meaningful participation of Black communities in HIV policy. “We need to strengthen the capacity of Balck communities and leaders in the U.S. South to engage in health policy deliberations to improve policy, programs and research,” said Jones-Hill. “Community has to be in the middle of the conversation.”
“Now, after the death of George Floyd and many others, you see this complete shift in sensibility where a majority of white Americans, Black Americans, Latino Americans, and Asians support the Black Lives Matter movement,” said Millet. “And one of the things that was really one of the happiest things that I see lately was in my own neighborhood, two blocks from where I grew up in Brooklyn, there was a rally for thousands of people in support of trans Black women’s lives–saying their lives mattered as well. We need to make sure that communities are at the center of the response and at the center of providing solutions for some of these health crises.”
Visit AIDS2020.org for information about the conference. Presentations and materials from the conference will be made available to the general public at the end of July, 2020 through the conference website.
Instagram’s public policy director Tara Hopkins acknowledged the harm it causes as she explained how the company is changing the way it handles conversion therapy content.
“We don’t allow attacks against people based on sexual orientation or gender identity and are updating our policies to ban the promotion of conversion therapy services,” she said, speaking exclusively to the BBC.
She continued: “We are always reviewing our policies and will continue to consult with experts and people with personal experiences to inform our approach.”
Earlier this year Instagram banned the promotion of conversion therapy in ads. From Friday (July 10), any content linked to the practise will be banned across all posts on the platform.
The company stresses that it will take time to update all of its policies to reflect this blanket ban, so while some content that users flag may not immediately be removed, over time that should change.
But conversion therapy is still legal in the UK, despite the government promising to eradicate it two years ago in its July 2018 LGBT+ Action Plan.
Campaigners are now urging the government to make good on its promise, with Elton John, Stephen Fry, Munroe Bergdorf and Dua Lipa joining over influential public figures in calling for a ban.
“Theresa May, as prime minister, vowed to eradicate this “abhorrent” practice in 2018 and since then the British public has been waiting expectantly, not least the LGBTQ+ community,” they write.
“The government has said recently that conversion therapy is complex, which it undoubtedly is, and although we acknowledge this issue is nuanced we strongly believe that effective legislation, supported by a programme of work to help tackle these practices in all their forms, is possible.
“Any form of counselling or persuading someone to change their sexual orientation or behaviour so as to conform with a heteronormative lifestyle, or their gender identity should be illegal, no matter the reason, religious or otherwise — whatever the person’s age.”
The global fight against AIDS was faltering even before the COVID-19 pandemic, and this newly emerged viral disease is now threatening to put progress against HIV back by 10 years or more, the United Nations said on Monday.
“The global HIV targets set for 2020 will not be reached,” the U.N.’s AIDS agency said in a report. “Even the gains made could be lost and progress further stalled if we fail to act.”
Latest data from 2019 show that 38 million people worldwide are now infected with the human immunodeficiency virus (HIV) that causes AIDS, the report said, a million more than in 2018.
Some 25.4 million HIV positive people were on antiretroviral treatment in 2019 – a huge advance on a decade ago, but one that still leaves 12.6 million not getting medicines that can keep the virus at bay and prevent its spread.
The report also found the world is far behind in preventing new HIV infections, with 1.7 million new HIV cases in 2019.
“Every day in the next decade decisive action is needed to get the world back on track to end the AIDS epidemic by 2030,” said Winnie Byanyima, UNAIDS’ executive director.
The worst regions for HIV’s spread were eastern Europe and central Asia, which together have seen “a staggering” 72 percent rise in new HIV infections since 2010, UNAIDS said.
New HIV infections also rose in the Middle East and North Africa, by 22 percent, and by 21 percent in Latin America.
The report said the COVID-19 pandemic, which emerged in China in January, has already “seriously impacted” the AIDS fight, with lockdowns and travel and trade disruptions delaying or halting HIV treatment and testing services.
It said a six-month complete disruption in HIV treatment could cause more than 500,000 extra deaths in sub-Saharan Africa over the next year, bringing the region back to levels of AIDS death rates last seen more than a decade ago, in 2008.