Fifteen months after firing all members of the Presidential Advisory Council on HIV/AIDS, President Trump has restaffed the advisory body with nine new appointments.
The Department of Health & Human Services confirmed the new appointments to PACHA morning Thursday morning after letters went out last week informing the new members of their appointments.
Brett P. Giroir, HHS assistant secretary for health, said in a statement the new members “will play a critical role” in responding to HIV/AIDS in the wake of Trump’s recently announced plan to end new HIV infections by 2030.
“More than 1 million Americans are living with HIV and nearly 40,000 are newly diagnosed with the virus each year,” Dr. Giroir said. “Working together, we have the opportunity to tackle some big issues, and I know our new members are up to the task.”
The new members are come from variety of professions, including the pharmaceutical industry, activism and academia.
Gregg Alton, chief patient officer for Gilead Sciences, Inc.;
Wendy Holman, CEO and Co-Founder of Ridgeback Biotherapeutics;
Marc Meachem, head of External Affairs North America for ViiV Healthcare;
Rafaelé Roberto Narváez, co-founder and director of Health Programs for Latinos Salud;
Michael Saag, professor of medicine and associate dean for global health at UAB School of Medicine and director of the University of Alabama at Birmingham Center for AIDS Research;
John Sapero. office chief for the HIV prevention program at the Arizona Department of Health Services;
Robert Schwartz, head of Dermatology at Rutgers New Jersey Medical School;
Justin Smith, aPh.D. Candidate at Rollins School of Public Health at Emory University; and
Ada Stewart, lead provider and HIV specialist at Eau Claire (South Carolina) Cooperative Health Centers.
The new members will join Carl Schmid, deputy director of the AIDS Institute, and John Wiesman, secretary of health in Washington State, who were already serving as co-chairs.
Created in 1995, PACHA has provided advice to the U.S. presidents on policy and research to promote effective treatment and prevention for HIV — maintaining the goal of finding a cure.
But PACHA has languished in the Trump administration. In June 2017, six members of the advisory council appointed during the Obama administration resigned in protest over the perceived inaction from Trump on HIV/AIDS.
Cited by the six members as evidence of inaction was Trump’s failure to appoint a director of the White House Office of National AIDS Policy, a position that still remains vacant to this day.
Six months later, as first reported by the Washington Blade, Trump terminated the remaining members of the council without explanation via letters sent to them via FedEx.
PACHA was entirely vacant for an entire year, but that changed in December as the Trump administration seemed to have awakened on HIV/AIDS.
In a speech recognizing gay people as among the victims of the epidemic, Secretary of Health & Human Services Alex Azar announced the new co-chairs for PACHA.
In the next month, Trump announced a new initiative during his State of the Union a new initiative to end new HIV infections in the United States by 2030. Trump’s fiscal year 2020 budget seeks $300 million for domestic HIV/AIDS to fulfill that commitment (although global programs are facing a steep cut).
The new members of PACHA will likely provide advice to the administration on pursuing Trump’s stated goal to beat HIV by 2030. After all, achieving that goal will require a multi-year sustained effort, not just additional money found in a single budget request.
PACHA will also have an additional goal: Updating the National AIDS Strategy developed under the Obama administration..
The 2010 strategy, which enumerated gay and bisexual men as groups vulnerable to the disease, is due for an update in 2020. The update is expected to reassess the epidemic domestically and make new goals in combatting it.
It remains to be seen what recommendation PACHA will make. A progress report from the Trump administration last year adopted Obama-era goals in combatting HIV/AIDS, which includes reducing the rate of new diagnoses among gay and bisexual men.
With court orders barring President Trump from enforcing his transgender military ban out of the way, the Defense Department late Tuesday unveiled its plan to make the policy a reality, announcing it would begin April 12.
A 15-page memo signed by David Norquirst, who’s performing the duties of deputy secretary of defense, spells out the timeline, procedures and potential exemptions for implementing the plan ordered by Trump and created by former Defense Secretary James Mattis.
As stated on the first page of the memo, the new policy “is effective April 12, 2019.” On the date, the policy of open transgender service as implemented June 30, 2016 during the Obama administration will come to an end after nearly three years.
The memo takes great pains to demonstrate the policy isn’t a ban because it allows transgender people to enlist, provided they have no diagnosis of gender dysphoria and are willing to serve in their biological sex.
“When a standard, requirement, or policy depends on whether the individual is a male or a female (e.g., medical fitness for duty; physical fitness and body fat standards; berthing, bathroom, and shower facilities; and uniform and grooming standards), all persons will be subject to the standard, requirement or policy associated with their biological sex,” the memo says.
The memo also includes an exemption to the ban in certain circumstances. These cases include a transgender person with gender dysphoria who enters into a contract to enlist before the new policy takes effect and has remained stable in their gender identity for 18 months.
“A history of gender dysphoria is disqualifying, unless, as certified by a licensed mental health provider, the applicant has been stable without clinically significant distress or impairment in social, occupational or other important areas of functioning for 18 months,” the memo says.
As outlined in the Mattis plan last year, that provision would suggest transgender people in the military who came out during the current policy would be able to stay in the armed forces.
According to the Williams Institute at University of California, Los Angeles, an estimated 15,500 transgender people are in the armed forces. A 2016 RAND Corp. study came up with a smaller number, estimating between 1,320 to 6,630 are currently on active duty.
Transgender people who obtain an exemption also appear to be eligible for transition-related care, including gender reassignment surgery, through the military health care system.
“Service members who are exempt may continue to receive all medically necessary treatment, as defined in DoDI 1300.28,” which is the policy outlined during the Obama administration when former Defense Secretary Ashton Carter first implemented transgender military service.
Individuals won’t be eligible for an exemption, however, in other situations, such as having “a history of cross-sex hormone therapy or a history of sex reassignment or genital reconstruction surgery is disqualifying.”
Moreover, a waiver system seems to be part of the policy. These waivers will be granted “in whole or in part, to the requirements in this attachment in individual cases,” the memo says.
Transgender advocates shredded the plan as a discriminatory effort to prohibit qualified individuals from joining the armed forces.
Harper Jean Tobin, director of policy for the National Center for Transgender Equality, said in a statement the policy represents a “looming purge” and “an unprecedented step backward in the social and civil progress of our country and our military.”
“Throughout our nation’s history, we have seen arbitrary barriers in our military replaced with inclusion and equal standards,” Tobin said, “This is the first time in American history such a step forward has been reversed, and it is a severe blow to the military and to the nation’s values.”
Aaron Belkin, director of the San Francisco-based Palm Center, told the Washington Blade the waivers to the ban aren’t significant and the policy as a whole amounts to “Don’t Ask, Don’t Tell.”
“This is a ban that affects all transgender troops in a similar way that ‘Don’t Ask, Don’t Tell’ affected gay and lesbian troops,” Belkin said. “Now we know that during ‘Don’t Ask, Don’t Tell,’ that didn’t mean that every gay and lesbian person was fired and the same phenomenon is going to be true here, where the transgender ban will burden all transgender troops, but that doesn’t mean they’ll all be fired.”
Belkin estimated 10 percent of transgender troops currently in the military have received a diagnosis of gender dysphoria and said “those folks are grandfathered in under the new policy.”
“But it’s really important to remember for those people, they are serving under a double standard that applies only to them, and they’re serving at the discretion at the secretary of defense,” Belkin said. “For all other service members, they have basically job protections. For trans troops, if the secretary decides tomorrow, we don’t want grandfather clause to apply anymore, then trans troops are out.”
The Pentagon unveiled the policy on the same day the National Center for Lesbian Rights and GLBTQ Advocates & Defenders filed a brief in the D.C. Circuit Court of Appeals against its implementation, arguing one court injunction remains in place against the Trump policy.
Jennifer Levi, GLAD’s transgender rights project director, said in a statement the implementation of the Pentagon’s policy was unlawful.
“Not only does the Trump-Pence transgender military ban violate the Constitution, but now the administration is also defying a court order,” Levi said, “With brazen disregard for the judicial process, the Pentagon is prematurely and illegally rolling out a plan to implement the ban when a court injunction remains in place prohibiting them from doing so.
Speier in a statement slammed Trump and his administration for moving forward with a policy undermining and disregarding the service of those troops.
“I would like to know what it is that the President is so afraid of? Transgender troops have served for decades and carried out multiple deployments, including Afghanistan, Iraq and Syria, to protect our country and freedoms,” Speier said. “These tough, brave servicemembers have never used bone spurs as an excuse to dodge their duty and service to our country. We owe them our gratitude, not government-sanctioned discrimination. This policy is malicious, demeaning and destructive and it does not serve our country’s interests. I will fight it with every fiber of my being.”
Pending before the U.S. House is legislation Speier introduced that would block the transgender military ban. Sen. Kirsten Gillibrand (D-N.Y.) has introduced a companion bill in the U.S. Senate.
Tobin called on Congress to take action and reverse the Pentagon in the aftermath of the unveiling of the new policy.
“The Trump Administration is built on demonizing minority groups; reversing the civil rights gains of immigrants, people of color, women, and the LGBTQ movement will forever remain the hallmarks of their time in office,” Tobin said. “That is why Congress must act now and secure the fate of nearly 15,000 transgender troops. We cannot let an incompetent administration guided by a petulant bigot stand as the mascot of our time. History is watching Congress and will judge them harshly for inaction. That is why we must act swiftly to protect transgender troops, our military, and the dignity of our own legacy.”
The uptake of HIV-preventing PrEP drugs by gay and bisexual men faces a huge racial disparity in the US, experts have warned.
The news comes from research by the Centers for Disease Control and Prevention (CDC) which was presented at an HIV conference on Friday (March 8).
PrEP use faces ‘huge disparity’ between ethnicities
The research presented by the CDC’s Dr Teresa Finlayson found that between 2014 and 2017 there was a 500% increase in the use of pre-exposure prophylaxis among gay an bisexual men “who are at substantial risk for HIV infection.”
However, the surge in use has not been uniform across ethnicities.
Although awareness of PrEP had increased significantly among at-risk gay and bisexual men of all races and ethnicities, the use of PrEP by black and Latino men was significantly lower than for white men.
42 percent of at-risk white men were using PrEP in 2017, according to the research, but just 26 percent of at-risk black men and 29 percent of at-risk Hispanic men were doing so.
CDC director HIV/AIDS prevention Dr Eugene McCray warned: “PrEP awareness is high among all men who have sex with men, but PrEP uptake is not where we want it to be.
“It’s much better than it was in 2014, but there’s huge disparities that we’re seeing [on race].
“What we’ve got to do is ensure PrEP gets to the communities that need it the most.”
People on PrEP take a daily anti-retroviral pill to build up their resistance to HIV, which significantly reduces their risk of HIV infection.
McCray added that PrEP should be implemented “not just for men who have sex with men, but also injection drugs users, high-risk women, and others at risk.”
Overall use of PrEP has surged
The overall uptake of PrEP remains strong.
In 2014, just five percent of at-risk gay and bisexual men were using PrEP, while four years later the proportion of at-risk gay and bisexual men using PrEP had reached 34 percent.
General awareness of PrEP had also significantly increased among at-risk gay and bisexual men during the time period, from 59 percent in 2014 to 90 percent in 2017.
The research was based on interviews with 3,978 gay and bisexual men at substantial risk for HIV infection who were interviewed in 2014, and 4,182 who were interviewed in 2017.
Sexually active gay and bisexual men were deemed to be at high risk of HIV infection if they had condomless anal sex with a male partner also in the past 12-months, or had been treated for a sexually transmitted infection in the past 12 months.
35 percent of gay and bisexual men in the US who are considered at “high risk” of contracting HIV took PrEP in 2017, according to new research.
PrEP – or pre-exposure prophylaxis – is taken by people who do not have HIV, but who may be at risk of contracting the infection. The medication significantly reduces a person’s chances of getting HIV.
The new research was presented in Seattle this week at the 2019 Conference on Retroviruses and Opportunistic Infections, an annual HIV/AIDS conference, according to NBC News.
The research – which was based on 8,000 interviews across 20 American cities – also revealed that there has been a 500 percent increase in the number of high-risk gay and bisexual men taking PrEP since 2014.
Researchers also found that white gay and bisexual men are more likely to take PrEP than other groups, at 40 percent, compared to 30 percent of Latinos and 26 percent of African-Americans.
While PrEP is considered highly effective as a preventative measure, the cost is still extremely high in some quarters, meaning many gay and bisexual men struggle to afford it.
The study also found high awareness of PrEP among the gay and bisexual men interviewed, with 95 percent of white men, 86 percent of Latinos and 87 percent of African-Americans having heard of the drug.
PrEP remains ‘underutilised’
The Centers for Disease Control and Prevention (CDC) said that the findings suggest that efforts to increase awareness of PrEP are working, but that the drug still remains underutilised.
The increase in the number of men taking PrEP will come as welcome news to many in the LGBT+ community, however more will have to be done if the US government wants to reach targets set out in its new plan for combating HIV.
In a new plan called “Ending the HIV Epidemic: A Plan for America”, the US government say they aim to reduce new HIV infections by 90 percent in the next 10 years.
The CDC noted in its press release to NBC News that there are one million Americans who are at “substantial risk” of contracting HIV who could benefit from PrEP – but the overall number of those taking it is just 10 percent.
Those considered at substantial risk include those who take drugs with needles and heterosexual people.
Second patient is ‘cured’ of HIV
Meanwhile, this week saw a landmark case that saw a man in the UK cured of HIV – making him the second person in the world to be cured of the infection.
The patient received a bone marrow transplant from a donor who has a rare HIV resistant gene. 18 months after receiving the transplant, the patient is showing no sign of the HIV virus – despite no longer taking his antiretroviral drugs.
Doctors in the Netherlands may also have cured another patient in the same way – although they say it is too early to be definitive.
“Scientific breakthroughs have brought a once-distant dream within reach.”
– President Donald Trump
Speaking in February, US President Donald Trump pledged to end HIV/AIDS, saying: “No force in history has done more to advance the human condition than American freedom. In recent years we have made remarkable progress in the fight against HIV and AIDS.
“Scientific breakthroughs have brought a once-distant dream within reach.”
However, Trump has previously come under fire for his inflammatory rhetoric around HIV/AIDS funding. In a 1997 interview, he said he would force the late Princess Diana to take a HIV test before having sex with her.
News the “London patient” has become the second-person ever found in remission of HIV has been hailed as a medical triumph, but new developments with pre-exposure prophylaxis, or PrEP, could mark additional steps in combatting the disease.
In the works for potential approval in the next couple of years is medicine based on PrEP, but for long-acting treatment, such as an injectable drug and antibodies that block HIV infection as well as PrEP-on-demand for use on a case-by-case basis for sexual encounters.
Anthony Fauci, an immunologist and head of the National Institute of Allergy & Infectious Disease, said during an interview with the Washington Blade a number of studies are ongoing to develop drugs for patients at risk of contracting HIV so they don’t need to take a pill every day.
“People sometimes get pill fatigue, and it becomes onerous to have to take the medicine every single day of your life, particularly a medicine that you know is important for a disease that’s potentially lethal,” Fauci said.
One alternative evaluated in clinical trials, Fauci said, is a long-acting injectable drug version of PrEP a patient would take at first take every four weeks or so, and then every two months, and then every four to six months.
“So instead of having the obligation of remembering to take a pill every day, you hopefully, we’re not there yet, can have an injection that you get maybe two or three times a year to allow you to essentially suppress the virus,” Fauci said.
The same drug, Fauci said, would be able to work for both HIV prevention and treatment, so patients both with HIV looking to suppress the viral loads and patients at risk of contracting HIV would have use for the medication.
Fauci said the injectable drug is “the most common and optimistic one and promising one,” but other options are in the works.
A large study, Fauci said, is taking place in developing countries, mostly in Southern Africa, where individuals would have to use a device intermittently about every eight weeks that would transfer a broadly neutralizing antibody, or a natural protein, that acts against HIV.
“And you give that to people who are at risk of getting infected, so that’s for prophylaxsis,” Fauci said. “So instead of taking that single pill every day to prevent infection, you can get an infusion of any antibody about every eight to 12 weeks or so to prevent infection.”
Another possible alternative, Fauci said, is PrEP-on-demand that individuals would take on an intermittent basis when they expect they would have a sexual encounter.
But Fauci cautioned PrEP-on-demand is “a little bit risky” because it might require expecting a sexual encounter before it happens and “often people, they get into situations where they can’t anticipate what’s going to happen.”
Carlos del Rio, chair of the Hubert Department of Global Health at Emory University’s Rollins School of Public Health, told the Blade new medications would be effective as a compliment to existing treatment.
“I think it’s another strategy,” del Rio said. “I think it’s something that we can clearly do, and I think it’s something that needs to be looked at. For some populations that may be the way to go. If I was infected, maybe I’d rather take a pill a day, but some other people may want to get an injection once a month.”
For each of the possible medications, Fauci said the timeline for approval is “tough to say” with trials ongoing. The medication, he said, won’t be made available to the public for “at least a year or two.”
“Nonetheless, that PrEP-on-demand is a study that is being conducted to see how effective it is,” Fauci said. “It might be as effective as a pill a day. We don’t know. Hopefully it will be because we could save people the obligation of taking a pill every day.”
“You’d have to have a clinical trial that shows that it’s highly effective in preventing HIV infection, or, in the case of the people who are infected, and using it as a treatment, you’d have to show that compared to taking a pill every day that the people who get the injection every several months, they suppress their virus as well as if you take a pill every day,” Fauci said. “That’s the data that are generally end points of the study.”
James Driscoll, a Nevada-based HIV activist who supported Donald Trump for president in 2016, said the long-acting medicine for HIV prevention and treatment is “an essential tool” for combatting the disease.
“Current efforts are not doing the job,” Driscoll said. “An aggressive campaign to get out long-acting PrEP, will reduce new infections, but also increase AIDS awareness and lower stigma.”
The Food & Drug Administration, Driscoll said, should move expeditiously on the approving the medication.
“In the 1990s, FDA delays in approving new treatments resulted in unnecessary deaths,” Driscoll said. “It is crucial that President Trump and Secretary Azar stress to FDA the urgency of avoiding the errors of the past with this critical new weapon in the war against AIDS.”
The new medications are being studied as news recently broke in The New York Times an individual known as the “London patient” has become the second person found to have been in remission after HIV infection. (The first was the “Berlin Patient,” whose apparent remission was announced in 2008.) The treatment consisted of a bone marrow transplant from donors with a genetic makeup resistant to HIV infection.
Del Rio, however, said the treatment provided to the “London Patient” is “not feasible” for widespread treatment of HIV.
“That’s a very nice science discovery, but it’s not a feasible result,” del Rio said. “You are not going to be able to do bone marrow transplants for 35 million people globally. It’s a good science study, we’re learning a lot from it, but this is not something that can be implemented.”
The achievement, del Rio said, was comparable to John Glenn becoming the first American to orbit the Earth in 1962.
“From that to say that we’re going to be traveling in space, all of us, is not the case,” del Rio said.
Del Rio said the existing medication and long-acting treatments in development, on the other hand, are practical in combatting HIV.
“But at the end of the day, we do need to find a cure, and I think research and cure has advanced with this patient, but there’s still a lot of research to be done.”
Development of these medications to treat and prevent HIV occur as President Trump announced in his State of the Union address his administration’s plan to end new HIV infections by 2030.
The effort will target areas in the United States where new infections are taking place: 48 counties in the United States, D.C., and San Juan, Puerto Rico, as well as seven states where the epidemic is mostly in rural areas. The seven states are Missouri, Kentucky, Oklahoma, Arkansas, Mississippi, Alabama and South Carolina.
Fauci said the development of alternative treatment for HIV and prevention “certainly could wind up being helpful” in achieving the administration’s goal of ending new infections.
“Obviously, if it’s an improved way to treat the disease, any improvements in that always help the program that you’re involved with,” Fauci said. “Right now, we think we can do with the currently available drugs. If we get a situation where it’s more user-friendly.”
The private sector, Fauci said, is “absolutely an essential component” of developing long-acting PrEP because they’re responsible for manufacturing the medication. For PrEP, the manufacturer of the drug is Gilead, but other companies, such as ViiV, are involved.
“Although the NIH does the research that develops the concept and often does the clinical trial, the fact is it’s absolutely essential to partner with the pharmaceutical industry,” Fauci said.
Gilead didn’t respond to repeated requests from the Washington Blade to comment for this article, nor did ViiV respond to a request for comment.
The new drugs are being developed amid calls for Gilead to make the existing product generic, and therefore less expensive for purchase. Although Gilead offers a coupon for Truvada and many insurance companies cover the medication, the average retail cost is $2,000 a bottle and many say the existing mediation is out of reach.
Leading the charge calling on Gilead to make Truvada generic is New York City Speaker Corey Johnson, who’s openly gay and HIV positive. During a news conference last month at an AIDS Memorial Park event, Johnson said the current system is unfair, according to the New York Daily News.
“It’s life or death for people who do not get access to this live-saving medication that they need,” Johnson was quoted as saying. “Other countries pay $100 year for PrEP. Americans end up paying more than $20,000 a year for the same medication.”
Asked about Gilead making Truvada generic, Fauci said “whenever you can get a drug at a less expensive price, it always helps matters,” but declined to comment specifically on whether Gilead should make that move.
“I can’t comment on that,” Fauci said. “That’s a legal issue. It’s purely legalize to determine if that can be done. I really can’t comment on it.”
Del Rio said some Truvada drugs are “already becoming generic” and that will “help us decrease costs of these medications, right?”
A coalition of 161 major businesses —including Apple, Coca-Cola and Target Corp. — has formed to urge Congress to ban anti-LGBT discrimination with passage of the Equality Act, the Human Rights Campaign announced Friday.
The initiative, known as the Business Coalition for the Equality Act, was first launched in 2016 with 60 members, but now includes nearly three times that number of businesses.
Forming a coalition organized by the Human Rights Campaign, these companies operate in all 50 states, have headquarters in 26 states, more than $3.7 trillion in combined revenue and more than 8.5 million employees in the United States.
House Speaker Nancy Pelosi (D-Calif.) announced on Thursday the Equality Act, which would amend the Civil Rights Act of 1964 to include LGBT people, will be introduced next week. Capitol Hill sources have to the Blade the bill will be introduced on Wednesday.
Pelosi has already said passage of the Equality Act will be a priority for the New Democratic majority in the House of Representatives.
Chad Griffin, president of the Human Rights Campaign, said in a statement the 161 businesses “are sending a loud and clear message that the time has come for full federal equality.”
“By standing with the LGBTQ community and joining the fight to pass the Equality Act, these companies are demanding full federal equality for the more than 11 million LGBTQ people in this country who deserve to earn a living, raise their families and live their lives free from discrimination,” Griffin said. “These leading employers know that protecting their employees and customers from discrimination isn’t just the right thing to do — it’s also good for business.”
Kevin Walling, chief human resources officer of the one of thew new coalition member Hershey’s, said in a statement the Equality Act is consistent with his company’s mission.
“At The Hershey Company, we recognize that our talented employees are our business edge, and that retaining our place as the market leader in our category requires the best talent,” Walling said.“To help us achieve our goal of recruiting the nation’s top employees, we know that we must foster a business culture that is welcoming to all, regardless of sexual orientation, or gender, or race, or other status. By the same token, if our nation is to compete on a global stage, our federal laws must ensure that all employees are treated with the same respect. That is why The Hershey Company supports the Human Rights Campaign and the Equality Act.”
A federal judge in Maryland lifted on Thursday his order against President Trump’s transgender military ban, bringing the administration one step closer toward enforcing the policy.
In a six-page order, U.S. District Judge George Russell III, an Obama appointee, rules he must lift his order “because the court is bound by the Supreme Court’s decision” that essentially green lighted Trump’s policy.
Russell was one of four district judges to have issued an order against the transgender military ban, which Trump announced in a series of tweets pledging to bar transgender people from the armed forces “in any capacity.”
But in January, the Supreme Court lifted two of these orders issued by judges in Ninth Circuit, essentially allowing the military to enforce Trump’s ban as litigation against it proceeds through the courts.
Weeks earlier, the U.S. Court of Appeals for the D.C. Circuit had sided with Trump on the transgender military ban, issuing an order against the injunction issued by U.S. District Judge Colleen Kollar-Kotelly.
Although courts have now lifted each of the initial injunctions, transgender advocates say the order from Kollar-Kotelly remains in effect, keeping openly transgender service in place for the time being.
The U.S. Circuit of Appeals for the D.C. Circuit has yet to issue the mandate on its decision, which gives the legal team supporting transgender plaintiffs the chance to seek “en banc” review before the full court. Transgender advocates say the absence of the mandate keeps the Kollar-Kotelly order intact for now.
But with the Supreme Court lifting the orders in two other cases, it’s hard to see how the D.C. Circuit would change its mind and take up “en banc” review of its case. After all, the Supreme Court is the superior court, and lower courts are bound by its order to allow enforcement of the ban as litigation proceeds.
The American Civil Liberties Union, which filed the case against the transgender ban in Maryland, sought to convince Russell after the Supreme Court to at least keep the injunction for each of the five plaintiffs in the case, known as Stone v. Trump.
But Russell says in his order the Supreme Court made no such exceptions in its decision on the Ninth Circuits orders, which compels him to deny the request.
“The Supreme Court implicitly rejected the option to narrowly tailor its stays so that the preliminary injunctions were still in effect as to the individual plaintiffs,” Russell writes. “Further, the Stockman and Karnoski plaintiffs include transgender individuals who intend to join the military…like certain plaintiffs in this case. The court, therefore, cannot materially distinguish plaintiffs in this case from those for whom the Supreme Court rejected a narrow tailoring of the stays.”
Joshua Block, senior staff attorney for the ACLU said in a statement “while not surprising, this decision is deeply disappointing for our clients and for transgender service members across the nation.”
“Each and every claim made by President Trump to justify this ban can be easily debunked by the conclusions drawn from the Department of Defense’s own review process,” Block said. “We will continue to fight against this discriminatory policy and the Trump administration’s attacks on transgender people. Our clients are brave men and women who should be able to continue serving their country ably and honorably without being discriminated against by their own commander in chief.”
Jessica Maxwell, a Pentagon spokesperson, said the military will continue to allow openly transgender service for the time being, but that should change soon.
“The department is pleased with the district court’s decision to stay the final injunction against the department’s proposed policy. The 2016 policy will remain in effect until the department issues further guidance, which will be forthcoming in the near future.
A gay man and trans woman are suing Burger King after they were allegedly attacked by two of their employees.
Raymond Ortega and Toni Llerena claim they were eating at a Burger King near gay club Twist, on South Beach, Miami, when an employee approached. The employee, said to be a woman, asked them to leave the restaurant because the section they were eating was closing.
The pair protested, saying others weren’t asked to leave. The employee allegedly called them ‘f**king faggots’ and told them to leave again.
The security guard – a man – then called them ‘faggots’ and sprayed Ortega with mace, before beating him, according to the suit. Ortega claims his jaw is damaged and his knee injured, causing him to walk with a limp and pay more than $10,000 in dental bills.
The assault allegedly occurred on 13 October 2018 at around 3.30am, in the Burger King on 1101 Washington Avenue.
Their lawyers, Matthew Ladd and Robert Pelier, say they will report the attack to the Miami-Dade police after Burger King reveals the names of the employees.
They said: ‘These two are going to get justice. We are going to hold everyone accountable.’
Burger King has CCTV of the event and other customers began recording on their phones when the scuffle broke out.
If arrested, the employees could be charged with Florida’s hate crime laws. This makes the penalties harsher, adding ‘with prejudice’ to the charges.
The fast food chain has previously supported LGBTI people during their ‘Proud Whopper’ campaign.
The retired police officer from Coffs Harbour in northern New South Wales hid her identity from friends and family for decades, but has finally been able to become her true self at age 82.
“I lived in my own world to because I had to. Most of my life I never had anybody to talk to about ‘the problem’,” Colleen explains.
“When I was younger I asked my mum if I might be a girl but she died when I was five or six. I didn’t dare mention it to my father or I would have got a clip around the head.
“I was scared of anyone finding out… You had to hide your reactions and feelings a lot. Just how I managed to do that, I don’t quite know. There’s such a hatred of transgenderism at my age, my vintage.
“It would mean so much to me to be able to be what I want to be… If I passed away under that surgery, I’d go quite happily because I’d be going the way I want to be, as a total woman.”
Earlier in her life, Colleen married wife Heather and became the father of two sons. It was only years later that Colleen was able to open up about her secret to Heather.
“Even though Colleen only came out as transgender at 82, she told Heather in her early 40s,” the doco’s filmmaker Ian Thomson told News.com.au.
“They would draw the curtains of their suburban bungalow and have this secret life dressing up and going promenading under the cover of darkness.
“Heather was a true insight into human nature, about how we fall in love with a person not a gender.”
After Heather’s death to cancer a few years ago, Colleen found herself back in the depths of secrecy.
But after explaining her situation to her GP and other support services, Colleen was able to begin her transition with their help.
The documentary follows her journey with the help of social worker Rowena and Colleen’s youngest son John as she moves into full-time aged care.
Thomson said he was drawn to this documentary project because while trans visibility in the media is increasing, there are a lack of transgender stories from working-class people in regional Australia.
“[Colleen’s] was such a compelling story that I asked her if she would be interested in sharing and she said yes,” he said.
“I think at this point she was in her eighties and didn’t want to keep secrets anymore.”
After the MGFF screening of Becoming Colleen in Sydney on February 24, a panel discussion on diversity in aged care will be held including trans advocate and author Sandra Pankhurst.
When Herbert* moved to San Francisco, he left friends, family, and his doctor behind. He lost access to the combination of HIV medications that had kept him healthy and prevented him from transmitting the virus to others. He was relieved when he found a provider who was able to kick-start his HIV treatment using a highly potent, durable combination of drugs to fight back against the virus. That treatment was an emergency intervention that would not otherwise be first-line, and served as a “bridge” to the preferred longer-term therapy that his doctor would prescribe based on lab results and the details of his prior care. Existing Medicare rules allowed Herbert’s doctor to order that more expensive HIV medication. That choice not only helped Herbert avoid getting very sick, but also decreased the chance that the HIV in his body would become resistant to treatment.
Today, more than 60 percent of people living with HIV in the Bay Area are over the age of 55 and nearly a quarter of all such persons use Medicare to pay for their care and treatment.
Herbert was able to get the care he needed, when he needed it, because of Medicare Part D’s protected class policy. The policy ensures that people have access to the treatments they and their providers believe are the most effective, not only the ones that save health insurance companies a buck.
This policy has helped save and improve millions of lives – and helped prevent new infections through early initiation of HIV antiretrovirals, which decreases forward transmission of HIV while improving medical outcomes in those treated early. In fact, thanks in part to this policy and local efforts to expand HIV treatment access, new diagnoses dropped by more than 50 percent in San Francisco from 2012 to 2016.
However, a new proposed rule by the Trump Administration could remove these protections, giving insurance companies the power to restrict access to medications that people living with HIV need.
Under the proposal, insurance companies could also require “prior authorization” and/or “step therapy,” which would force patients to use and fail cheaper therapies before getting access to more effective ones.
We know this is bad policy. Choosing antiretroviral medications is a complex exercise, especially for those patients with unknown or suspected HIV resistance patterns. Specialized medical training and credentialing inform those decisions, and these are the domain of HIV specialists, not insurance companies or their algorithms. HIV medicines vary considerably in terms of side effects, and recent innovation has made more recently developed therapies vastly more tolerable. Selecting treatment regimens tailored to the medical conditions and idiosyncrasies of individual patients requires close collaboration between people living with HIV and their health care providers.
Efficient selection of appropriate regimens is key. People living with HIV rely on daily access to life-saving medications and do not have the luxury of experimenting with drug combinations their health care providers have ruled out. Starting antiretrovirals immediately on diagnosis – barring insurance-imposed delays – holds the promise of averting new infections. Restricting HIV medication selection based on cost and ignoring doctors’ professional judgment is awful public policy.
To be clear, reducing health care system cost is important, but letting insurance companies decide which drugs to cover under Medicare for people living with a highly-infectious and potentially costly disease is dangerous. It would move us backwards in our fight to end the HIV epidemic, which is now in reach, notwithstanding this disturbing proposal.
Our entire community — health care providers, advocates, people living with HIV, government, and corporations — has made extraordinary strides against HIV transmission since the worst days of the epidemic, with new diagnoses in San Francisco falling to 221 in 2017. This proposed rule would put this vital progress in jeopardy. That’s why we are calling on our community to contact their members of Congress and tell them to oppose this rule. To find your member of congress visit www.contactingcongress.org or call (202) 224-3121.
(*Name has been changed)
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Ernest Hopkins has been engaged with legislative policy affecting the lives of People Living with HIV/AIDS for more than two decades. He has led national advocacy coalitions, testified before congressional committees, and advised Congress on legislative initiatives. He is the recipient of the Congressional Black Caucus Leadership Award, and leads national policy and legislative affairs at San Francisco AIDS Foundation.
Dr. Christopher Hall has more than 30 years’ experience in the HIV movement as a clinical provider and researcher. Dr. Hall is vice president of medical affairs at San Francisco AIDS Foundation where he oversees medical services and related research.