Britain’s High Court today ruled to overturn pharmaceutical company Gilead Science’s patent extension on Truvada. The HIV medication is also used for PrEP (Pre-Exposure Prophylaxis). When taken as advised, this stops HIV negative people acquiring HIV.
PrEP is not yet available on the NHS in England and Wales. The NHS is currently conducting a trial to test its cost efficiency. It is still in the process of recruiting around 10,000 high-risk participants for the ongoing trial.
Opponents of the NHS supplying Truvda say the medication is expensive. They point to the fact branded Truvada could cost the NHS up to £350 per month per person.
Supporters of PrEP say this is a price worth paying given its effectiveness. They argue the NHS has to pay more to provide a lifetime of HIV treatment to someone with HIV.
Currently, the NHS is only allowed to supply branded Truvada from Gilead.
Truvada was due to come off patent in July 2017, but Gilead extended its exclusivity until 2020 by a supplementary protection certificate (SPC). This prohibited smaller pharma companies from selling generic versions of the drug in the UK.
Generic versions could cost from around 80-90% cheaper, depending on the manufacturer. The NHS is often able to negotiate cheap deals because it buys in bulk.
The High Court today ruled against Gilead Sciences. The court’s decision follows a similar ruling in Ireland last year. There, those with HIV and or seeking Post-Exposure Prophylaxis treatment can use Truvada. Ireland does not yet offer Pre-Exposure Prophylaxis.
‘This represents a huge cost saving’
Many HIV and sexual health advocates welcomed today’s decision.
Deborah Gold, chief executive of NAT (National AIDS Trust) said: ‘We welcome this court decision, which overturns the patent extension for Truvada.
‘The decision will mean that unbranded versions of the drug can be legally prescribed. This represents a huge cost saving to buying a drug that would save public money, even at full price.
‘We continue to urge the NHS in England to commission PrEP by April 2019, as the current trial is not reaching everyone at risk. Indeed some have acquired HIV after being turned away from clinics whose trial places are full.
‘With the generic, unbranded version of the drug available at a fraction of the cost, the pressure increases on NHS England to begin routine commissioning, and make PrEP available to all who need it, urgently.’
‘I would urge NHS England to seize this moment’
Matthew Hodson, Chief Executive of HIV information organization NAM, also welcomed the judgement.
‘PrEP was already cost effective for people at high risk of HIV at Gilead’s price. This ruling should mean that much cheaper generic versions can be purchased by the NHS, ultimately saving even more money.
‘I would urge NHS England to seize this moment and swiftly rollout PrEP to all those who need it. This can be done in parallel to the existing trial.
‘PrEP has contributed to the significant declines that we have recently seen in HIV diagnoses among gay and bisexual men.’
Dating app Grindr today launched its new ‘Kindr’ initiative. The project arrives in response to complaints from some users after experiencing racist, body-shaming or stigmatizing language.
Grindr announced Kindr a few weeks ago, but provided scant details as to what the project would entail.
Today, it released the first of a series of videos in which it addresses the debate around online behaviour. It also unveiled new user community guidelines. These state profiles face moderation if they list what they disliked based on racial group or gender expression
The first video features app users explaining why stating what you’re not looking for – in relation to racial groups – is problematic.
It starts by stating some blatantly racist language users have heard online (‘Go back to Mexico’, ‘People like you are the reason Ebola exist’), before moving on to the ‘covert racism’ of profile preferences.
One man explains how reading exclusionary messages online feels like walking down a street and seeing shop signs welcoming only one kind of customer.
‘Racism is you thinking I’m not going to be smarter than you when you first meet me,’ says one black contributor, Rakeem Cunningham.
Rakeem Cunningham (Photo: Grindr)
‘Or when black people are articulate and other people go, “Oh, you’re so well spoken!” Like, that’s the stuff that bothers me, and that’s the stuff I think needs to be addressed. I think the racism that’s not overt but that’s covert is the main problem.’
An Asian contributor, Joel Kim Booster, says that he began to wonder if there was something wrong with him, or if there was something he should be ashamed about when interacting with guys online. ‘It opened my eyes to a hierarchy that I wasn’t participating in before.’
Why not just stay quiet instead of needlessly offending someone?
‘If you don’t put “No Asians” in your profile, that doesn’t mean you have to fuck Asians now. It just means I don’t have to see it,’ he says.
‘It is not racist to not be attracted to me personally,’ he adds. ‘But for you to say “I know what every Asian guy looks like and I know for a fact that I would not be attracted to any of them…” Like that comes from a racist place because you don’t know what we all look like. That’s ugly.
‘We have only so much in our profiles to get across whatever the fuck we want to get across to all the other guys on this app, and you’re going to take space to narrow it by what you don’t want. Just tell me what you do like. If you tell me you like the fucking Jonas Brothers, I know I’m not for you.’
Former Queer Eye alum Jai Rodriguez also takes part. He points out, ‘You don’t know what the person on the other side of the phone is going through. You have no idea what they’re experience is or what else they have going on. Or what that comment might do to them.’
Many talk about the impact of language.
‘No matter what battle you’re going through, you don’t have to break other people in order to feel good,’ says contributor Jasmine Aksornkij. ‘You don’t have to hurt other people in order to make you feel uplifted.
The video ends with the campaign’s tagline: ‘It’s time to play nice.’
‘Responsibility to not only protect our users, but also to set the standard’
‘Sexual racism, transphobia, fat and femme shaming and further forms of othering such as stigmatization of HIV positive individuals are pervasive problems in the LGBTQ community,’ said Landen Zumwalt, head of communications at Grindr, in a press statement.
‘These community issues get brought onto our platform, and as a leader in the gay dating space, Grindr has a responsibility to not only protect our users, but also to set the standard for the broader community that we serve.
‘Online discrimination has reached epidemic proportions affecting not only Grindr but other social networks. Our ‘Kindr’ initiative is a rallying call for Grindr and our community to take a stand against sexual racism and all forms of othering.
‘Together, we will work to maintain a welcoming and inclusive environment and end the need for people to include exclusionary statements on profiles.’
New community guidelines and moderation
Grindr says it will be rolling out more videos over the next five weeks. It has also updated its community guidelines. In these, it says that moderators will act if they see people making statements such as ‘No Asians’ in their profile descriptions.
‘We have a zero-tolerance policy for discrimination, harassment, and abusive behavior. We want you to be yourself, but not at the expense of someone else. Anyone found bullying, threatening, or defaming another user will be banned.
‘We will also remove any discriminatory statements displayed on profiles. You’re free to express your preferences, but we’d rather hear about what you’re into, not what you aren’t.
‘Profile language that is used to openly discriminate against other users’ traits and characteristics (“No fats, no fems, no Asians”) will no longer be tolerated and will be subject to review by our moderation team.’
Other apps take action
Grindr is not the only dating app acting to moderate racist language and stigmatizing behavior. Last week, Chappy launched its own ‘zero tolerance for abuse’ campaign. Scruff also announced earlier this month that it would make its ‘ethnicity’ field optional.
Grindr was launched in 2009 and now claims to have 3.8million daily active users. It was sold in its entirety to Chinese gaming company Beijing Kunlun Tech last year. Grindr remains headquartered in Hollywood, California, but The company is considering an initial public offering.
Integrase inhibitors—potent antiretrovirals that quickly and powerfully suppress HIV—have allowed HIV researchers and clinicians to explore dosing regimens that involve fewer than three or four drugs. Proponents of dual therapy say that effective regimens involving fewer drugs will lower costs, decrease pill burden and reduce the potential for drug-drug interactions and side effects. But is it that simple?
Monica Gandhi, MD, MPH
“Two-drug regimens are exciting,” said Monica Gandhi, MD, MPH, medical director of the Ward 86 HIV clinic at San Francisco General Hospital and associate division chief of the Division of HIV, Infectious Diseases, and Global Medicine at UCSF. “But there are many clinicians who have been treating HIV for a long time that are a little bit alarmed over the two-drug fanfare. We’re not quite ready to jump on board with two-drug regimens for everybody.”
“On principal, fewer drugs is better,” said Keith Henry, MD, from Hennepin County Medical Center. “I like the philosophy of using fewer drugs, but I’m still not convinced that it’s going to be hugely beneficial. There may be only nuanced or subtle clinical advantages of a two- versus three-drug strategy evident over time—that we haven’t fully studied—especially if the drug you’re jettisoning is relatively non-toxic. In the U.S., most people that are on standard three-drug regimens are increasingly on one of the simplest, safest regimens currently available.”
Currently, there is only one recommended two-drug regimen option for people living with HIV, but the future may well bring more. Here’s a summary of challenges with the current option, and an overview of two other combinations currently being tested.
Dolutegravir plus rilpivirine
Juluca tablet (Photo: ViiV Healthcare)
Dolutegravir (integrase inhibitor) plus rilpivirine (NNRTI) is the only two-drug regimen currently recommended by the U.S. Department of Health and Human Services (DHHS). These medications can be purchased separately (no generic versions are available in the U.S.), so some people on this regimen take two pills once per day. This combination is also formulated as a single-tablet under the brand name Juluca, which is one tablet taken once per day.
This two-drug combination is not recommended for people just beginning antiretroviral therapy—it’s only a switch option for people who have been virally suppressed for at least six months.
Gandhi said that at Ward 86, the HIV clinic at San Francisco General Hospital, very few people are taking Juluca or dolutegravir and rilpivirine. The combination has been studied only in patients without a history of virologic failure, which is not common among people treated for HIV at Ward 86. Moreover, the risk of drug resistance, and need for food security, makes this regimen only a good choice for people who are highly adherent to their medications—and Ward 86 sees many patients who are unstably housed, struggling economically or otherwise experiencing life challenges that can stand in the way of perfect adherence.
“The concern about a two-drug regimen and starting patients on this regimen is that if you lose something like dolutegravir [to drug resistance], that would make it really difficult in the future in terms of treatment options,” said Gandhi. “I think Juluca is very exciting, but it may be more so for people who haven’t had any failure to previous regimens and who are highly adherent. It’s not for everybody,” she said.
Another issue is that Juluca—a new drug approved in November 2017—is expensive, and the ease of a complete one-tablet regimen may be offset by its high price tag. Henry from Hennepin County Medical Center said that at his hospital’s pharmacy, Juluca can cost more than $38,000 for one person’s year-long supply. (The wholesale acquisition cost is nearly $31,000/year.)
“If we purchase the tablets separately, it’s hundreds of dollars per month cheaper than that. If you look at what’s happening in society in healthcare in general, we still have to be good stewards of resources,” he said. “If you have individual small pills that are well-tolerated, I am not convinced that you always have to go with the single-tablet.”
Dolutegravir plus lamivudine
Dolutegravir plus lamivudine (3TC) is a promising two-drug regimen that is currently being studied. (It is not yet approved or recommended for use by the U.S. DHHS.) A generic version of lamivudine is available in the U.S.
At the AIDS 2018 conference in July, Pedro Cahn, MD presented results from the GEMINI-1 and GEMINI-2 studies comparing dolutegravir/lamivudine to a standard three-drug regimen of dolutegravir/tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC). The study enrolled treatment naïve people who had not yet started antiretrovirals, with no evidence of drug resistance.
The researchers compared the percent of people who achieved viral suppression after 48 weeks between the two treatment groups, in addition to differences in CD4 count gains, adverse events and other safety and tolerability data.
Overall, the studies demonstrated that the two-drug regimen was non-inferior to the three-drug regimen: 93% of participants in the two-drug regimen and 94% of participants in the three-drug regimen achieved virological suppression at 48 weeks.
There were fewer drug-related adverse events with the two-drug regimen, and the two-drug regimen was also associated with better kidney and bone outcomes.
“As you well know, today ART means lifelong treatment,” said Cahn. “So as much as we can do to reduce drug burden for our patients is very welcome in terms of less long-term drug toxicity.”
Henry said that it will be interesting to see, as more efficacy data becomes available, what the differences might be between dolutegravir paired with lamivudine versus rilpivirine. He also plans to keep an eye on cost, and says this will continue to be a concern for patients and providers.
“This is part of the confusion of our health care system right now—and we’ll continue to have more of these dilemmas as time goes on and as we have more two-drug options and more generic drugs available. What is the real benefit of a single-tablet integrase regimen versus two or three small pills that are generic and much cheaper? If the single-tablet is 5% or 10% better tolerated or effective, but 45% to 50% more expensive, would a cost analysis support the use of the branded drug? We haven’t gotten into this as much as we should, but the overall state of healthcare financing means that we need to be more cost-benefit conscious.”
Cabotegravir plus rilpivirine
Cabotegravir LA vial and syringe (Photo courtesy of David Margolis)
Perhaps the most exciting two-drug regimen currently being tested is the long-acting formulation of rilpivirine and cabotegravir (which is an experimental integrase inhibitor). The dosing regimen now being tested frees people from taking oral antiretrovirals every day. Instead, people receive a long-acting injection once every four weeks or once every eight weeks.
So far, results of the LATTE-2 study, which is testing this formulation, are very promising. The injected cabotegravir and rilpivirine medications kept viral loads suppressed in 94% of people receiving injections every eight weeks and in 87% of people receiving injections every four weeks, when measured at the 96-week time point. People receiving the injections report high levels of satisfaction and convenience with the regimen, and also express willingness and desire to continue with this drug regimen.
If the long-acting injectable comes to market, Gandhi said she believes it could benefit people who struggle to take medication every day—in addition to people who are highly adherent (a bimodal population).
“We have many patients at Ward 86 who simply cannot fit taking a medication every day into their lifestyle, but, who actually show up to the clinic fairly often. People who are homeless may not come in for their primary care visits, but they show up for acute care visits. They’re engaging with the clinic a lot, which gives us hope that this will be an opportunity for treatment.”
More than half (51 percent) of trans male teenagers have attempted suicide in the past year, according to new research.
The new study by researchers at the University of Arizona also found that more than four in 10 (42 percent) of non-binary adolescents and 30 percent of trans female teens had attempted suicide.
The new research has found trans and non-binary teenagers are significantly more likely to attempt suicide. (Getty)
Suicide is the second leading cause of death among teenagers and young adults aged between 10 and 34 in the US.
The latest data revealed that transgender and non-binary teens—aged between 11 and 19—are at a significantly greater risk of attempting suicide than their peers who are cisgender, meaning
Nearly two in 10 (18 percent) of cis female teens, and 10 percent of cis male adolescents, had tried to end their lives, according to the study.
Russ Toomey, an associate professor at the University of Arizona, who led the research, based his findings on an analysis of data from the Profiles of Student Life: Attitudes and Behaviors survey—a national survey of 120,617 adolescents in the US.
The survey, carried out between 2012 and 2015, included data from 202 transgender teenagers, 70 per cent of which were trans male adolescents.
Previous research has show that an alarming percentage of transgender people have attempted suicide. (Scott Olson/Getty Images)
Commenting on his research, Toomey said: “Transmasculine youth and non-binary youth are the two populations that often are the least focused on in the transgender community.
“So really reorganising our efforts to focus in and try to really understand and learn about the experiences of these youth is critical.”
Past research has shown that a shocking proportion of transgender people have attempted suicide.
In 2016, a study by the NationalCentre for Transgender Equality found that 40 percent of transgender people had tried to end their lives.
Other studies have also revealed that lesbian, gay and bisexual (LGB) young people are more likely to attempt suicide than their straight counterparts.
A 2016 study by the Centers for Disease Control and Prevention found that lesbian, gay and bisexual (LGB) young people are almost three times as likely to seriously contemplate suicide than heterosexual youths.
It also found that LGB youth were five times more likely to have attempted suicide than heterosexual young people.
If you are in the US and are having suicidal thoughts, suffering from anxiety or depression, or just want to talk, call the National Suicide Prevention Line on 1-800-273-8255. If you are in the UK, you can contact the Samaritans on 116 123.
A group of House lawmakers is calling on the Department of Veterans to incorporate gender reassignment surgery as part of its coverage for U.S. veterans, calling denial of the procedure for transgender people “unconscionable.”In the Sept. 7 letter, the lawmakers respond to a request for comment on coverage for gender reassignment surgery.
“Simply put, the VA has an obligation to provide the necessary care that is prescribed to enrolled veterans by their health care practitioners,” the letter says. “It is unconscionable to deny veterans the same access to health care services that civilians receive in the private sector, and that is available to Medicare beneficiaries and federal workers, simply because of outdated and unscientific prejudice against their gender identity.”
The VA has request comment on gender reassignment surgery as a consequence of ongoing litigation against the department seeking coverage for the procedure. The case is currently pending before the U.S. Circuit Court of Appeals for the Federal Circuit.
Given the anti-LGBT policies of the Trump administration, including the attempt to ban transgender people from the U.S. military, it’s hard to see how the solicitation for comment could result in a proposed rule change. In fact, the administration could use comments against coverage as justification for current policy.
Brownley, top Democrat on the House Veterans’ Affairs Health Subcommittee, said in a statement the estimated 160,000 transgender veterans in the United States are deserving of coverage and “have put their lives on the line in order to protect our constitutionally protected freedoms.”
“It is simply unacceptable that we would ask our veterans to risk their lives to protect our rights but we would refuse to defend theirs in return,” Brownley said. “The VA must put an end to this discriminatory and outdated ban on treatments for gender dysphoria and ensure that all our nation’s veterans have access to the healthcare they have earned.”
The lawmakers’ letter to the VA has a blemish of bipartisanship. Among the 83 House members who signed the missive was Rep. Ileana Ros-Lehtinen (R-Fla.), who has a transgender son and is slated to retire from Congress at the end of this year.
Charlotte Clymer, a transgender veteran and spokesperson for the Human Rights Campaign, said in a statement the exclusion of gender reassignment surgery from VA coverage is harmful.
“The Department of Veterans Affairs’ exclusion of many forms of transition-related health care flies in the face of every major medical authority and undermines the health and wellbeing of transgender patriots who have laid their lives on the line for this country and their families,” Clymer said.
Indeed, the letter says studies have shown transition-related care, including gender reassignment surgery, can reduce the rate of suicide among transgender people as well as mental health problems, such as anxiety and depression.
“This broad medical consensus on the treatment of gender dysphoria is based on decades of peer-reviewed studies and clinical observation — including studies of veterans — that demonstrate its efficacy and substantial health benefits,” the letter says.
The Department of Veterans Affairs during the Obama administration had floated the idea of covering gender reassignment surgery, but the planned was scrapped after the election of President Trump — but before his inauguration — under the pretext of concerns about cost.
A VA spokesperson said in response to the letter the department “appreciates the lawmakers’ views and will respond to them directly.”
“VA will consider the comments received and determine the appropriate response,” the spokesperson added. “Although there is no specific timeframe required for this type of consideration, VA will announce any action it takes in the Federal Register.”
The National LGBT Cancer Network is the newest recipient of a $2.5 million five year award from Centers for Disease Control and Prevention to expand resources for their grantees serving LGBTQ people at risk for tobacco-related cancers.
“The LGBTQ communities smoke at rates significantly higher than other populations. That alone increases our cancer risks dramatically,” said Liz Margolies, the Executive Director of the National LGBT Cancer Network.
The Cancer Network’s new award will expand their NYC presence to Providence, RI, the base for their Principal Investigator, Dr. Scout. For more than a decade, Dr. Scout has led this CDC health priority at other agencies. He emphasizes that the next five years will bring a new vision for this work: “We are really looking to expand the online knowledgebase and toolbox for LGBTQ community members at risk for cancer, living with cancer, and policymakers serving us. Watch our website at www.cancer-network.org; each month we will be adding new resources, building a robust library of information and tools everyone can access.”
The CDC award leverages a trusted network of organizational members who specialize in tobacco-related cancers and/or serving LGBTQ people. The Cancer Network reports early membership commitments from a wide range of LGBTQ serving national organizations, including the Human Rights Campaign, the National LGBTQ Task Force, the Gay & Lesbian Medical Association, the Equality Federation, and more. Likewise, many states health departments and national health organizations have already signed on as members: American Cancer Society, The Truth Initiative, Association of State and Territorial Health Officers, and more. “The American Cancer Society has a longstanding commitment to addressing cancer in the LGBTQ communities. We are very excited about this new award and look forward to helping further reduce the cancer impact for this population,” said Tawana Thomas-Johnson, Vice President, Diversity and Inclusion at ACS.
Ms. Margolies added, “We are particularly excited to have members work with the state health departments, who collectively are the second largest health funder in the United States.”
The National LGBT Cancer Network works to improve the lives of LGBT cancer survivors and those at risk, through education, training, and advocacy. They recently created the most comprehensive LGBTQ cultural competency training program available, which has been used to train thousands people across the country to date. Learn more at www.cancer-network.org.
Shantee Tucker is the 19th reported case of a trans person being killed in the US so far in 2018. (Shantee Tucker/Facebook)
A black trans women shot dead in Philadelphia on Wednesday morning has become the 19th reported case of a trans person being killed in the US so far this year.
Shantee Tucker, who had celebrated her 30th birthday on Sunday (September 2), was found suffering from a gunshot wound by police at about 1am on a highway in the Hunting Park area of the city, according to local media reports.
She was taken to Temple University Hospital, where she was pronounced dead.Police are reportedly looking for a suspect in connection with the murder.
According to local magazinePhiladelphia, a police report state that Tucker had been arguing with an unidentified person or persons in a black Ford truck, who then started shooting at Tucker.
Philadelphia Police Department are appealing for any witnesses to contact the Homicide Unit on 215-686-3334.
Friends have paid tribute to Tucker on social media.
One friend, Samantha Jo Dato, wrote on Facebook: “R.I.P Shantee Tucker I was just on your live checking in on your birthday. May you forever live in our hearts and justice be swift and ruthless.
“This is so close to home Philly Stay Strong and wrap one another in love.”
Another friend, Tameer Harris, posted on Facebook: “Omg I can’t believe the news I just got R.I.P Shante !! you was really like another big sister to me!”
Harris added: “I really can’t even believe this phone call I got ❤️❤️❤️ this morning I woke up to a confirmation that I can’t even stomach to believe 😔 May you Rest In Peace baby 💋 I Love You So Much!”
Sarah McBride, national press secretary of the Human Rights Campaign, told PinkNews: “There is a growing epidemic of violence targeting transgender people, particularly Black transgender women.
“This is an urgent crisis that is a by-product of the toxic and violent combination of transphobia, misogyny, and racism. As a society, our policymakers and lawmakers must do more to combat this violence.
“Our hearts go out to the family—both blood and chosen—of Shantee Tucker, and we must never forget that behind the headlines was a real person whose life of love, hopes and dreams was tragically cut short.”
Dejanay L. Stanton (left) and Vontashia Bell were both found dead on August 30. (Facebook)
Dejanay L. Stanton, a 24-year-old woman, was found on a street in Chicago on Thursday morning with a gunshot wound to the head, the Chicago Sun-Times reported.
The other woman, 18-year-old Vontashia Bell, was also found in a street in Shreveport, Louisiana, with gunshot wounds to the chest and wrist.
Born on May 21, 1923, the pastor marched at early gay rights protests, years before the Stonewall Riots in 1969.Wood reportedly came out as gay to the public when his article titled “Spiritual Exercises” was published in a gay magazine, showing him photographed in a clerical collar.
He published his groundbreaking book Christ and the Homosexual in 1960, which called for church-approved equal marriage and for Christian clergy to welcome gay people.
Wood wrote that the “saving message of Christ and the freely flowing grace of God are as much for the homosexual as the heterosexual,” adding that “the church must minister equally to both; that the demands of Christ apply to both; that both are capable of being moral, as well as immoral and amoral.”
In 1960, Wood was honoured with an Award of Merit from The Mattachine Society, an early gay rights group.
Wood was also known to have carried out same-sex marriage ceremonies many years before it was enshrined in law across the entirety of the US in 2015.
Wood advocated for equal marriage. (BORIS HORVAT/AFP/Getty)
In his younger years, Wood studied as an undergraduate at the University of Pennsylvania, and went on to be enlisted as a soldier during World War II.
He was injured during the invasion of Italy and honourably discharged for his efforts.
In 1962, Wood met his long-term partner, Hugh M. Coulter, an artist and cowboy, who was also a World War II veteran.
The pair met in a gay leather bar in Manhattan.
Wood marched at gay rights protests, years before the Stonewall Riots in 1969. (Creative Commons)
Wood and Coulter were also present at the country’s first gay picket line in 1965, reportedly protesting outside the Civil Service Building after it had been revealed that the head of the Civil Service Department said it would not employee gay people.
The couple spent 27 years together until Coulter’s death in 1989 and each wore a gold wedding ring.
In 2001, Wood was honoured as a gay pioneer by the Christian Association at the University of Pennsylvania.
And, in 2004, the United Church of Christ Coalition of LGBT Concern gave him its pioneer award.
Jeff Cobb was denied early boarding (jeffcobb415/twitter)
A gay couple has claimed that they were denied early boarding with their daughter—only to see straight parents walk through with children.
Jeff Cobb and his husband were flying with Taiwanese airline EVA Air from San Francisco to Thailand on Saturday (September 1) when they were reportedly separated on the false basis that only one parent could accompany a child onto the plane.
Cobb described on Twitter how “my husband and I were told only one of us could join our 19-month-old in the family boarding group of EVA Air 27 from SFO on 9/1/18.
“I explained we were both the fathers of the child, and they said it was their policy that only one parent can board and the other has to wait in the normal line.
“Not having flown EVA before, I accepted it and let my husband and child go while I boarded later.”
But Cobb said he was in for a surprise when he was finally reunited with his husband and daughter.
“When I met him on the plane, he said there were many other (straight) families all boarding together,” he wrote.
“I’m very disappointed that the EVA ground staff at SFO thinks it’s ok to separate same-sex families during boarding.
“I will definitely not be flying this airline again after this incident.”
When they got their connection in Thailand with EVA Air, the two dads were allowed to walk through early boarding with their daughter, according to Attitude.
An EVA Air spokesperson said: “EVA Air and most especially our San Francisco International Airport team sincerely apologise to all the passengers affected by this incident.
Cobb said he “will definitely not be flying this airline again after this incident” (EVA Airways Corp./Facebook)
“It is our policy that passengers travelling with infants can have priority boarding. The policy does not limit the number of accompanying adults or specify the relationship to the infant.
“This unfortunate incident was due to misunderstanding. Our San Francisco ground-handling agent understood that only one parent could board with an infant.
“We have apologised to our passengers and reminded our airport staff and agents about our priority boarding policy so that we can prevent this kind of incident from happening again.”
Last year, Grant Morse and husband Sam said Southwest denied them priority boarding to a flight because the airline didn’t consider them and their three children to be a family.
We don’t talk much about chlamydia, gonorrhea, or syphilis, in part because it can seem like they’re not big health issues anymore. But it turns out more and more Americans may be quietly suffering from these once nearly eliminated STDs.
According to a new report from the Centers for Disease Control and Prevention, there were nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis reported in the United States in 2017 — the highest cumulative number ever recorded, and one that surpassed a 2016 record high.
The leap in cases over the last few years are truly eye-popping. Between 2013 and 2017, the rate of:
Gonorrhea increased by 67 percent to 555,608 cases
Syphilis increased by 76 percent to 30,644 cases
Chlamydia increased by 22 percent to 1.7 million cases
To appreciate just how astonishing the trends are, consider that as recently as a decade ago, these STDs were at historic lows or near elimination, with more and better screening and diagnostics to help identify cases and get people into treatment.
Syphilis can show up on the body in sores and rashes. Gonorrhea and chlamydia can lurk with no symptoms. They’re all generally easy to cure with a timely antibiotics prescription, but when left untreated, they can lead to infertility or life-threatening health complications. That’s what makes screening and access to health care so important.
The increase in cases between across all three diseases was significant, and represents changing disease dynamics.“We are sliding backward,” said Jonathan Mermin, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, in a statement. “It is evident the systems that identify, treat, and ultimately prevent STDs are strained to near-breaking point.”
African Americans and men who have sex with men have traditionally been the populations most plagued by gonorrhea and syphilis (and they’re still disproportionately affected). But other groups are now catching up too, especially women and babies in contracting syphilis.
So what’s behind the spread of these diseases here? There’s no single explanation. Like most health trends, it’s complicated. But here are a few ideas, according to experts:
1) There’s been a rise in condomless sex among men who have sex with men: Gay, bisexual, and other men who have sex with men are generally more at risk for STDs than women and men who have sex with women only. (The majority of new syphilis and gonorrhea cases occurred among men, and in particular, men who have sex with men.) And there’s been some concern about a shift toward riskier sexual behaviors in this group — like not wearing condoms — that may be contributing to the rise in STDs.
The reason for this shift has been explained by everything from the success in treating HIV (and therefore making sex less scary) to the advent of PrEP (pills that can prevent HIV). A systematic review published in the journal Clinical Infectious Diseases found that some PrEP users are having more risky sex — and are being diagnosed with more sexually transmitted infections.
HIV and syphilis are also interlinked: Some half of men diagnosed with a new syphilis infection also have HIV. And as these diseases spread in particular populations, like men who have sex with men, there’s a greater risk of them moving even further.
“The fear, which I share, is that we won’t contain syphilis among men who have sex with men,” Matthew Golden, director of the Public Health for the Seattle and King County HIV/STD control program, told Vox in 2017. “And if the epidemic in men who have sex with men gets big enough, which is what is happening, there are enough people who have sex with both men and women that it won’t be possible to contain it.”
2) STDs are spreading more broadly and into populations that weren’t traditionally affected — like babies: A 2017 CDC report on STDs in America showed that more women are getting syphilis these days, and they’re passing it to their babies. When an expectant mother is infected with the disease, and goes undiagnosed and untreated, the bacteria can get into her bloodstream and move through her placenta to her baby. Congenital syphilis is associated with serious health consequences, like stillbirths and neonatal deaths.
In 2016, there were 628 cases of congenital syphilis, an increase of 27.6 percent from 2015 — and that number includes 41 related deaths. According to the CDC, much of the rise was driven by increases in cases in the Western US. Between 2012 and 2016, Western states saw an astounding 366 percent rise in congenital syphilis.
The large increase has to do, in part, with the fact that many Western states have recently had few syphilis cases in women. “We were starting from almost nothing [in Washington],” said Golden. But that’s changing, and with more women getting the disease, their babies are at risk too.
Rates of reported cases of primary and secondary syphilis by state in the United States, 2016.CDC
3) With the rise of dating apps, sex is more readily available and more anonymous — and that makes it harder for health investigators to track outbreaks: Health experts increasingly view apps and sites such as Tinder, Grindr, and OkCupid as enablers of high-risk sex, helping people meet and hook up more efficiently than ever before. The impact of these sites is so profound they are also transforming the way health officials track and prevent outbreaks.
“We used to think about what we can do with bathhouses and sex clubs to make sure people’s risk was reduced,” said Dan Wohlfeiler, director of Building Healthy Online Communities, a public health group that works with apps to support STI prevention, told Vox in 2017. These places, after all, had become important meeting points for men who have sex with men — the group most affected by the HIV epidemic.
Today, the public health focus has shifted to “digital bathhouses.” Wohlfeiler said, “Now that dating sites and apps have become so common, we know we need to work with them.”
But many of the major dating networks don’t want to be involved in STD prevention, nor have they acknowledged the impact they’re having on public health, health experts told Vox.
4) The numbers may be higher because we may be better at detecting cases in some groups: The rise in chlamydia — which overwhelmingly causes no symptoms but can lead to infertility in women — may be an artifact of better detection and screening. The CDC keeps finding that rates of chlamydia are highest among young women, the group that’s been targeted for routine chlamydia screening. So an increase could just mean more testing.
5) Cuts to public health funding mean fewer STD clinics: Public health in the US — which includes operating STD clinics where people can get tested and into treatment — is historically underfunded. (As of 2012, only 3 percent of the health budget went to public health measures; the rest went mostly to personal health care.) And since the global financial crisis, public health funding has really taken a battering. There are 50,000 fewer public health jobs since 2008, and many STD clinics have had to reduce their hours or shut down.
STD clinics were a traditional safety net for people with these diseases. If those clinics continue to be harder to reach or vanish, finding and treating STDs will become even more difficult — and the diseases will continue to spread.
So in some ways, the STD increases across the country may have less to do with a changing sexual landscape, and more to do with more limited access to sexual health care. With Trump’s proposed public health budget cuts, the problem may be poised to get worse.
“It’s not a coincidence STDs are skyrocketing — state and local STD programs are working with effectively half the budget they had in the early 2000s,” said David Harvey, executive director of the National Coalition of STD Directors, in a statement today. “If our representatives are serious about protecting American lives, they will provide adequate funding to address this crisis. Right now, our STD prevention engine is running on fumes.”
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