HIV Transmission -> What We Know & Why States Are Getting It Wrong

HIV

andrew shaughnessy

By: Andrew Shaughnessy, Manager of Public Policy
PROMO Missouri
@AndrewShag

AIDS.gov states that certain body fluids from an HIV-positive person can transmit HIV.

The body fluids mentioned are: Blood, Semen (cum), Pre-seminal fluid (pre-cum), Recital fluids, Vaginal fluids, & Breast milk.

Nowhere on this list does it mention saliva. Missouri laws, similar to several States, criminalizes behaviors that the CDC regards as posing either no risk or negligible risk for HIV transmission, this includes saliva. The Justice Department goes so far as to detail the best practices States should incorporate to make HIV-related laws align with science.

However, earlier this week, Missouri Legislator Travis Fitzwater (R -49) introduced Missouri House Bill 1181, which would have made it a crime for an individual knowingly infected with HIV to intentionally project saliva at another person.

HB 1181


Missouri is no stranger to strict laws (MO Rev. Sec. 565.085) that criminalize certain behaviors that have been proven by science to not transmit HIV. Several States still reference criminal statutes that fall under this category, which is why States should start modernizing their HIV criminal laws: now. Enacted through the fear of the 80s – early 90s, Missouri, like many States, continues to get it wrong it when it comes to effective HIV/AIDS policy. States enacted these laws with the intention of reducing HIV transmission, however research shows that these fear-based laws have the opposite effect and help HIV proliferate.

Missouri House Bill 1181 was scheduled for a hearing on Tuesday April 7th, but at the last moment was taken off of the docket. This hopefully signals a step in the right direction — but we still have a long journey ahead. Advocates in Missouri and nationwide should continue to monitor any legislation that seeks to further criminalize people who live with HIV.

Ending Exclusions Under Obamacare

Andrew Shaughnessy, Manager of Public Policy for PROMO

By: Andrew Shaughnessy
@andrewshag

For the LGBT community health is a complicated matter. It is further complicated when health insurance companies deny or exclude certain forms of coverage that for some are basic health needs. For LGBT folks seeking gender-affirming health care coverage barriers exist at every turn — until the Affordable Care Act. Or so we thought…

Section 1557 of the Affordable Care Act prohibits discrimination on the ground of race, color, national origin, sex, age, or disability under “any health program or activity, any part of which is receiving Federal financial assistance … or under any program or activity that is administered by an Executive agency or any entity established under [Title I of ACA]….” To ensure equal access to health care, Section 1557 also applies civil rights protections to the newly created Health Insurance Marketplaces established under the Affordable Care Act.

End

Upon researching a complaint raised to us by a Missourian, who qualified and enrolled in a federal marketplace plan, we concluded that exclusions still exist under ACA plans that inhibit transgender patients from getting the basic care they need. Under certain Federal marketplace health insurance plans exclusions have been put in place that state “sex change services and supplies for a sex change and/or reversal of a sex change.”

A real life example of how this affects transgender patients was raised to me, “I had a large cyst on my ovary that had to be removed a several years ago. I hadn’t started transitioning, so my insurance company didn’t blink when I claimed the surgery to remove it. Fast forward to now. If I had the same problem and walked into the doctor’s office with a beard and “male” on my documents, the insurance company can (and would absolutely) deny my claim.”

The State of Missouri’s, along with several states’ ACA exchange, is administered by the federal government and is governed by this rule, however this exclusion is a clear violation of Section 1557. Transgender patients who rely on marketplace coverage for health insurance are forced to censor their own health management for fear that marketplace plans will deem any healthcare on a transgender body excluded from the plan.

I along with the support of hundreds of Missourians requested that the Department of Health and Human Services investigate these claims and make efforts to remedy any claims of sex discrimination in health insurance plans under the Affordable Care Act.

If you are or know someone who is affected, please consider making a request to the Department of Health and Human Services to investigate these claims.

For Immediate Release- LGBT HealthLink Grades States on LGBT Tobacco Integration

PRESS RELEASE
December 10,  2014

For Immediate Release
Contact:
Dr. Scout
(954) 765-6024
scout@lgbtcenters.org

LGBT HealthLink Grades States on LGBT Tobacco Integration

Ft. Lauderdale, FL – December 10, 2014 – LGBT HealthLink today announced the first ever grades for state tobacco programs’ LGBT inclusion practices. The grades, based on a survey of best practices originally conducted in 2013 and updated this fall, represent an assessment of the overall progress each state has made in addressing inclusion, including policies, training, data collection, and community engagement. Grades span from “A” to “F”, with the average across states a “C+”.

LGBT people smoke at rates that are over 50% higher than the general population and experience profound health disparities in both cancer and smoking-related disease. The survey was developed to bring transparency to how successful states are at integrating this disproportionately affected population into their overall tobacco control work.

According to Daniella Matthews-Trigg, Administrator of LGBT HealthLink, “The results of this survey not only illustrate the work that needs to be done, but highlights the impressive efforts by many states. Our hope is that creating a system for comparison will motivate states to adopt as many best practices as possible, thereby improving acceptance and wellness in LGBTQ communities around the country”. LGBT HealthLink is offering resources to each state to improve their grades.

For several years, LGBT HealthLink (formerly the Network for LGBT Health Equity) has been circulating “Identifying and Eliminating LGBT Tobacco Disparities”, a document outlining the best practices for state programs in LGBT tobacco control, and working closely with states to implement them. These report cards are intended to gauge adoption of those best practices at a state level and create a baseline for future work.

The release of the report cards comes just after the CDC’s Office of Smoking and Health recently accepted applications from states for their next five years of tobacco funding. Dr. Scout, Director of LGBT HealthLink, noted that “In order to eliminate the LGBT smoking disparity, we need to make sure the tobacco control community targets us just like the tobacco industry already does.”

Matthews-Trigg emphasized how closely HealthLink is working with states improve their grades, “We are the people providing technical assistance to these states to do this well, so this is really a report card of our work as much as theirs. We look forward to continuing our work with the many amazing state representatives to get these grades even higher.”

View the report cards: www.lgbthealthlink.org/Report-Cards/2014

For more about the methodology and scoring:

www.lgbthealthlink.org/Report-Cards

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 LGBT HealthLink, a program of CenterLink, spreads LGBT wellness best practices across state and federal health departments and community organizations. LGBT HealthLink is one of eight CDC-funded tobacco and cancer disparity networks. www.lgbthealthlink.org

CenterLink: The Community of LGBT Centers was founded in 1994 as a member-based coalition to support the development of strong, sustainable LGBT community centers. Serving over 200 LGBT community centers across the country in 46 states. Puerto Rico and the District of Columbia, as well as centers in Canada, Mexico, China, Cameroon and Australia, the organization plays an important role in supporting the growth of LGBT centers and addressing the challenges they face by helping them to improve their organizational and service delivery capacity and increase access to public resources. www.lgbtcenters.org

“It’s Your Time To Shine!” 2014 LGBTQ Youth Regional Retreats Recap

Motivational-Inspirational-Life-Quotes-2243National Youth Pride Services recently hosted it’s 2014 “It’s Your Time To Shine” Regional Retreat series in Detroit, Michigan (Midwest), Columbia, South Carolina (South) and Washington D.C. (East) thanks to sponsors CenterLink, Lambda Legal, 3LW TV, South Carolina Black Pride, Palmetto AIDS Life Support Services and Al Sura. The retreat was designed to uplift, inspire and motivate the black LGBTQ youth communities in a way that had never been done before. Below, the retreat facilitator and participants recap the events of the three retreats.

In 2014 NYPS changed it mission and vision to be MORE uplifting, positive and empowering; to focus on the positive and less of the negative. We believe that people who are self-confident are more willing to help lift others. After All, winners help others win. Many people are looking for hope, and may just not know where to find it or how to get there. “One Shinning Moment” is our nationwide effort to uplift and inspire our target population. There is much to be said about all the negativity in our communities. This video, shown to all attendees, highlights some of the negative opinions about our community, but we feel this is our #OneShinningMoment to come up with solutions and move to the next level.

The goals of the retreats were to make sure each participant would leave the weekend knowing how to:

Live your life on purpose.

Not on “default.” Be Proactive. Make conscious and deliberate choices. When you don’t choose, circumstances choose for you and you are never leading: you are following or catching up—or worse, living in “default” mode.

Utilize your full potential.

Give what you’re doing your best and fullest attention. Be here now. Even if you’re not where you want to be, giving it half of your effort doesn’t move you forward. Master what you have at hand, for the sake of mastering it, and something will shift.

Live in the question.

There is nothing you cannot be, do, or have, so do not impose limitations on yourself. Instead of saying you can’t get there, ask “How can I get there?” Live in the affirmation of possibility rather than the declaration of negativity.

There is always a way, and it is being presented consistently, but you have to live in the question to be on the lookout for the answer.

Learn to say “No.”

To live your best possible life, you need to learn how to say no to the things that aren’t serving you. The best barometer to measure this by is: if it isn’t a “hell yeah” (Yippee, so fun, can’t wait!), then it is most probably a no. If you have to talk yourself into it, it’s a no.

Once you get comfortable saying no, everything becomes a matter of choice. Living a life of choice is a living a life of freedom.

Know your own value.

Others may be more educated, skilled, or talented in one or another area, but there is something magnificent and valuable about what you have to offer this world that, in comparison, is equal.

Do not allow yourself or anyone else to diminish it. You have a learning disability? So did Dr.King, and that’s what makes him the most powerful speakers. Joe Vitale came from homelessness. Look at him now. Stop idolizing anyone else’s gifts and dismissing your own.

The Midwest version (June), the largest of the three, was held in conjunction with FIERCE, a national program working towards LGBTQ youth of color liberation and located at the Allied Media Conference at Wayne State University. Andrew Rahme, attended the Midwest Regional and based on his experiences and interactions during the weekend, actually became a member of NYPS. Here are some of his thoughts on the Detroit even which had a greater focus on community building and activism:

10383485_10203476696491931_6806017940715506034_nCreation, connection, and transformation are the words that come to mind when thinking about the Midwest Regional at the Allied Media Conference (AMC). Being a queer or trans person of color, it is reality that you have to constantly create solutions for yourself in order to live happily, and successfully. We create walls, stories, identities, spaces, and sometimes we even create realities different from the ones that we are confined to. At the AMC networking gathering, we had a chance to come together as QTPOC and identify the current issues to implement change in our community. Through games, laughter, relationship building, and amazing food, we discovered things about ourselves and about each other that allowed us to grow in ways we didn’t expect.

A very large focus of the network gathering at AMC was surrounded around connection. Connection to each other, to the world around us, and to our personal selves. We mapped out where our interests of change are and brainstormed what steps we can take to implement that change. We connected in ways we didn’t expect through common interests, experiences and the sharing of our wants, needs, hopes, and realities. Many of us began combining different realities and solutions in order to produce ideas for the most effective change.

The end result was inspiring and truly transforming. We got to be first hand witnesses of the beauty that comes out of organizing with QTPOC youth. Ideas as well as lasting relationships were created and strengthened, and to see what change these new alliances will create is exciting to watch for.

The South version (August) was held in Loft’s at The Claussen’s Inn. On Friday night all participants watched the video on the State of The Black LGBTQ Community. Some in the room agreed with some of the statements made, but the majority felt that there were some things that could be done to change the perception of what it is like to be black and LGBTQ.

On Saturday, the first session focused on a common theme in the video: “Status Anxiety”. This is the constant comparing of yourself to others. We looked at how the people you surround yourself with can be stressful and a few ways to get rid of status anxiety. Other issues touched on were: “Later Never Comes” (procrastination), Self Respect, Self Esteem, How Not To Care What Others Think About You as well as our other Life Development Series for Black LGBTQ young adults: “Dollars and Good Sense” and “Born To Win”.

Brandon Berry, of Orlando, FL gives his thoughts on the south retreat:

Brandon Dykes served as a facilitator for the South Region Retreat, as did Brandon Berry.

Brandon Dykes served as a facilitator for the South Region Retreat, as did Brandon Berry.

It was the epitome of comfort, which was a pleasant surprise to me. Imagine walking into a beautiful inn, rich with its area’s history and augmented tall ceiling including a large glass window clearly displaying the beautiful sky. Imagine a two-story loft for a room with all of the space necessary for yourself as well as any of your guests and fellow attendees. One would think no real productive work would be done. Contrary to that thought, we spent a majority of our days with each other having deep, lengthy and intelligent conversations. One of the highlights of this weekend is that great work took place in the comfort of our own rooms. It was a great experience.

I not only met strong and intelligent Black men of distinction, but I got to get personal with them and discuss life and goals and our journeys to our respective unfolding greatness. We held discussions on how to be an effective leader, things to remember when inheriting a leadership position from someone else, and other miscellaneous subjects like the Quality of Education from HBCUs vs PWIs.

Overall the conference was great, and the experience was even greater.

The East version (September) was held at the Akwaaba, a luxury, African inspired house in LGBTQ friendly DuPont Circle. Like the south version, on Friday night, participant’s gathered to watch the video and discuss it. They were more aggressive in their defense of the black LGBTQ community and pointed out how no one in the video took any personal responsibility.

The East Region participants, not only went over all of the same Life Development series topics covered in the South Region, they were able to

Jabbar Lewis facilitated the "Selfies" series in DC.

Jabbar Lewis facilitated the “Selfies” series in DC.

preview parts of our new series: “Choices”: Whether you believe it or not, everything up to this point in your life that has or has not happened to you is because of the choices you have made. Every aspect or our life when examined a little closer can be traced back to a series of choices we have made.

In addition, each participant was given a section of each series to study and then present to the group.

The East Region allowed participants to live together for 3 full days in a fully furnished house, similar to a reality show. This dynamic might have made the East Region one of the best experiences out of the three, so much so, we are looking to hosts future retreats in a luxury house setting. The South and East Regions are also where we tested out having each participant follow each presentation on their tablet/laptop or mobile devices instead of the traditional power points and projectors. They now will be able to relive each session on their mobile device at any time.

Here is a  complete list of all Life Development topics, related videos and handouts from the retreats.

Missouri Coalition Pushes State to National Leadership on LGBT Health

Missouri might not top many LGBT people’s lists of great places to live, but after today you might want to rethink the charms of the Show Me State. For the last year a local coalition has been pushing adoption of LGBT-welcoming policies at hospitals. In this week’s release of HRC’s Healthcare Equality Index, Missouri zoomed from 37th in the country to sixth in the number of local LGBT leader hospitals.

We don’t see policy changes this quickly very often, especially when they require many companies to adopt new policies. What’s the secret to this unlikely success? A few years ago Missouri Foundation for Health funded a partnership with the local Equality Federation partner, PROMO, and SAGE Metro St. Louis. My project, LGBT HealthLink, was also brought on board to provide them with technical assistance. With funding and staff and policy expertise all in place, the Missouri team got down to business to see what they could change to affect LGBT health disparities in their state.

If you just look at the situation today, you’d think they immediately stumbled on the equivalent of oil and a match for policy change, but, like many good projects, they started slowly. First they mapped the policy environment; then they tried a few different strategies for change. One of the things they identified was a big gap: While most hospitals were required to have LGBT-nondiscrimination policies by the agency that accredits them, they could find little evidence of those policies by searching. And if we can’t find them, then patients couldn’t either.

For a while the PROMO staff played nice with the hospitals, trying to build relations and seeing how to move the changes gradually. Some hospitals did respond, but the work was crawling forward. Eventually, we switched to a different tactic, blanketing many hospitals with letters pointing out that these policies were required. Then, of course, the PROMO staff person, Andrew Shaughnessey, was there following up with multiple phone calls offering to help them with policy resources. The new strategy, which we’ve taken to calling the “terrier approach,” worked. Eventually even the hospitals that said they weren’t interested started to call Andrew back. And if they needed LGBT-cultural-competency training as part of the new policy changes, Sherrill Wayland from SAGE was ready to step in to set up in-person trainings at a moment’s notice.

The upshot of all of this work was that, while in 2013 seven hospitals had LGBT-nondiscrimination policies in place, now 31 do. While seven hospitals protected LGBT status in employment, now 30 do. While two had achieved Healthcare Equality Index leader status in 2013, now 19 have. Today several of those hospitals are putting out their own press releases lauding their LGBT-welcoming policies. It’s a far cry from 2013, and that means much better access to health for thousands of LGBT people in Missouri.

What I want to see now is this amazing level of success replicated. I’ve worked in policy change for a very long time, and trust me, a model to change policies this fast comes extremely rarely. While they had a funder in Missouri giving them the time to experiment with different strategies, any other community center or equality organization in another state can take advantage of that work and just do what worked for them. Nicely, the PROMO team has documented their steps really clearly in the LGBT HealthLink blog. See the first post about it here.

Kudos to everyone in Missouri. From the amazing staff team at PROMO and at SAGE to Missouri Foundation for Health, who cared enough to invest, and the many hospital systems who jumped on board, this is an amazing job by all, and it’ll really affect the health of the LGBT communities in your state.

Now who else wants to do it for their states?

Missouri Case Study 10 – Making LGBT Health Matter in Missouri Hospitals

Andrew Shaughnessy, Manager of Public Policy for PROMO

Andrew Shaughnessy
Manager of Public Policy, PROMO Missouri
@andrewshag

This year has proven to be a monumental year for LGBT Missourians. Those monumental steps have been the recognition of out-of-state marriages by the State of Missouri, and the leadership of nearly 47 Missouri hospitals, who have included 105 new LGBT welcoming policies to their core values. As an LGBT Missourian it certainly gives me relief to know that I can access health care facilities and be me: my authentic self.

In 2013, only two Missouri Hospitals, Children’s Mercy in Kansas City and the VA in St. Louis, qualified as leaders in the Human Rights Campaign Care Equality Index (HEI). In the coming days the health sector will see the launch of the 2014 HEI, where several of Missouri’s top hospitals have been reviewed on their lesbian, gay, bisexual and transgender (LGBT) welcoming policies.  This year, Missouri will see several hospitals both in rural and urban areas that have been working to ensure their facilities are welcoming to all.

To learn more about the policies of Missouri Hospitals, click here for a map detailing their LGBT welcoming policies.

We have truly made LGBT health matter among Missouri’s top hospitals, but the work of the LGBT health policy project does not stop there. Through the technical assistance of Dr. Scout, Director of LGBT HealthLink, we will continue to work with health and social services organizations in Missouri to ensure that we are creating spaces free from discrimination. Through our collaboration with Sherrill Wayland, Executive Director of SAGE Metro St. Louis, we will be training Missouri’s health and social service professionals to understand the unique needs of LGBT patients.  And we will continue to advocate for the health of LGBT families and our families of choice.

As we begin to look at the legal future for the LGBT community, we must be concerned with the growing disparities we find in LGBT health. Our next frontier is on the borders of health and making sure that we are a strong and healthy community. I’m humbled to be a part of this work. Having experienced discrimination in a health care setting myself, I assure you your voice is not going unheard.

 

Trans First World Problems

Pride Center Staff Photo

 

Bishop S.F. Makalani-Mahee

Minister. Performing Artist. Community Organizer

 

 

 

 

So I’m sitting in  this workshop at Philly Trans Health Conference entitled “Everything in Africa is Gendered”  given by  a south African trans woman of color, and before the workshop even begins she comes over to me introduces herself and tells me that she is living and working in rural South Africa as an out trans woman of color.  I am immediately sobered by the courage of her reality and share my thoughts as such with her; and her response to me was somebody’s got to do the work for those who come after her, so why not her and what I got in that moment is that as difficult as navigating a transgender experience in America can be, I am grateful to be doing so.

 

I and most of the trans folk I know have access to services like mental health and medical services, we have access to education, and most of us have access to food and community.  While our sister’s and brother’s in developing countries struggle to simply eat, find language that speaks their truth,  experience boundaries to accessing competent and lifesaving  medical  care, limited (if any) education, and they may not  have community for support.  Those of us that are employed, have access to care and community resources (like the ability to attend Philly Trans Health) may want to consider that we have trans first world problems and I would offer that we bare this in mind when wanting to fall out with each other or want to go to battle over things that really don’t matter; like young trans folk thinking older trans folk are stuck in the past and just “don’t get it”.

 

I would offer instead that we remember that there are trans people who wish they had other’s to relate to; and as we fight amongst each other about setting a trans agenda there are trans folk in our world just trying to stay alive.   We should find ourselves extremely grateful for what we have and the community we have, and if we recognize that even given the work yet to be done we are in a unique place of privilege that other trans people would perceive as the promised land, and we have a responsibility to do the work so that those that come after us have a promised land to enter into.

 

Continue To Walk In The Light, Redefine Your Faith, and Remember It’s All The Rhythm.