Thursday, December 10, 2015

JeCorey Holder Explains Privilege

Imagine a young kid whose parents are pretty well-off. They can afford to give this kid the things they want. Gaming systems, toys, exotic pets, fancy clothes, varieties of food, all waiting for them at home to utilize whenever they please. 

Now imagine this kid sees another kid. Kid B is living on the margins. This kid can't really afford to get anything super valuable until holidays. But something great happened. Kid B got super creative and MADE themselves an awesome toy. Something they thought they'd never be able to have. It's pretty patchwork and rough, but it's theirs.
 
Kid A is furious. Kid A is utterly indignant. Kid A doesn't have this toy! They scream and cry at Kid B about how unfair it is! Despite Kid A's room being filled with all kinds of valuable things, they're still throwing a tantrum at Kid B's gain. Annoying, right?

This is how it feels when people say All Lives Matter. This is how it feels when people say "If there's a Black Entertainment channel, why isn't there a White Entertainment channel?" This is how it feels when men tell feminists "What is feminism doing for men?" This is how it feels when people criticise marginalized groups for making safe spaces for themselves.

Tuesday, December 8, 2015

#ITLQBM Guest Post: George M Johnson On Erasure & Historical Intersectionality

Intersectionality Through the Lens of a Queer Black Man

I often see these meme's of "we were kings" or "queens" or relating that we derived from royalty. And yes, SOME of us may have but why does black history have to be this all or nothing doctrine with complete removal of intersectionality and full insertion of respectability politics.

By this I am saying that we didn't start at slavery, but all of us aren't derived from royalty either. Some of us lineage will start from being slaves, or kings, or share croppers, or shepherds, or blacksmiths, or Egyptians or Mesapotamians or a plethera of other things.

All this to say, we need a full appreciation of what our history is. Erasure of where some of us derived is just as bad as white washing it or starting our history at slavery.

In remembering that ‪#‎allblacklivesmatter‬, we must know that a slave has just as much value as a king. It doesn't matter where we start, its all about where we finish.

Monday, December 7, 2015

Check Your Religious Privilege - The Texas Bill Of Rights

I was reading an article about Cristin Padgett, a fellow Atheist and member of the Democratic Party from Dallas, TX. It just so happened that stumbled upon some information about the Texas Constitution that I just could not believe. According to Article 1, Sec. 4. RELIGIOUS TESTS. No religious test shall ever be required as a qualification to any office, or public trust, in this State; nor shall any one be excluded from holding office on account of his religious sentiments, provided he acknowledge the existence of a Supreme Being.

Christian privilege - is the system of advantages bestowed upon Christians in some societies. This system arises out of the presumption that the belief in Christianity is a social norm, leading to the exclusion of the nonreligious and members of other religions through institutional religious discrimination. Christian privilege can also lead to the neglect of outsiders' cultural heritage and religious practices.


Religious discrimination - is valuing or treating a person or group differently because of what they do or do not believe. Specifically, it is when adherents of different religions (or denominations) are treated unequally, either before the law or in institutional settings such as employment or housing.
Religious discrimination is related to religious persecution, the most extreme forms of which would include instances in which people have been executed for beliefs perceived to be heretic. Laws which only carry light punishments are described as mild forms of religious persecution or as religious discrimination.

Atheism - is the rejection of belief in the existence of deities.In a narrower sense, atheism is specifically the position that there are no deities.Most inclusively, atheism is the absence of belief that any deities exist. Atheism is contrasted with theism, which, in its most general form, is the belief that at least one deity exists.

Agnosticism -  is the view that the truth values of certain claims – especially metaphysical and religious claims such as whether or not God, the divine or the supernatural exist – are unknown and perhaps unknowable.

I really had a hard time believing this and went to seek out the truth for myself, and it was really in the constitution! Then I flashed back to an earlier post in this series where I said "The truth is that I see religion as a means of social control and domination for those who are in control of governments and other institutions that are used to govern. It does not mean that do not respect a person's convictions or belief in a higher power, and in my acceptance, I am exposed to the constant barrage of God this and prayer that memes, comments and posts via social media. The problem comes when I decide to make a post in reference to my Atheism, someone tries to flex their privilege and respond with some chastisement about how THEIR God is the real deal, mind you, I don't comment on others' posts when it regards religion! I have constantly question whether or not I want to go to certain events because someone will try to guilt me into a prayer circle or saying grace at a dinner.

Faced with the idea that my plans for a possible run for office in Texas can be rejected because I don't believe in God is really outrageous. While there is no requirement to respect any religion in any way, shape or form, it is clear that those who fall on the spectrum of Atheist to Agnostic are not respected. In other words, Atheists and Agnostics need not apply. Just when I thought that Texas could be anymore ass backwards, we have reached new lows.  This is now the time to challenge the constitutionality of the Texas Constitution.

#HIV: Genesis 1981

A Survivor's Guide to HIV



In 1981 a report on the discovery of the initial outbreak that lead to the AIDS epidemic came out. The report written by Lawrence K. Altman, was published by the New York Times and at the time it was thought to just be a rare cancer outbreak:

"Doctors in New York and California have diagnosed among homosexual men 41 cases of a rare and often rapidly fatal form of cancer. Eight of the victims died less than 24 months after the diagnosis was made.

The cause of the outbreak is unknown, and there is as yet no evidence of contagion. But the doctors who have made the diagnoses, mostly in New York City and the San Francisco Bay area, are alerting other physicians who treat large numbers of homosexual men to the problem in an effort to help identify more cases and to reduce the delay in offering chemotherapy treatment.

The sudden appearance of the cancer, called Kaposi's Sarcoma, has prompted a medical investigation that experts say could have as much scientific as public health importance because of what it may teach about determining the causes of more common types of cancer. First Appears in Spots

Doctors have been taught in the past that the cancer usually appeared first in spots on the legs and that the disease took a slow course of up to 10 years. But these recent cases have shown that it appears in one or more violet-colored spots anywhere on the body. The spots generally do not itch or cause other symptoms, often can be mistaken for bruises, sometimes appear as lumps and can turn brown after a period of time. The cancer often causes swollen lymph glands, and then kills by spreading throughout the body.

Doctors investigating the outbreak believe that many cases have gone undetected because of the rarity of the condition and the difficulty even dermatologists may have in diagnosing it.

In a letter alerting other physicians to the problem, Dr. Alvin E. Friedman-Kien of New York University Medical Center, one of the investigators, described the appearance of the outbreak as ''rather devastating.''

Dr. Friedman-Kien said in an interview yesterday that he knew of 41 cases collated in the last five weeks, with the cases themselves dating to the past 30 months. The Federal Centers for Disease Control in Atlanta is expected to publish the first description of the outbreak in its weekly report today, according to a spokesman, Dr. James Curran. The report notes 26 of the cases - 20 in New York and six in California.

There is no national registry of cancer victims, but the nationwide incidence of Kaposi's Sarcoma in the past had been estimated by the Centers for Disease Control to be less than six-one-hundredths of a case per 100,000 people annually, or about two cases in every three million people. However, the disease accounts for up to 9 percent of all cancers in a belt across equatorial Africa, where it commonly affects children and young adults.

In the United States, it has primarily affected men older than 50 years. But in the recent cases, doctors at nine medical centers in New York and seven hospitals in California have been diagnosing the condition among younger men, all of whom said in the course of standard diagnostic interviews that they were homosexual. Although the ages of the patients have ranged from 26 to 51 years, many have been under 40, with the mean at 39.

Nine of the 41 cases known to Dr. Friedman-Kien were diagnosed in California, and several of those victims reported that they had been in New York in the period preceding the diagnosis. Dr. Friedman-Kien said that his colleagues were checking on reports of two victims diagnosed in Copenhagen, one of whom had visited New York. Viral Infections Indicated

No one medical investigator has yet interviewed all the victims, Dr. Curran said. According to Dr. Friedman-Kien, the reporting doctors said that most cases had involved homosexual men who have had multiple and frequent sexual encounters with different partners, as many as 10 sexual encounters each night up to four times a week.

Many of the patients have also been treated for viral infections such as herpes, cytomegalovirus and hepatitis B as well as parasitic infections such as amebiasis and giardiasis. Many patients also reported that they had used drugs such as amyl nitrite and LSD to heighten sexual pleasure.

Cancer is not believed to be contagious, but conditions that might precipitate it, such as particular viruses or environmental factors, might account for an outbreak among a single group.

The medical investigators say some indirect evidence actually points away from contagion as a cause. None of the patients knew each other, although the theoretical possibility that some may have had sexual contact with a person with Kaposi's Sarcoma at some point in the past could not be excluded, Dr. Friedman-Kien said.

Dr. Curran said there was no apparent danger to nonhomosexuals from contagion. ''The best evidence against contagion,'' he said, ''is that no cases have been reported to date outside the homosexual community or in women.''

Dr. Friedman-Kien said he had tested nine of the victims and found severe defects in their immunological systems. The patients had serious malfunctions of two types of cells called T and B cell lymphocytes, which have important roles in fighting infections and cancer.

But Dr. Friedman-Kien emphasized that the researchers did not know whether the immunological defects were the underlying problem or had developed secondarily to the infections or drug use.

The research team is testing various hypotheses, one of which is a possible link between past infection with cytomegalovirus and development of Kaposi's Sarcoma."

For an expanded timeline click HERE.

Sunday, December 6, 2015

#HIV: Pre-Exposure Prophylaxis (PrEP)

"Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently." - CDC

CDC Guidelines


May 14, 2014 -

  • Daily oral PrEP with the fixed-dose combination of tenofovir disoproxil fumarate (TDF) 300 mg and emtricitabine (FTC) 200 mg has been shown to be safe and effective in reducing the risk of sexual HIV acquisition in adults; therefore,
    • PrEP is recommended as one prevention option for sexually-active adult MSM (men who have sex with men) at substantial risk of HIV acquisition (IA)1
    • PrEP is recommended as one prevention option for adult heterosexually active men and women who are at substantial risk of HIV acquisition. (IA)
    • PrEP is recommended as one prevention option for adult injection drug users (IDU) at substantial risk of HIV acquisition. (IA)
    • PrEP should be discussed with heterosexually-active women and men whose partners are known to have HIV infection (i.e., HIV-discordant couples) as one of several options to protect the uninfected partner during conception and pregnancy so that an informed decision can be made in awareness of what is known and unknown about benefits and risks of PrEP for mother and fetus (IIB)
  • Currently the data on the efficacy and safety of PrEP for adolescents are insufficient. Therefore, the risks and benefits of PrEP for adolescents should be weighed carefully in the context of local laws and regulations about autonomy in health care decision-making by minors. (IIIB) 
  • Acute and chronic HIV infection must be excluded by symptom history and HIV testing immediately before PrEP is prescribed. (IA) 
  • The only medication regimen approved by the Food and Drug Administration and recommended for PrEP with all the populations specified in this guideline is daily TDF 300 mg co-formulated with FTC 200 mg (Truvada) (IA)
    • TDF alone has shown substantial efficacy and safety in trials with IDUs and heterosexually active adults and can be considered as an alternative regimen for these populations, but not for MSM, among whom its efficacy has not been studied. (IC)
    • The use of other antiretroviral medications for PrEP, either in place of or in addition to TDF/FTC (or TDF) is not recommended. (IIIA)
    • The prescription of oral PrEP for coitally-timed or other noncontinuous daily use is not recommended. (IIIA)
  • HIV infection should be assessed at least every 3 months while patients are taking PrEP so that those with incident infection do not continue taking it. The 2-drug regimen of TDF/FTC is inadequate therapy for established HIV infection, and its use may engender resistance to either or both drugs. (IA)

  • Renal function should be assessed at baseline and monitored at least every 6 months while patients are taking PrEP so that those in whom renal failure is developing do not continue to take it. (IIIA)
  • When PrEP is prescribed, clinicians should provide access, directly or by facilitated referral, to proven effective risk-reduction services. Because high medication adherence is critical to PrEP efficacy but was not uniformly achieved by trial participants, patients should be encouraged and enabled to use PrEP in combination with other effective prevention methods. (IIIA)

Affected Communities:

  • LGBT People of Color
    • Black and Latino men

Access:


You can get prep from any healthcare provider that specializes in HIV prevention in your local area. Many providers offer PrEP free of charge, but if you encounter a barrier to access here are some resources.

If you have insurance:
  • The Gilead Co-pay Coupon Card can help eligible uninfected individuals save on a TRUVADA for PrEP co-pay.* For more information, visit www.GileadCoPay.com or call 1-877-505-6986
If you don't have insurance:

  • Gilead’s U.S. Medication Assistance Program - This program provides assistance to uninfected individuals in the United States who do not have insurance or who need financial assistance. As part of this program, Gilead provides assistance for uninfected individuals who are eligible and who cannot afford to pay for TRUVADA for PrEP. To learn about eligibility, contact Gilead’s U.S. Medication Assistance Program at 1-855-330-5479between 9:00 a.m. and 8:00 p.m. (Eastern). You can also download the enrollment form to be completed by your client and your client’s healthcare provider.Partnership for Prescription Assistance (PPA) Program
  • Partnership for Prescription Assistance (PPA) Program -This program is designed to help uninsured Americans get the prescription medicines they need at no or low cost. Your clients can find out if they are eligible by calling 1-888-4PPA-NOW 
  • (1-888-477-2669) or visiting the PPA Website at www.pparx.org.
If any of your clients do not have insurance, help may also be available through:


Origins

The Clinical Trials:

There were four clinical trials conducted, these trials are the foundation for what is now PrEP: 

December 30, 2010 -


  • BACKGROUND

    Antiretroviral chemoprophylaxis before exposure is a promising approach for the prevention of human immunodeficiency virus (HIV) acquisition.

    METHODS

    We randomly assigned 2499 HIV-seronegative men or transgender women who have sex with men to receive a combination of two oral antiretroviral drugs, emtricitabine and tenofovir disoproxil fumarate (FTC–TDF), or placebo once daily. All subjects received HIV testing, risk-reduction counseling, condoms, and management of sexually transmitted infections.

    RESULTS

    The study subjects were followed for 3324 person-years (median, 1.2 years; maximum, 2.8 years). Of these subjects, 10 were found to have been infected with HIV at enrollment, and 100 became infected during follow-up (36 in the FTC–TDF group and 64 in the placebo group), indicating a 44% reduction in the incidence of HIV (95% confidence interval, 15 to 63; P=0.005). In the FTC–TDF group, the study drug was detected in 22 of 43 of seronegative subjects (51%) and in 3 of 34 HIV-infected subjects (9%) (P<0.001). Nausea was reported more frequently during the first 4 weeks in the FTC–TDF group than in the placebo group (P<0.001). The two groups had similar rates of serious adverse events (P=0.57).

    CONCLUSIONS

    Oral FTC–TDF provided protection against the acquisition of HIV infection among the subjects. Detectable blood levels strongly correlated with the prophylactic effect. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; ClinicalTrials.gov number, NCT00458393.)
July 11 2012 -


  • Abstract

    Introduction

    Antiretroviral pre-exposure prophylaxis (PrEP) reduces the incidence of acquisition of human immunodeficiency virus type 1 (HIV-1) in men who have sex with men and is a promising approach for preventing HIV-1 in heterosexual populations.

    Methods

    We conducted a randomized, three-arm trial of oral antiretroviral PrEP among heterosexual couples from Kenya and Uganda in which one member was HIV-1 seronegative and the other HIV-1 seropositive. Seronegative partners were randomly assigned to once-daily tenofovir (TDF), combination emtricitabine/tenofovir (FTC/TDF), or matching placebo and followed monthly for up to 36 months. At enrollment, HIV-1 seropositive partners were not eligible for antiretroviral therapy under national guidelines. All couples received standard HIV-1 treatment and prevention services, including individual and couples risk-reduction counseling and condoms.

    Results

    4758 couples were enrolled; for 62%, the HIV-1 seronegative partner was male. For HIV-1 seropositive participants, the median CD4 count was 495 cells/μL (interquartile range 375–662). Of 82 post-randomization HIV-1 infections, 17 were among those assigned TDF (incidence 0.65 per 100 person-years), 13 among those assigned FTC/TDF (incidence 0.50 per 100 person-years), and 52 among those assigned placebo (incidence 1.99 per 100 person-years), indicating a 67% relative reduction in HIV-1 incidence for TDF (95% CI 44 to 81, p<0.001) and 75% for FTC/TDF (95% CI 55 to 87, p<0.001). HIV-1 protective effects of FTC/TDF and TDF were not significantly different (p=0.23), and both study medications significantly reduced HIV-1 incidence in both men and women. The rate of serious medical events was similar across the study arms.

    Conclusions

    Oral TDF and FTC/TDF provided substantial protection against HIV-1 acquisition in heterosexual men and women, with comparable efficacy of TDF and FTC/TDF. (Funded by the Bill and Melinda Gates Foundation; ClinicalTrials.gov number NCT00557245)
    Keywords: HIV-1 serodiscordant couples, pre-exposure prophylaxis, HIV-1 prevention, randomized clinical trial, Africa.

August 2, 2012 -


BACKGROUND

Preexposure prophylaxis with antiretroviral agents has been shown to reduce the transmission of human immunodeficiency virus (HIV) among men who have sex with men; however, the efficacy among heterosexuals is uncertain.
  • METHODS

    We randomly assigned HIV-seronegative men and women to receive either tenofovir disoproxil fumarate and emtricitabine (TDF–FTC) or matching placebo once daily. Monthly study visits were scheduled, and participants received a comprehensive package of prevention services, including HIV testing, counseling on adherence to medication, management of sexually transmitted infections, monitoring for adverse events, and individualized counseling on risk reduction; bone mineral density testing was performed semiannually in a subgroup of participants.

    RESULTS

    A total of 1219 men and women underwent randomization (45.7% women) and were followed for 1563 person-years (median, 1.1 years; maximum, 3.7 years). Because of low retention and logistic limitations, we concluded the study early and followed enrolled participants through an orderly study closure rather than expanding enrollment. The TDF–FTC group had higher rates of nausea (18.5% vs. 7.1%, P<0.001), vomiting (11.3% vs. 7.1%, P=0.008), and dizziness (15.1% vs. 11.0%, P=0.03) than the placebo group, but the rates of serious adverse events were similar (P=0.90). Participants who received TDF–FTC, as compared with those who received placebo, had a significant decline in bone mineral density. K65R, M184V, and A62V resistance mutations developed in 1 participant in the TDF–FTC group who had had an unrecognized acute HIV infection at enrollment. In a modified intention-to-treat analysis that included the 33 participants who became infected during the study (9 in the TDF–FTC group and 24 in the placebo group; 1.2 and 3.1 infections per 100 person-years, respectively), the efficacy of TDF–FTC was 62.2% (95% confidence interval, 21.5 to 83.4; P=0.03).

    CONCLUSIONS

    Daily TDF–FTC prophylaxis prevented HIV infection in sexually active heterosexual adults. The long-term safety of daily TDF–FTC prophylaxis, including the effect on bone mineral density, remains unknown. (Funded by the Centers for Disease Control and Prevention and the National Institutes of Health; TDF2 ClinicalTrials.gov number,NCT00448669.)
June 13 2013 - 

  • Summary

    Background

    Antiretroviral pre-exposure prophylaxis reduces sexual transmission of HIV. We assessed whether daily oral use of tenofovir disoproxil fumarate (tenofovir), an antiretroviral, can reduce HIV transmission in injecting drug users.

    Methods

    In this randomised, double-blind, placebo-controlled trial, we enrolled volunteers from 17 drug-treatment clinics in Bangkok, Thailand. Participants were eligible if they were aged 20–60 years, were HIV-negative, and reported injecting drugs during the previous year. We randomly assigned participants (1:1; blocks of four) to either tenofovir or placebo using a computer-generated randomisation sequence. Participants chose either daily directly observed treatment or monthly visits and could switch at monthly visits. Participants received monthly HIV testing and individualised risk-reduction and adherence counselling, blood safety assessments every 3 months, and were offered condoms and methadone treatment. The primary efficacy endpoint was HIV infection, analysed by modified intention-to-treat analysis. This trial is registered withClinicalTrials.gov, number NCT00119106.

    Findings

    Between June 9, 2005, and July 22, 2010, we enrolled 2413 participants, assigning 1204 to tenofovir and 1209 to placebo. Two participants had HIV at enrolment and 50 became infected during follow-up: 17 in the tenofovir group (an incidence of 0·35 per 100 person-years) and 33 in the placebo group (0·68 per 100 person-years), indicating a 48·9% reduction in HIV incidence (95% CI 9·6–72·2; p=0·01). The occurrence of serious adverse events was much the same between the two groups (p=0·35). Nausea was more common in participants in the tenofovir group than in the placebo group (p=0·002).

    Interpretation

    In this study, daily oral tenofovir reduced the risk of HIV infection in people who inject drugs. Pre-exposure prophylaxis with tenofovir can now be considered for use as part of an HIV prevention package for people who inject drugs.

    Funding

    US Centers for Disease Control and Prevention and the Bangkok Metropolitan Administration.