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Health

New Cases Of HIV Infection Are Stabilizing, But Some Groups Remain Particularly Vulnerable

New data from the Centers for Disease Control estimates that even though the total number of Americans living with HIV steadily increased between 1980 and 2010, the rise is partly due to the fact that treatment programs are helping HIV-positive individuals live longer and healthier lives. Overall, new HIV infections have not increased, and the CDC estimates that prevention efforts have averted more than 350,000 cases of infection to date. Unfortunately, that good news doesn’t hold true for every community once the data is broken down by specific demographics.

The HIV epidemic is still disproportionately impacting the LGBT community — particularly men who have sex with men (MSM), who accounted for nearly two-thirds of all new infections in 2010. And the CDC reported last month that young people between the ages of 13 and 24 aren’t getting the message about HIV testing and treatment, despite the recent public education campaigns on the topic, which may be why the number of new HIV infections among MSM in that age group increased 22 percent from 2008 to 2010:

And gains in HIV treatment are also racially stratified, as African-American men continue to bear the biggest burden. Although the cases of new HIV infections among African-American women did decline between 2008 and 2010, black women still accounted for nearly two-thirds of all new infections among women in 2010. Nearly 90 percent of those women contracted the virus from heterosexual sex. Altogether, the rate of HIV infection for black Americans is about eight times higher than the rate for white Americans:

Fortunately, the U.S. made big strides toward combating HIV over the past year, a time period that is not reflected in the CDC’s new report. Breakthroughs in HIV research and drugs may help ensure that HIV-positive individuals’ life expectancy is extended even further, and the health reform law will help ensure that HIV testing and treatment is affordable for Americans who may have previously gone without it. The next time the CDC runs the numbers, there may be even more good news to report, even for typically hard-hit demographic groups.

Health

How Tobacco Can Be Deadlier Than The HIV Virus

As the global health community makes significant strides toward effectively combating the HIV/AIDS epidemic, HIV-positive individuals are now living longer and healthier lives, largely thanks to advances in treatments for the virus. Research suggests that the virus itself is hardly a death sentence anymore — and, for HIV-positive people, other public health issues are beginning to surpass their HIV status as the biggest threat to their life expectancy.

According to a new study, health complications resulting from smoking — and not from HIV itself — are actually the biggest cause of death among HIV-positive individuals. Researchers tracked HIV-positive people with access to highly active antiretroviral therapies (HAART), the medications that have drastically lowered the rates of HIV-related deaths since they first became available in 1996, and found stark differences between the smokers and non-smokers who received HAART treatment:

In a large case-control study, smokers with HIV had substantially higher rates of all-cause and non-AIDS mortality than HIV-positive nonsmokers, according to Marie Helleberg, MD, of Copenhagen University Hospital, and colleagues. [...]

The bottom line, Helleberg said in a statement, is that “more than 60% of deaths among HIV patients are associated with smoking,” compared with slightly more than a quarter associated with HIV.

In the general population, Helleberg and colleagues noted, smoking is one of the major factors that reduce life expectancy.

Among those with HIV, the advent of highly active anti-retroviral therapy (HAART) has meant that lifestyle factors are increasingly affecting survival, while the mortality risk associated with the virus has diminished.

Researchers also noted that HIV-positive individuals are much more likely to smoke than the people who are not infected with the virus, potentially due to stress or socioeconomic factors. In fact, men who have sex with men — the population that remains at the greatest risk for contracting HIV — are themselves more likely to be smokers, both because of minority stress and because Big Tobacco has worked to specifically target LGBT individuals. Anti-smoking activists emphasize that the U.S. should start focusing its smoking cessation campaigns specifically on the LGBT community.

The fact that tobacco could be deadlier than HIV is yet another reason why public health resources need to be invested into anti-smoking programs. But over the past few years, states have been dedicating fewer and fewer funds to anti-tobacco programs, as budget cuts have forced those public health initiatives to be scaled back or ended altogether.

LGBT

Scalia’s Son: Don’t Label Kids ‘Gay’ Or It’s Harder To Condemn Them

Rev. Paul Scalia

Now that the Supreme Court will be weighing in on the issue of same-sex marriage, the Justices’ biases on the basic principles of sexual orientation are under scrutiny — none perhaps moreso than Justice Antonin Scalia. Recently, he defended his comparison between homosexuality and murder, arguing simply that either can be morally condemned. He obtusely couldn’t understand why the gay Princeton student who asked the question wasn’t convinced by his response.

Insights into Scalia’s understanding of homosexuality (or lack thereof) can perhaps be found through his son, Rev. Paul Scalia, a Catholic priest in Arlington, Virginia. The younger Scalia has worked with the Church’s Courage ministry, which promotes “chastity” for gay Catholics using principles from ex-gay therapy. He has also spoken openly on the topic, and though he’s proven quite capable of reiterating the Church’s anti-gay teachings, a 2005 article reveals just how distorted the family’s view on homosexuality may be.

Writing about labels, Rev. Scalia compares identifying as gay to other school stereotypes like “preps,” “jocks,” and “geeks,” and argues that it’s unhelpful to young people to encourage them to embrace such labels. Challenging the notion that homosexuality even exists, he tries to distinguish between having “homosexual inclinations” or identifying as “a gay,” suggesting that some kids are “just confused.” Of course, his intention is to reduce homosexuality to “behaviors,” inferring that people with same-sex orientations are simply heterosexuals inclined to a special kind of sin. His true goal with this wordplay is to find a way to justify parents’ rejecting their gay children:

Granted, the more accurate phrases do not trip easily off the tongue. But what is lost in efficiency is gained in precision. Terms such as “same-sex attractions” and “homosexual inclinations” express what a person experiences without identifying the person with those attractions. They both acknowledge the attractions and preserve the freedom and dignity of the person. With that essential distinction made, parents can better oppose the attractions without rejecting the child. And as the child matures, he will not find his identity confined to his sexuality.

Further, opposition to homosexual attractions and actions makes sense only when it is rooted in the full truth of human sexuality. Gay school groups gain approval and support partly because heterosexual unchastity (contraception, masturbation, premarital sex, adultery, and all the rest) has compromised so many. Our culture’s deliberate separation of sex from procreation has destroyed our ability to articulate a coherent explanation of sexual ethics. Parents and educators have damaged the tools that would allow them to explain why homosexual activity is wrong.

For the Scalias, moral condemnation of homosexuality is just assumed, and the consequences of that judgment are par for the course. The consequences of family rejection for LGBT youth have been thoroughly documented, but for these men, rejecting “homosexual inclination” takes priority. Rev. Scalia relies on genetic uncertainty to conclude that homosexuality is not a “fixed, inborn orientation,” even though science does not doubt that is exactly how sexual orientation presents, regardless of its causes. He seeks to reject people for something that is wholly part of who they are and how they will lead their lives, ignoring that such an approach unquestioningly deprives them of life’s most basic sources of happiness and support: a loving partner and the opportunity to raise a family.

The phenomenon of “coming out” only exists because a culture that shuns homosexuality has demanded gay invisibility. The concept of “gay pride” came about not as flamboyant flaunting, but to counter the expectation of “gay shame.” These unique aspects to gay identities reflect the consequences of condemnation, not an impetus for them. Moral condemnation is not inherent; in the court of law, it must be justified beyond tradition and religious belief. Unfortunately, it seems Justice Scalia is not interested in such intellectual justice.

NEWS FLASH

Michigan Lawmakers Abandon Numerous ‘License To Discriminate’ Bills | The Republican-controlled Michigan state legislature has abandoned several anti-gay “license to discriminate” bills, opting not to hold final votes on them during the lame-duck session. Senate Bill 975 would have allowed healthcare providers to refuse any treatment to any patient if it violates their ““religious beliefs, moral convictions, or ethical principles.” House Bills 5763 and 5764 would have allowed adoption agencies to discriminate against same-sex couples and would prevent the state from penalizing them for doing so. This is a reprieve from numerous other extreme bills that have passed, including the anti-union “right-to-work” law and an extreme ban on abortion.

LGBT

STUDY: Marriage Improves Mental Health Of Same-Sex Couples

A new study shows that marriage significantly lowers psychological distress for people who are gay, lesbian, and bisexual. Researchers note that marriage provides the same “higher perception of social integration and support” for same-sex couples as it does opposite-sex couples. According to the study’s abstract, the benefits of legally recognizing same-sex couples were indistinguishable from the benefits for heterosexuals:

Results. Same-sex married lesbian, gay, and bisexual persons were significantly less distressed than lesbian, gay, and bisexual persons not in a legally recognized relationship; married heterosexuals were significantly less distressed than nonmarried heterosexuals. In adjusted pairwise comparisons, married heterosexuals had the lowest psychological distress, and lesbian, gay, and bisexual persons who were not in legalized relationships had the highest psychological distress (P < .001). Psychological distress was not significantly distinguishable among same-sex married lesbian, gay, and bisexual persons, lesbian, gay, and bisexual persons in registered domestic partnerships, and heterosexuals.

Conclusions.Being in a legally recognized same-sex relationship, marriage in particular, appeared to diminish mental health differentials between heterosexuals and lesbian, gay, and bisexual persons. Researchers must continue to examine potential health benefits of same-sex marriage, which is at least in part a public health issue.

According to study author Allen LeBlanc, the research suggests that policies banning same-sex marriage “may indeed harm sexual minority populations.” Conservatives often boast the importance and benefits of marriage for opposite-sex couples, but it seems gay couples can expect the same from their marriages.

LGBT

Why Anti-Smoking Campaigns Need To Focus Their Efforts On The LGBT Community

A new report from the Legacy Foundation highlights the lack of structural support within the public health community to combat the disproportionately high rates of smoking among LGBT individuals. Despite the fact that members of the LGBT community are about twice as likely to smoke as their heterosexual counterparts — largely due to minority stress, but also because the tobacco industry has specifically targeted LGBT Americans in their marketing campaigns over the past decade — Legacy notes that mainstream anti-smoking campaigns still tend to lack adequate LGBT representation to ensure their messages are having an impact on that population.

And the LGBT community itself doesn’t have enough infrastructure and capacity to address issues of tobacco use either, partly because LGBT leaders often don’t cite smoking as a pressing health concern for the members of their community. But high rates of smoking — and the subsequent increased risks of asthma attacks, lung cancer, and heart disease — is putting a strain on the well-being of LGBT Americans. According to some estimates, tobacco use causes at least 30,000 gay and lesbian deaths each year (PDF).

“It’s very likely that smoking is the single greatest health issue stealing years off the lives of LGBT people,” Dr. Scout, the director of the Network for LGBT Health Equity, explains in video that Legacy produced to accompany the report. “More LGBT civil rights leaders’ voices have been silenced by tobacco disparities than any other single thing. For me, tobacco is one of the biggest social justice issues.”

Legacy’s video also features Bil Browning, editor of The Bilerico Project, who chronicles his personal struggle to quit smoking. Watch it:

Although the CDC has directed a few of its anti-smoking advertisements at LGBT populations, Legacy’s report recommends that public health organizations can continue to improve their engagement with the LGBT community by focusing more of their research specifically on LGBT smokers and designing their smoking cessation campaigns with LGBT-inclusive messages. And since Big Tobacco currently targets LBGT individuals partly by sponsoring campaigns and events in the community — cultivating a false sense of being allied with LGBT causes — Legacy notes that the public health sector could also step up by providing the LGBT community with alternatives to tobacco industry funding.

LGBT

Michigan Counseling Program Settles Suit With Anti-Gay Student

Julea Ward

Eastern Michigan University has agreed to settle a suit with counseling student Julea Ward who insisted that she could not counsel somebody who was gay without condemning their sexual orientation. When the program expelled her for violating counseling ethics, she sued (with support from the anti-gay Alliance Defending Freedom), and though a district court originally dismissed her complaint, the 6th Circuit ruled in her favor. EMU has agreed to pay a settlement and remove the expulsion from her record.

Ward argued that it was a violation of her religious beliefs to affirm a gay or lesbian client’s sexual orientation, but claimed she could counsel them on anything else. When such a client sought relationship counseling, she insisted that she should be able to refer that client to another counselor. EMU faculty argued that this constituted two ethics violations: “imposing values that are inconsistent with counseling goals” and “engaging in discrimination based on sexual orientation.” The 6th Circuit argued that “tolerance is a two-way street” for religious beliefs and that there was no negative impact on the client because the client never knew of the referral.

Unfortunately, the circumstances of the artificial counseling environment that benefited Ward in this case do not reflect the negative impact her approach could easily make in reality, which in turn would reflect on the university’s reputation. The American Psychological Association explains that sexual orientation defines an “essential component of personal identity” for many people. A gay client could start therapy with Ward for a different issue and face her rejection should his concerns arrive at an intersection with his gay identity. If Ward simply avoided serving gay and lesbian clients to prevent this from happening, then she would be engaging in discrimination based on sexual orientation.

This summer, a federal judge in Georgia ruled against a student who faced a similar conflict in the counseling program at Augusta State University. Judge J. Randal Hall took more careful note of the counseling impact of condemning homosexuality and accused student Jennifer Keeton of conflating “personal and professional values.” By the same standard, Ward is equally guilty of imposing her personal values over what the professional ethics of counseling demand on the question of sexual orientation. Unfortunately, conservatives will now champion her victory to further obfuscate the psychological importance of affirmation for gays and lesbians.

NEWS FLASH

Michigan Senate Advances ‘License To Discriminate’ Healthcare Bill | The Michigan Senate approved a “license to discriminate” bill today that would allow healthcare providers to discriminate against patients if it violates their “religious beliefs, moral convictions, or ethical principles.” It’s one of many anti-women and anti-LGBT bills state Republican lawmakers are trying to sneak through during the lame duck session. In the House, a similar pair of bills would allow adoption agencies to discriminate against same-sex couples without losing state funding.

Health

Virginia Gubernatorial Candidate Called Safe Sex Fair ‘Soft Porn,’ Sought To Censor It

Virginia Attorney General Ken Cuccinelli (R)

Virginia Attorney General Ken Cuccinelli (R)

Virginia Attorney General Ken Cuccinelli II (R), the state Republican Party’s apparent choice for governor in 2013, claims he is “best known for his efforts to preserve liberty and defend the Constitution.” But in 2005, he used his position as a state Senator to try to censor a university sexual education event he felt was “pushing a pro-sex agenda and an anything goes agenda.”

In 2005, a pro-choice student group at George Mason University organized its inaugural “Sextravaganza” event — a campus sexuality and health fair aimed at teaching attendees about practicing safer sex and preventing unplanned pregnancy. For this event, the group organized 15 booths to provide “information on abstinence, condoms and self-help exams, as well as sexual orientation.” An array of views were presented to approximately 500 attendees: a minister from the Campus Catholic Ministry staffed one of the tables promoting abstinence and opposing abortion, while others promoted abortion rights and provided information about safer sex.

Sen. Cuccinelli, however, was outraged that his alma mater — a public state university — would host an event he believed “really just designed to push sex and sexual libertine behavior as far, fast and furiously as possibly.” Among Cuccinelli’s objections to the event:

  • Upset that information about sexuality — other than abstinence only — would be presented to adult college students, he said it was symptomatic of the “moral depravity that has crept across this commonwealth and this country.”
  • Upset that the event was sponsored by the Pro-Choice Patriots, he said, “They’re selling their product. They are selling abortions.
  • Upset that the GMU Pride Alliance presented information on sexual orientation, he said, “You can’t have safe homosexual sex. There is no such thing and yet one of the sponsoring groups is the homosexual group on campus.”
  • Upset about an (ultimately scrapped) plan to raffle off sex toys at the fair, he said the event would “push every form of sexual promiscuity there is out there.”
  • Upset that some of the advertising for the event was paid for out of student activity fees, he said, “”This is a how-to fun fair for sex. This isn’t education. This is pushing sex. It’s encouraging it… It doesn’t swell me with pride to see my alma mater putting on a soft porn show.”
  • Upset that “aphrodisiacs” including Hershey’s Kisses, cucumber slices, strawberry Jello-O, and oyster crackers were given out at the event, Cuccinelli, Black, and three other Republican legislators wrote to the GMU’s president, “We appropriated $33.1 million in FY 2005 to treat STDs and AIDS. We are concerned that the frivolous manner in which human sexuality is being treated here with GMU approval is counter productive to the best interests of Virginia citizens.”
  • Upset that presenters encouraged attendees to properly use condoms to “protect” themselves, he took use with that term, calling itfactually incorrect,” because “condoms do not stop HPV or Herpes.”
  • Upset that attendees were invited to lobby for increased federal funding to fight sexually transmitted diseases, he dismissed the idea that “funding offers any kind of solution to the significant consequences of voluntary behavior.”

Cuccinelli maintained the event would disgrace the school, warning that Virginia government might need to “establish some statewide standards” to prevent this and similar events at other public colleges and universities. But the university’s administration emphatically rejected suggestions from Cuccinelli and then state-Delegate Dick Black (R) that they cancel the event. The chief of staff to the president of GMU called Sextravaganza 2005 “as well an organized and delivered student event as we’ve had on campus,” and it was repeated in future years.

How did Cuccinelli square his efforts to censor the event with his professed desire to “preserve liberty?” He told Bacon’s Rebellion, a Virginia blog, “in the realm of morality, freedom is not the right to do whatever you want (license), it is, in fact, the ability to do as you ought (self control).”

LGBT

The Complicated Question Of Diagnosing Transgender Identities

Kelley Winters has been an outspoken advocate for GID reform.

A number of ThinkProgress readers have expressed concern over Monday’s widely-shared post, “APA Revises Manual: Being Transgender Is No Longer A Mental Disorder,” about the American Psychiatric Association’s decision to revise the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to reclassify “Gender Identity Disorder” (GID) as “Gender Dysphoria.” A prominent LGBT scholar called the headline “erroneous,” noting that as long as a designation exists in the DSM, trans identities are still treated as a disorder. One trans advocate pointed out that “Gender Dysphoria” still stigmatizes trans people because there’s no exit clause to the diagnosis. Another activist shared a letter (Ansara, et al) that she and others submitted to the APA criticizing much of its framing around trans identities and providing possible alternatives. One other trans health activist called the article “a bit of a pinkwash” — essentially an attempt to give the APA more credit than it deserves.

As a cisgender (not trans) gay male who edits ThinkProgress’s LGBT vertical, I assume a heightened responsibility to report on trans issues effectively and thoroughly. For all members of the LGBT community, there are many issues that impact us in very personal and unique ways, resulting in many seemingly-conflicting points of view that all have validity. Many of the points submitted by readers have such merit, and the continued discussion seems an apt opportunity to further explore the complexity of anti-trans stigma and the potential impact of the APA’s decision.

For what it’s worth, ThinkProgress was not alone in its framing. Slate similarly reported “Being Transgender Is No Longer a Disorder.” The AP also compared this change to the 1973 removal of homosexuality as a disorder. Other LGBT outlets, like GLAAD, reported that “Gender Identity Disorder” had been removed from the DSM and that the idea trans people are disordered is now antiquated. Indeed, this was the intention behind yesterday’s post: to emphasize the value of the rhetorical change while acknowledging that complications remain.

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