Tuesday, September 15, 2015

We Remember, We Honor, We Continue the Fight

We remember the thousands upon thousands of lives lost to HIV. We Honor the trailblazers who have struggled and fought so bravely for so long to bring us to where we are now. We Celebrate the progress that has brought longer, healthier lives with new medicines, new freedom and new hope in the fight against HIV/AIDS.

Today, much has changed in the fight against HIV. As with many other diseases and infections, early detection can mean a person living with HIV can lead a long and healthy life, no longer condemned to early death, disability or sickness.  Beginning treatment early means medicines can reduce HIV viral loads quickly and almost entirely prevent transmission. Pre-exposure prophylaxis (PrEP) can prevent a person without HIV from becoming infected. Post-exposure propylaxis (PEP), when begun within 72 hours of exposure or accidents can prevent HIV infection. We now have more treatment and prevention tools than at any other time in history. This is a huge leap forward for a community devastated by HIV for more than 30 years!

Sadly, much remains the same. Most Americans and many San Diegans do not have access to accurate information about HIV disease today. Too many are left with the mental images and information of the late 1990s – information almost two decades out-of-date. Many non-specialist medical and mental health professionals continue to be unfamiliar with the detection and treatment of HIV, leading to dangerous delays in detection, testing and treatment.  Too many still continue to believe this is a disease of “moral character” instead of a battle against a virus. The resulting stigma attached to HIV keeps many silent, shamed or afraid. Too many in our communities – particularly communities of color, Trans and gender-fluid communities, youth communities, communities with fewer resources and those less privileged – have no reliable access to information, qualified medical care, medicines or prevention tools. Even in the face of groundbreaking new possibilities, these things have not changed. 


We can change what remains the same. We know this fight well. Science moves forward and so can we. We don’t have to be silenced. We don’t have to accept unfair, unequal treatment. We don’t have to accept continued stigma, ignorance, nor an America that continues to look the other way, leaving so many behind. Join us at AWSD 2015 and #bethegeneration that ends new cases of HIV.
#NoStigma #Undectable #PrEP #PEP


Our LGBTQ youth live in an increasingly intersectional world.  Intersectionality - post the SCOTUS marriage equality decision, this is the word on everyone’s lips. But what does it really mean?

In part, intersectionality refers to the reality that in San Diego (like other urban coastal areas) 55% of the LGBT community are of color. Friends, family members, colleagues, coworkers, potential partners and spouses – all of different races, gender identities and social classes – that is the world of our youth. That means the majority of our community has had to endure all of the impacts of systemic racism, a broken immigration system, and the propagation of gender stereotypes that work for few - in addition to homophobia. For the transgender community in particular, these intersectional realities are too often deadly.

When youth are asked “What’s next for the LGBTQ movement?” – many are acutely aware that issues of race, gender policing and immigration lie at the heart of their lived experience and those of their friends. They often reply: these are the issues of LGBTQ people; these are the important LGBTQ issues. And our youth want to know what the LGBTQ movement is doing to help address them.

When Marriage Equality Became Law

What an incredible weekend! In the words of President Obama, "…and then there are days like this, when that slow, steady effort is rewarded with justice that arrives like a thunderbolt." We are still absorbing the thunderbolt! 

It is in community that we are most hopeful, smarter, stronger, braver and more able to see the full justice vision. From the cradles of our newest members to the last farewells to those who are now behind the sun – from beginning to end – in community we are our best selves.

As we are grateful to so many for this victory and we remember all who led us, helped us, sustained us on the journey. We remember.

• We remember and are grateful for the tremendous bravery of hundreds of early trailblazers who dared to live their lives openly and to love bravely. 
• We remember Stonewall and Trans community friends who stood and fought... and launched a movement. 
• We remember the dark days of the Defense of Marriage Act. 
• We remember the hope born first in Massachusetts and then with the California Supreme Court. 
• We remember the bravery of those who fought the Prop 8 ballot initiative... and the pain and devastation when it passed. 
• We remember the lifting of Don’t Ask, Don’t Tell. 
• We remember the defeat of DOMA and the reversal of Prop 8.

We remember the hundreds of thousands of people, allied and LGBT, who have given their time, energy, creativity and dollars, and had all of the hard conversations that have fueled and sustained this movement. 

And we remember that there are many vital battles ahead. History and all other justice movements teach us that victories like this are the starting points of the long walk toward justice, not the end. We cannot and will not leave any of our community members behind.

From trans and non-binary gender rights and acceptance, ending new HIV cases, youth protections and school safety & inclusion, Federal Civil Rights protections for LGB and absolutely T, to comprehensive immigration reform and racial justice…  #JusticeistheDream.

Transgender Day of Empowerment

On Friday, April 10, we celebrated Transgender Day of Empowerment. Established as a way to celebrate the growing empowerment of the trans community and the courage, dedication and changes the trans movement has been able to achieve, it is an inspiring evening and a great way to show support for our trans brothers and sisters.

In 2005, The San Diego LGBT Community Center changed its name to specifically acknowledge and include the bisexual and transgender members of our community. Since that time and across the last decade we have begun to see changes that are encouraging – changes in the hearts, minds and attitudes of many within our community and in the larger society. As we all allow ourselves to be educated and grow, our understanding and policies change, often too slowly but change nonetheless.

However, there is much left to address. Our transgender community is still subject to horrifying levels of violence and discrimination. The number of transgender women – particularly women of color – beaten and murdered each year is appalling. There are far too few protections against blatant discrimination in employment, housing and more, and as ludicrous as it is, there are still places trying to pass laws about which bathrooms trans folks are allowed to use.

Yet in spite of all the obstacles, there are trans people accomplishing great things every day nationwide. Transgender Day of Empowerment is a way for us to celebrate their courage and honor the accomplishments of those who do so much locally to educate all and move us forward. As a community we still have much to learn about being helpful allies to our trans brothers and sisters, but joining us at The Center each year to celebrate Transgender Day of Empowerment is a great place to start.

It's Not Over

The LGBT social justice movement has made great progress very quickly, schooled by the courage and hard-won lessons of the civil rights movement, the reproductive rights movement and all others who have worked toward the vision of fairness and justice. We have learned the lessons of mobilizing, the importance of seeking allies and help, of electing the right minded and continuing to build and stand loyal to coalitions. We've seen powerful results and we are optimistic and hopeful as we wait for a Supreme Court judgement on marriage equality.

But we are also beginning to learn the painful next lesson, the one our justice partners know all too well. While thousands have worked hard for this moment in the sun, the vestiges of hate and ignorance are still alive in far too many. Because of them, change comes only unevenly and is not guaranteed. Ignorance survived the battle.

Today the so-called "religious freedom" laws being considered in more than 25 states seek to undermine LGBT equality and non-discrimination laws and policies. Whether these laws can be legally successful is a matter for the lawyers to argue, but the political motivations and animus of those lobbying for them are clear. They represent the stubborn and tantrum-like refusals of those who cannot share a vision of a free and just society. "We don't want to evolve or change," they say. "We want special exemptions to continue to discriminate, especially against gays and trans people." (www.acslaw.org/acsblog/indiana's-rifra-the-law-is-complicated-but-the-anti-gay-politics-are-not). Like a virus, this type of ignorance seeks any mutation of itself to survive.

Our right to be served in the public marketplace without discrimination is one of our most cherished freedoms and one of the highest obligations of our American government. It does not infringe one's right to believe and worship as one chooses.

The lesson is painfully clear - some battles may be won, but the mission is NOT accomplished.

No matter how tired we are, we can't stop fighting. We owe it to all those who came before us. We owe it to our seniors. We owe it to those who will have to fight after us. We owe it to our youth. We are Californians - we owe it to all the LGBT people and their families in all the states to keep leading forward.

We have to fight. And we will have to fight exactly as we began - state by state, city by city, issue by issue, in schools, in the military, in healthcare, in housing, in employment, in benefits like social security and mediCare, in the battle for HIV treatment and care. In the words of Michelangelo Signorile, #itsnotover.

To Fight Effectively for Any, We Must Fight for All

Many pundits and a number of national LGBT leaders have called for increased post-marriage equality focus on cross-movement justice work from LGBTQ organizations. 

Cross-movement work involves us in not only in the direct LGBTQ concerns of the movement, but also the racial justice movement, immigrant justice movement, the environmental justice movement, the HIV justice movement, the worker justice movement and the reproductive justice movement, among others. The Center is and will continue to be, a proud partner with many in the various justice movements and struggles. But more than just cross-movement work, this work involves the explicit recognition of the intersectionality of all of these identities and issues. All of these struggles and communities are interconnected. 

To fight fully and effectively for any of them requires that we work together to fight for all of them.  More than 50% of our LGBTQ community members in San Diego are of color and/or struggle to find the resources to live healthy lives in the most unaffordable area in the nation.  These are the issues of our community.

For example, as we fight against the stigma that exists for those living with HIV and work to ensure equal access to current information, insurance, HIV treatments and new protective treatments like PrEP and PEP – we are instantly faced with the obstacles of anti-LGBT attitudes and discomfort about gay male sexuality, along with the profound issues of poverty and racism. Thirty years after the virus exploded in America these struggles remain. In the age of possibility provided by Truvada, undetectable viral loads and the Affordable Care Act, with the promise of manageable, healthy lives and prevention treatments that can truly protect - epidemic levels of HIV continue. 

The issues and attitudes (poverty, racism, discrimination, bias and anti-LGBT attitudes) impact the lives and hopes of our youth, our black and Latino brothers, our transgender community and all those infected with HIV. 

This is intersectionality. This is the work. Join us. #Bethegeneration that does the work.

Monday, September 14, 2015

Fear, Shame and Stigma Cripple Us

Thanks to medicines and medical progress, HIV can be a manageable, chronic disease. Most infected people can live a normal, relatively healthy life as long as they are diagnosed early enough and take their medication as prescribed. Today’s antiretroviral drugs suppress the viral load – (they lower the amount of HIV virus circulating in the bloodstream) – to the extent that someone in appropriate and regular care who is taking medicines as prescribed is healthier and has almost no risk of infecting someone else. That’s a game-changer for all of the folks dating or in relationship with anyone with HIV, and all those who have spent so long afraid. Treatment, is in some important ways, prevention!

But, nationally, only about a third of HIV-positive people reach the point of being and staying virally suppressed. That’s because 18-20% of people with HIV have not tested and do not know they are HIV positive. Additionally, too few people have easy access to appropriate care and medicines
and even amongst those who begin care too many are not able to stay in care, and thus are not able to reach or sustain viral suppression. 

This HIV Cascade or cycle is worst in environments high in poverty, high in stigma/shame, and with significant racial disparities in health education and access. The conversations Center Staff and I are having with too many in the LGBT community are filled with crippling fear, shame and stigma - fear that prevents regular HIV testing, stealing the chance for early detection and treatment.

But San Diego can change all that. People living with HIV/AIDS can receive medicines, care, respect and fair treatment. They have an illness that can be treated and doesn’t need to be transmitted. 

We can help those not testing regularly to get tested. Early detection of HIV gives everyone their greatest chance at living a healthy, normal, long life. Silence, fear and stigma limit our chances for that full, healthy life. We can help all those without easy access to care, to get into appropriate HIV care and to be able to stay in care and achieve viral suppression.

San Diego has incredible care available for HIV – but that care cannot be effective if we do not focus on reducing fear and stigma, on regular testing for the untested and on getting/keeping all people in care. Education and information can make a huge difference. Fear, shame and stigma cripple us.

Together we can reduce new cases of HIV in San Diego to zero. Together we can  #bethegeneration

Be the Generation

When AIDS first hit us, it was like a bomb went off in our community, leaving too few survivors. A generation of gay men suffered and died. Some buried partners. We all buried friends - too many friends. In spite of our grief and fear, we fought for compassionate care and medical interventions. We fought for funding and against government silence. We fought to end a plague that decimated our community, and to make the dying stop.

That fight was bold and courageous. More than three decades later, our efforts to end this epidemic must be equally bold. We still mourn our profound losses, but today we have increased knowledge and better tools to fight with.

Unfortunately, the stigma and shame remain. But we are dealing with a virus, not a moral condition. We have to fight through that stigma and shame, and talk openly to get to no new cases - through testing, treatment and new prevention tools.

The San Diego LGBT Community Center, which has been part of the fight since the beginning, remains committed to the battle against HIV/AIDS. Today, The Center and AIDS Walk San Diego call for San Diegans to join us and commit to reducing new cases in San Diego to zero within the next ten years.

We can be the generation that fights to end new cases, that stops the epidemic-level spread of HIV/AIDS. We can make it happen.

To reduce new infections, we must provide HIV/AIDS education without shame or fear, as well as access to condoms and medications for all who choose them. PrEP (pre-exposure prophylaxis - treatments like Truvada) and PEP (post-exposure prophylaxis) are revolutionary tools in this fight, and offer the most promising hope we have seen in prevention. There will be even more next-generation drugs behind these.

We must ensure those who have the virus can access the medical care and medications that will keep their viral loads undetectable so they will stay healthier and much, much less likely to transmit the virus. We need everyone to get tested and encourage others to do the same - frequently. With an intensified focus on prevention, testing and treatment, new infections can and will decrease. Ending new cases will decrease the transmission rate, which will help end this epidemic.

What will it take to end the epidemic in San Diego?

It will take Courage to face the fear and be willing to have the conversations that educate and support. It takes Clarity to create a plan designed for success. We need elected officials in the City and County to come together with the community of HIV activists, educators, healthcare professionals, service providers, business and community members to create a clear and achievable plan to end the epidemic levels of HIV in San Diego. And it will take Commitment to educate, to use the tools that we know will work and execute a plan designed to win. Courage, Clarity, Commitment.

With an intensified focus on education, prevention, testing and treatment, new infections can and will decrease. Ending new cases will decrease the transmission rate, which will help end the epidemic levels of this virus.

California has the second largest number of HIV and AIDS cases in the Unites States. San Diego County has the third largest number of HIV and AIDS cases in California. More than 20,000 San Diegans are living with the virus. Isn’t it time San Diego made a commitment to get to zero new cases by 2024?

Let’s end new cases of HIV/AIDS in San Diego. Let’s do it for those who fought before us, and for ourselves. Let’s do it for those we’ve loved and love. Let’s do it for those that come next and could grow up in a world less afraid of this virus. #bethegeneration