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CC11 Action Alert: Help Increase Services for HIV-positive older adults

Sasha Kaufmann, Blogging Scholar with the Network for LGBT Health Equity

by Sasha Kaufmann

Guest Blogger, reporting on Creating Change, Minneapolis 2011

Did you know that by 2013, half of the people living with HIV in the United States will be over 50? Between social isolation, stigma, and the normal effects of growing older on the body, without the right support aging for LGBT and/or HIV-positive individuals can be a harrowing experience.

I learned today that there is an opportunity to change that! The reauthorization of the older americans act is supposed to occur this year. The law funds community planning and social services for over 30,000 service providers nationally. Programs such as buddy systems, meal programs, and home care are included. Listing HIV-positive and LGBT older adults as vulnerable populations will increase funding and attention to the crucial services needed to give seniors in our communities a better life. There is also an opportunity to modify the definition of family caregiver in this reauthorization as well, allowing for the proper compensation and recognition for taking care of partners and loved ones.

Want to put in your two cents? Then submit a comment to the Administration on Aging and urge them to include LGBT and HIV-positive older adults as vulnerable populations!

Solidarity and Snuggles,

Sasha

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February 6, 2011 Posted by | Action Alerts, Creating Change 2011 | 1 Comment

Policing of queer bodies today: how possession of condoms is a crime

Sasha Kaufmann, Blogging Scholar

With the striking down of sodomy laws in 2003 with Lawrence vs. Texas, sex between two people of the same gender in the privacy of  their own home was decriminalized.  However, queer bodies in public spaces are still policed, with the most marginalized in our LGBT communities affected.

Take New York City for instance. The village is known to be the birth of the gay rights movement, but when complaints of loitering emerged in the expensive real estate areas, the police started weekend stings for loitering and prostitution. Reasons a person could be arrested range from standing in an area known for prostitution, wearing provocative apparel…and even tt clothing that does not match their perceived birth sex.

Who are  those arrested?  According to the panel, 100% of those charged in 2009 identified as LGBT, with the majority effeminate or gender non-conforming. poor persons of color under 25. Yet, when  policing of queer bodies is  done to those with privilege, proactive responses result. For instance, when over 30 white middle-aged gay men were tricked out of adult video store  in vice operations in 2008, protests outside Mayor Bloomberg’s house and police investigations resulted. Outrage on behalf of those with privilege, yet when the same occurs to the disenfranchised, the communities look the other way.

In New York City, having condoms on your person can be used as evidence for prostitution

Out of the whole conversation of the panel, the most shocking fact in my opinion is the use of condoms as evidence. You have a population who are at high risk of contracting HIV afraid to have condoms on their person because of getting arrested. With no possibility of explusion of files, the consequences are high; an individual can be denied programs in public housing and other assistance services. I was glad to hear that collaborative efforts are occuring in communities affected in as trying hinder this public health threat  of  condoms used as evidence are underway.

For more information on this panel, check out the awesome post Emilia Dunham wrote! But for now…

Over and out (of the closet),

Sasha

February 4, 2011 Posted by | Creating Change 2011 | Leave a comment

Creating Change- A blogger introduction

Sasha Kaufmann, Blogging Scholar with the Network for LGBT Health Equity

Good Morning from Creating Change! I am so happy to be participating in this amazing opportunity. I come to this conference as a training professional, studying for my masters in social work at the largest HIV/AIDS advocacy organization in New England, AIDS Action Committee. I also come to this conference also as a passionate activist, a board member for Join the Impact Massachusetts. I hope to learn more about the health issues that affect our communities, and what measures an activist clinician  like myself can take to make a difference in achieving health equity for lesbian, gay, bisexual, and transgender folks.

Solidarity and snuggles,

-Sasha

February 3, 2011 Posted by | Creating Change 2011 | Leave a comment

Sneak Peek: Roundtable Webinar on Social Media

Sasha at the 2009 LGBTQ Tobacco Control Summit, Hosted by the Network

As I prepare for my departure from the Network, I wanted to pass along my knowledge from launching and maintaining our campaigns on social media. Before I dive in I wanted to point out that LGBT individuals are more likely to use social media than the general population. With that being said, here is the preview for my social media webinar being held on Wednesday June 30th at 12pm EST! (Register here…)

1) Twitter: This was the network’s first bout with social media outside emails to our discussion listserv and newsletters. Twitter is a site that allows you to post quick updates of 140 characters or less (or what is also known as a “tweet”). Its a great promotion tool to disperse information to a wide array of individuals. You can also link to articles, parts of your website, or other messages from people who’s tweets you follow. There are different tools to magnify the productivity of twitter, such as hootsuite.com which allows you to post tweets immediately or schedule them for a future date.

spread your message on twitter, one 140 character tweet at a time

2) Facebook: Personally, I believe that Facebook is the most widely used and easily accessible social media tool out there. Last fall it was suggested it would be the 4th largest country in the world if it was a nation. A malleable medium, Facebook has multiple applications to magnify your page and encourage your friends to interact with you on your account. I have to say that looking back since our Facebook’s inception in October, about 75% of our members (guess-estimation) have not been active with the network prior to our facebook, so its a great way to incorporate individuals not usually familar with your organization. Some other hints:
  • You can link your twitter account to your facebook status. This has mixed pros and cons because while you can hit two different mediums with one update, if you use twitter talk in your facebook status it might not be as welcoming or targeted.
  • While the Network does have a friend page, having a fan page for your organization allows you to receive weekly updates from Facebook on page traffic including number of views and new members. With the new realm of social media changing and altering so frequently, its quite hard to evaluate these mediums overall so the more data you can collect to show oomph the better!

Wordpress is one of many blog services someone can ultilize

3) Blog: Sites such as blogger and wordpress are online publishing tools. The network uses their blog to highlight new resources and stories that surround LGBT tobacco control. My experience has been that Facebook has more online traffic than a blog. That doesn’t mean blogging should be ignored however! My suggestion? Post any blogs you have in your Facebook status. This allows you to get your information out there to audiences that might not usually be exposed to your information (e.g., twitter followers who might not read blogs regularly). You can shorten the web URLs by using sites such as tinyurl.com and bit.ly.


Supportive site runner-up
: Youtube
Youtube is great for uploading videos to put in your blog or facebook. As an individual medium it does not get as much traffic as the other sites, but it can add some flair to your other multimedia venues.
In conclusion, each of these social mediums have pros and cons in their use. I found this really cool rundown of the vast influence of social media on the masses.
Thanks for reading, and hope that you will join us (register here for call-in information) on June 30th at 12pm EST to learn more!
Sasha Kaufmann
Program Specialist
Network for LGBT Tobacco Control

June 21, 2010 Posted by | social media, webinar | 2 Comments

Resource Recap: June Edition

Our June resource recap kicks off with two articles that hit quite close to home, featured in the American Journal of Public Health.

This month's cover of the American Journal of Public Health focuses on systems modeling in tobacco control,

A systems analysis examined the cross-collaborations of five of the six national tobacco disparity networks, including us! The examination concluded that, “statistical network modeling promises to be a useful tool for understanding how public health systems such as networks and coalitions can be used to improve the nation’s health.” The 2nd article featured the state the Network calls home: Massachusetts. LGBT disparities are highlighted through high quality state data from 2001-2008, concluding a 2x to 2.4x higher rate of  smoking for lesbian, gay, and bisexual men and women.

A new study published online last month in Nicotine & Tobacco Research shows that menthol cigarettes are more addictive than general tobacco, with potentially increased oral exposure to carcinogens among users of menthol-flavored cigarettes and chewing tobacco.  CNN also recently debated the idea of the implications of banning menthol tobacco products altogether.  Kaiser Health News addresses the effects of prevention in health care reform utilizing tobacco as an example is worth a look too!

March's issue of AIDS and Behavior examines the relationship of mortality and smoking with PLWHA.

HIV data and its implications were also a highlight in resources this month.  A 12-year study on people living with HIV/AIDS (PLWHA) in Seattle was included in March’s issue AIDS and Behavior. Conclusions released compared never smokers to current smokers, finding individuals with an increased dose and/or duration of smoking at greater risk of all-cause mortality. Suggestions included further research on the matter and tailored cessation for PLWHA. The Center of Excellence for Transgender HIV Prevention also released “Recommendations for Inclusive Data Collection of Trans People in HIV Prevention, Care, and Services,” examining the issue of reliable inclusion of the transgender population in HIV data collection. Topics include questions to ask, helpful implementation of data collection, and resource assistance.

Lastly, Sexual Minority Youth were found to be more likely to have had acute respitorary illnesses than smokers in general. Particularly,  gay/lesbian smokers were more likely to have had strep throat, and bisexual smokers were more likely to have had sinus infection, asthma, and bronchitis. Hopefully the cyber resource trend like the one John Craig, MSW is hopping on will help combat this discourse: internet smoking cessation. Several of his internet radio programs focus on smoking-cessation projects and anti-tobacco initiatives around the country. Topics range from  political campaigns and anti-tobacco lobbying efforts to interviews and discussions designed for smokers themselves — if they are trying to quit or stay quit.  Click here to learn how to access the recordings and help stay ahead of the trend.

This will be my last resource recap, but be sure to tune in later on this summer when our new Program Associate, Emilia Dunham, will take over ship!

-Sasha aka queerthanqueer

June 18, 2010 Posted by | Resources | Leave a comment

HIV and Tobacco Webinar: Lessons Learned

Yesterday the Network co-hosted a great webinar with the National Youth Advocacy Coalition, examining the relationship between HIV and tobacco.  With over 50 participants, the information disseminated and discussions articulated was a fascinating opening dialogue.

Some really interesting facts I learned:

  • Smokers are contracting HIV faster than the general population: About two-to-three times faster actually, with 50-70% of HIV-positive individuals using tobacco.  HIV-positive men-who-have-sex-with men (MSM’s) are two times more likely to smoke than HIV-negative MSM’s.  This can be contributed to oral ulcerations caused by tobacco use, more minority-related stress, and the higher incidence of risky behaviors with smokers generally.
  • Smokers are developing AIDS faster than HIV-positive individuals overall:  With anti-retrovirals (ART’s) today, HIV is considered to be a chronic illness rather than a death sentence. But if you use tobacco, that notion decreases. Smoking can interfere with the processing of  anti-retrovirals (ART).  The liver processes the 4,000 chemicals ingested from cigarette smoke as well as the ART medications…and the liver always chooses the tobacco first. Tobacco also reduces immune function, increasing the susceptibility to opportunistic infections (OI’s).  One of the OI’s, Mycobacterium Avium Complex or MAC, is actually found IN the cigarette paper, active even when it burns down to the filter.
  • HIV-positive smokers are dying from tobacco-related illnesses rather than AIDSl: Consequences of smoking such as cardio-vascular disease and liver issues can kill you before AIDS can, influencing 53% of all AIDS moralities.  Studies have shown that quitting smoking does more to reduce cardiovascular attack risk in HIV-positive patients than ANYTHING else, including changes in ART regimens.  You can also be on less ART ‘s because your liver will have to digest less chemicals.  Less tobacco and less medications means you will be saving your body and a combined total of $5500 a year to be a smoker on ART’s.
  • HIV-positive smokers have a harder time quitting than tobacco users overall: Not only do HIV-positive people face increased tobacco use and effects, but their ability to quit is compromised as well. HIV-positive individuals have higher relapse rates and lower quit attempts…even though they need to quit and want to quit! Providers frequently have the perception that people living with HIV have enough on their plate as is, so why try and get them to quit if the self-medicating helps them with the stress of the disease. In turn, the provider feels uncomfortable addressing the issue. However, if patients don’t know the negative impacts of tobacco, how can they make educated decisions about whether or not they want to quit?

Helping to Quit: Lessons Learned

Barbara E. Warren, Psy.D.

Danielle Grospitch, CTTS

Danielle Grospitch, a certified tobacco treatment specialist and HIV educator, gave some great insight on how to aide HIV-positive smokers in quitting. There seems to be a success in numbers when it comes to cessation in positive communities rather than individual support.  Be careful if you use nicotine replacement therapy (NRT) in treatment. While it is covered by Medicaid in most states, cessation medications like Zyban can interact with protease inhibitors. For longer-term success, behavioral modification techniques such as cognitive behavioral therapy are more effective than NRT.

An example of a program that has all the above components is the first east-coast LGBT/HIV-positive support group to address tobacco cessation overall.  Apart of the LGBT center of New York City for 22 years, presenter and psychologist Barbara Warren helped to find all mental health and social services for the center, including the LGBT Smokefree project. The most interesting component of the case study I found was supporting the ambivalence of cessation. If your client is not ready to quit, that’s okay. Videos like the one below featuring “Mercedes Maybe”  allows individuals to explore their ambivalence about quitting, aiding them to quit when they feel its right and increasing their ability to quit successfully.

Videos are also great ways to get youth and young adults to think about quitting as well.

While incentives were found to be helpful to recruit and maintain people in the group, extrinsic motivations were replaced with intrinsic motivation by the end. 50% of the individuals who graduated from the program wanted to donate their final incentive back to the center because they were so grateful for being able to quit. Barbara found that the most important attribute for a group facilitator is  to be an ex-smoker, proclaiming that status allowed her to connect with the group members even though she was not HIV-positive or LGBT-identified.

Suggestions on what you can do to help:

  • Ask, Advise, Refer: Providers need to be asking and advising HIV-positive smokers, and feel comfortable doing so. Three simple steps will send the person in the right direction: ask if they use tobacco, advise them to quit, and refer them to the appropriate program.
  • Collaborate:  Collaborating with other local tobacco efforts can decrease costs and resources. If you are interested in funding opportunities, make sure to sign-up for our discussion listserv on our homepage, http://www.lgbttobacco.org, to learn about new tobacco RFP’s in your state.
  • Accessibility: If you are going to start a peer-led support group, providing the meeting at an easily accessible location by public transportation and in a comfortable environment like an LGBT center is helpful.
  • Following the leader: Howard Brown Health Center and the University of Chicago have just finished four focus groups examining smoking cessation in HIV-positive, African-American MSM’s. The major theme that emerged was that being an ex-smoker was the most deterimental factor for the group make-up. (Click here to request more information on the Chicago Study…) If you cannot have an ex-smoker facilitating, videos sharing success stories of HIV-positive individuals quitting can be used for motivation, like “Ready Rico.”
  • Address the whole individual: In cessation, examine the physical, mental, and emotional factors that influence a person’s tobacco use and ability to quit. Having information on nutrition is also pertinent because of the food limitations with ART medications and the use of snacking as a coping mechanism in cessation.

MORE RESOURCE INFORMATION NOW AVAILABLE FROM NYAC!

As I prepare for my departure from the Network to participate in my field internship at AIDS Action Committee, I will make sure to know my resources and to always ask if tobacco is used by my clients. Just a quick ask, suggestion, and resource referral can at least get the ball rolling and educate my clients so they can make the best decision for themselves possible!

June 9, 2010 Posted by | Presentations | , | Leave a comment

MSM Sexual Health Conference: Wellness and Resiliency

I had the pleasure of attending the MSM sexual health conference which occurred at our home site at Fenway Health. The convening hosted, “some of the United States’ top researchers, key stakeholders, and public health leaders to discuss the current state of knowledge about the sexual health of American men who have sex with men (MSM)” (Fenway Website).

Putting the “man” back into manifesting resiliency

The first session i attended looked at resiliency factors in gay men and how this untapped resource can be used to better gay men’s health, both physically and emotionally. The first speaker on the panel was Dr. Ron Stall, Ph.D., MPH from the University of Pittsburgh School of Public Health. One of the big influences on resiliency cited was childhood. We only have one shot at development , and even if you do not identify as GLBT as a child, homophobia affects ALL. I know I felt different growing up, and I have heard this story time and time again. As a future LGBT-identified individual goes through childhood and adolescents, they experience homophobia and victimization at a young age with no way of understanding, nor role models or community to support. These scars carry with you, but how can one grow stronger from them?

Dr. Stall used a syndemic theory model to show how the above psychosocial factors can influence gay men’s resilience.  For instance in adolescence, psychosocial health issues leads to higher substance use and depression, as well as more likely to engage in risky behavior and increased HIV prevalence. I was pleased to see Dr. Stall cite decreased tobacco use in population-based studies as an example on how resilent gay men can be with public health efforts. About half of MSM’s examined in the limited data analyzed used tobacco in the 90’s. Over the course of a decade, the number decreased to approximately 25%. Half of them had cited quiting over the past decade and achieving it cold turkey. MSM’s want to quit, they just need to have the knowledge and resources to aide them along.

So, how can public health providers help to manifest gay men’s strength in health promotion efforts? By promoting strength-based interventions to work on changing peer norms and raise skills to face homophobia.  An example given was of the house/ball community. It has produced a community for individuals that may not have anywhere to go for support, in addition to giving them a positive atmosphere not to be shameful about how they feel. Programs like HRSA’s “Stop Bullying Now Campaign” helps to de-normalize same-sex behavior and helping to hinder the psychosocial influences from the of homophobia from the get-go.

Lastly, the accessibility of equal marriage rights for same-sex couples and its health benefits was highlighted in this session, discussed further by Dr. Gilbert Herdt, Ph. D.,  from San Francisco State University. Healthy marriages have been shown to decrease the prevalance of diabetes and hypertension. By acknwoledging our love and families on the same plane as heterosexual couples, it decreases the stigma and discrimination that can have grave psychosocial consequences on LGBT individuals.

Policy to Practice: Next Steps
The second day covered what is next to do on a federal level with resesarch and policy. As we have seen time and time again in tobacco, chronic disease was a frequent theme that came up in policy implications, especially with AIDS now falling under the chronic disease umbrella.  Some important ideas to take away from this session:

Holistic health: Did you know that in the UK, sexual health looks at not just the individual and the disease but the systems that influence the prevalence? Well, that is what researchers in sexual health are trying to do now here in the States! Center for Mental Health Research on AIDS priorities were covered by Dr. Dianne Rausch, Ph.D. Behavior change and chronic disease management needs to be examined further than the 6 month point with a wellness approach incorporated to influence the development of the virus through proper nutrition and stress management including tobacco use.

Access:  I use this term broadly to describe the numerous institutions and protective factors that are necessary to have a successful prevention program. Having access to evidence-based research that is scaleable depending on the area is one. Sufficient infrastructure to apply the programs and evaluation measures to confirm success. Prevention programs are only reaching 25% of MSM’s, so accessing populations not normally targeted is key, including rural residents, young MSM black men, and runaway/”throwaway” youth.

De-stigmatization: How do we implement new prevention programs and increase wellness without solicitating further stigma? Train the providers in cultural competency. When having the invalueable conversations, discussing the adverse outcomes in a community framework. Terminology is important: even using “MSM” versus “Gay” helps to de-stigmatize the identity that is associated with HIV/AIDS. Empower men to have healthy and consensual sexual relationships will aid in mobilizing MSM sexual health as well.

Sharing Lessons Learned: Why re-invent the wheel if we already have one that spins well? The Network utilizes best community organization practices through our Sharing Our Lessons series, and conference participants reiterated such application time and time again.  Research and public health communities can collaborate research and public health initiatives to produce a toolbox of interventions while saving funds. The conference drew upon Massachusetts Department of Health as a successful program to highlight. Here in the Commonwealth, we collect data to show that our programmatic responses and policies follow the needs of the communities. This can be in state surveys or surveys that are released by LGBT rights organizations, such as in this case of Massequality. They have numerous programs that target vulnerable populations and individuals as a whole such as violence recovery programs and programs specific to youth.

ACT UP! Fight AIDS! (or any other LGBT disparity for the matter): Empowering our communities to speak up like in the days of ACT-UP can help raise awareness that HIV/AIDS is still an issue in our communities and our needs are still dire. If we dont speak up for ourselves, who will advocate for us? A great way to get involved is making sure that elected officials who support LGBT communities and their health disparities. 38 governor races are happening this fall; the house and senate both on a state and national level. Electing leaders that will advocate for us and our needs is crucial to have the support to keep up the fight!

Conclusion:
While tobacco is still a major issue in the LGBT communities, this presentation helped to shed some positive light on how tobacco use can be decreased. By giving individuals the support to empower themselves, one can overcome psychosocial factors. It will be very interesting to see how the policy changes and healthcare reform influences sexual health and psychosocial factors on LGBT health. The government wants to hear us and mobilize. We are the ones who can put the flame under the officials, let us be heard!

May 21, 2010 Posted by | Presentations | Leave a comment

   

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