Lesbians do not factor in HIV prevention that much, bisexuals still seen as only a ‘bridge’............

The more things change the more they stay the same and then expectations are out there to gain positive results when the nonsense continues as the farce thrives; in the face of new information, data driven work and so on, old entrenched thinking trumps (no pun intended) sensibility.

One would have thought with the expansion of the understandings of sexuality, the now more than ever urgent need to filter out subgroups alongside their sex seeking behaviours and psychologies associated with same we would have gotten passed this nonsense of omitting what some see as lower risk groups for HIV infections hence they need not be included. The lumping of transgender persons into MSM studies for example in times past seems not to be recognized as yet and accepted by the establishment as the 32% rate being bandied about from then is often referred to despite the error has been quietly seen. The figures are obviously flawed to begin with, one does not have to be a genius to see it; in the days when words such as “pre-operative” was not a dirty word in transgender realms and represented ‘transitioning’ suggestions were made to separate such persons out of the study as some trans did not pursue such but who identified as gay and found some comfort in the gay community

I find it most odd that it has to take a gay man like myself to be writing on this. It also stems from two greater conclusions I have drawn several years now, first being much more could have been achieved if not for forward thinking and action and secondly some of the very folks at the helms are the actual obstacle to said achievements to materialise. Frankly I am getting tired of the itty-bitty achievements it is time for monumental if not better positives and outcomes on a much larger scale after all these years, when the potential exists for forward movement.

As World AIDS Day came to a close and the cogs of HIV settled back to business as usual an old discussion came up via social media about risk for women on the strength of a post and article on transgender persons in Jamaica who were said to be HIV positive. In making the rounds on various platforms and literally examining the content over a host of presentations, a myriad of radio interviews, television appearances, hash-tagging and so on literally not a word came out on certain types lesbian sex as risky for HIV and or sexually transmitted diseases. A rather young bright young lady asked a potent question on Facebook as to why women seem missing or very low on the radar for prevention messaging saved and except for commercial sex workers and the emphasis that the rates had fallen in that category. The group she was in froze for a minute suggesting pause for thinking I assume and then the flood of answers/comments came mostly espousing words to the effect that she may be right in a sense. The omission if not invisibility of same gender loving women in HIV prevention especially in today’s world is telling yet again that the more things change the more they stay the same.

Trouble is the bureaucrats and board of governors of many of these HIV outfits are still mostly male or if women are there they are heterosexual and cannot speak to some issues directly from a space of real world experience along with an elitist chip on their shoulders (the males that is) despite some bragging that they have now employed more women in their midst but still have a gay male driven mindset by just mere observation in public policy/advocacy. They refuse to take ‘telling’ as country people would say from non elitists and experts while HIV infections dilly dally although it is known and accepted as a challenge in the gay community in terms of rates the lumping of transgender folks. The near total omission of bisexuals where they are only seen as a ‘bridge’ for infections and lesbians’ near total annihilation from the interventions altogether despite so called new women’s’ groups in operation still is too gay male and mainstreamed if not hetero-normatively focused. These new groups and advocacies if not added bureaucracies are more interested on the comfort of social media these days and really hardly do real work as one person puts it with ‘real people’ and issues, then it is no wonder the messages are flawed and overlook certain groups. Older outfits such as Womenforwomen, WFW seem all but dead publicly and offered not even a dribble in the department of HIV risk and women who have sex with women, hash-tagging and instagramming if you will are the latest crazes but while such platforms can work when you’re up against altered or bettered versions of individuals profiles including the very NGO republic hiding the actualities to give a near perfect of not falsified appearance then where it the truth to credibility to make the message more effective and lasting hence omission and oversight may be less.

an example of Tribadism

We now know of practices such as Tribadism probably the most risky of them all in sex between women and or the seeming increase in use of sex toys as evidenced by the very retailers within the same gender loving community who have said their sales have increased exponentially and their buyers are mostly women. The sex industry and or the human trafficking illegality that often forces women who are straight into lesbian sex by just mere observation has been clearly incorporating women on women action in bars, so called massage parlours that are really a front for ‘Madame’ services and so on, by virtue of those considerations alone it warrants more forward thinking on the part of the programs and new if not ‘outside the box’ thinking and not just typical responses. It’s all about the money for managers of these establishment and the old hetero-based restrictions are out the window as the rules of the game changes. A tip in the thousands of dollars for such entertainment is the norm today and not just the kissing touchy-feely eroticism but more raunchy presentations on stage to include Tribadism for example.

Tribadism is one of the most risky of all, a point I have been driving at for some years now in previous posts, effectively it is sex between two women where the clitoris and indeed the vaginal openings are made to come together to create friction in a kind of X pattern formed by the participants. The act can be very intense for the parties and led to multiple orgasms often with no barriers such as a dam, cut opened condom or so on. The theory that hairs if not shaven can act as an intervening item to create openings on the skin or the labia minora. We know that cuts and exposure to blood of an infected person can facilitate passing of the infection and given the literal receptiveness of a vagina by virtue of its shape this is grounds for reference at least or stronger advocacy at best.

The practice in particular is now more evident at strip clubs than ever before with often dancers/strippers/performers who may not even be lesbians but the job may require some lesbian sex as management may demand same to make a profit as more male patrons and indeed other lesbians such as butch identified women like this kind of thing and tip heavily, the possibility however slight or low is still a risk no matter what, risk is risk. The typical message for women has to be amended even in the commercial sex work category in the face of a reduction in the prevalence rates. It is well accepted that high knowledge of condom use is out there but conversion to action is another matter but as to the specifics for other groups that is woefully lacking so the messages flies over those groups heads as it feels as if it is not for them to follow as they may not see themselves as at any risk at all. When are the programs people going to include in the narrative wider messages to boldly and specifically (if not in raw language) mention plasticizing bisexuals you too are to consider safer sex options and not just rely on the hetero-normative mainstreamed sanitized near nonsense anymore.

Lesbians and bisexuals aside specifically there are also other nuances often overlooked as the response also miss even sub group practices under the MSM umbrella. Cruisers alone is where I’ll zoom in as cruisers as it were not only include gay or bisexual men but also other men who either experiment, are exposed to gay sex of some sort by way of prison (substitutional sex/situational homosexuality), jail houses or correctional facilities but who when released back into general society over time may pursue sexual experiences via this route as it tends to attract more masculine types who avoid any hint of effeminacy and self identification as ‘gay’ a term seen in their eyes as a man wanting to become a woman and is too loaded psychologically for those men. These are often men who have ‘baby-mothers’, girlfriends and so on and in a type of behavioural bisexuality pattern. Condoms if there is any anal penetration to be had (as mostly oral and hand action are the preferred practices) are not an option as it can be seen as the one suggesting condom use may be HIV positive and or the engaging party is also positive which can lead to serious violent reactions in a blame game. Most men who I have interacted with in this arena simply avoid any mention of condoms just in case as the reaction from the other party is unpredictable. The more raunchy the sex the better it is for some men to include bare-backing, cream-pie action and so on; HIV prevention seems to totally overlook these psychologies when contemplating tailoring the response.

Omissions, oversights cannot continue as the norm not in this day and age alongside hetero-normative sanitized narratives must fast become a thing of the past (a call made some 8 years ago), if it is some expect to bring down infection rates. Risk is risk however small and despite the groups involved. Everywhere else is somehow able to address their prevalence rates save and except for some sub-groups yet here we are wasting time.

Peace & tolerance

H

also see:

Tribadism & Safe Sex 2009

Human Rights Day ......

Here we are again this old familiar place on what is the annual International Human Rights Day and while the original egis of the recognition was made on credible aspirational terms towards a better world it seems that over several years since the world has turned to something else, counter to the objectives set out. We have a Syrian crisis festering right before our eyes, groups and advocates clashing over which rights should be prioritised or are morally acceptable, our least amongst us especially homeless persons on the MSM/transgender front are essentially left out in the cold by the very bureaucrats who claim to represent them but the populations are easily found and made use of for statistics especially in the department of HIV and such yet they are left alone no sooner after the results come to hand alongside the insulting tokenism that is often parading as legitimate answers.

So the main question is whose human rights really? 

recent Jamaica Observer Clovis toon as the debate continues on ganja rights/decriminalization also see: Tolerance, when, has the oppressed become the oppressor? 2009

We have a United Nations that seems near impotent if not just ceremonial on many issues including the refugee crisis madness in places like Greece, Germany, France, Austria and so on and yet as people flee mostly for genuine reasons very little help seems to come their way. Right wingers in the same breath are out in earnest now playing on the fears of sometimes ignorant populations who feel their peaceful countries or existence are being turned upside down with ‘foreigners’ disrupting their way of life but where is the human rights for the genuinely fleeing folks? It has become a political football for example in Germany’s upcoming elections or in France where there is an election to win and juxtapositions or populism seem to be making the fleeing refugees and their rights or protections shafted.

another Clovis toon in the wake of the controversy surrounding a US embassy tweet & a phone company, the old misconceptions on US/foreign impositions on us continue.

That recent telephone directory cover controversy as caused by the hypocritical antigay group Jamaica Coalition for a Healthy Society, JCHS is one such matter that shows us on the human rights front we are eons away from just true tolerance as the so called moral police who think they can impose on everybody else their views. No theocracy ‘round here is the loud rebuttal. Gay rights in the JCHS’ eyes are seen as a fallacy as they prey on yet again the ignorance of the masses sadly which includes clergy, theologians, lawyers and pastors with a gullible congregant populations. The fearmongering is palpable and is so easily done without fail by voices such as Dr Wayne West with obsequious servants who can’t think to save their own lives. Only so called pressured Christian groups or voices matter as some invisible hand somewhere is intent on silencing them they claim because they oppose for the most part homosexuality yet near silent on every other atrocity out there; that old victimhood card. The sad part is that honest, forward thinking and balanced/tolerance Christians or church body are batched as crackpots due to these fanatics.

Meanwhile ho is really standing up for the children these days?

It is disturbing to watch the news cast on television at a certain part of the presentation as a list of missing kids is shown and we wonder, yet groups find time for phonebook covers, homosexuals and buggery law but are all but blind to the things that sit right before our eyes on a daily basis. Some voices who have been championing children’s causes have simply stopped as they feel the thing looks hopeless as slow action from the state is a turn off, while the ones who are active continue to incorporate an old conflation of paedophila, homosexuality, crimes of passions beliefs and a so called gay agenda in their advocacy, case in point Betty Ann Blaine; which gives further strength to the fearmongering imperative as the key strategy y said groups. While I support the thrust for the rights of children to do so by ostracising others who one does not like or misunderstand is not the way to do so. The awful Ananda Dean murder and its unsolved case file status so many years ago is one of those cases that brought persons such as Blaine to prominence and who had mass support but as of late the support has waned somewhat as she shows her colours. Hope she does well at the upcoming Global Missing Children Conference and not let her antigay sentiments cloud her judgement.

We recently recognised the day of the girl child in a bid to raise awareness of girls their issues and abuse to include sexual abuse yet only days ago we had that awful report of a 14 year old rape victim in St Catherine was forced to ride in the very car of the police to the precinct alongside the very perpetrators; to be asked to relive the ordeal like that in the face of supposed enlightenment and training of cops but practice of what is taught is another matter. That other matter where the police spent the better part of eight plus hours at a crime scene of a murder of a teen arguing who has jurisdiction over the matter is another one that shows up the cracks in our justice system and rights. To have the family standing their already in their grief to look on helplessly on a body and to be told by the cops who arrived they cannot handle it is plain absurd, then why did they arrive in the first place then if when 119 or 911 told them the location they should spared the family the grief by telling 911/119 to find another team. Who cares about anything anymore these days? Then we wonder why vigilante justice is seen more and more as a credible option in the eyes of some? Call a ‘shotta’ perhaps; maybe in the eight hours of waiting maybe something would have been done already, at least a plot to find the bastards or best someone’s head back get lick out. Sigh! Of course the illegality of it makes it problematic plus persons who go that route never actually stop paying these men as they when broke simply find you and ask if not demand money on the strength of the secret.

We have CISOCA, Children’s Advocate & Office of the Children’s Registry and a myriad of child rights groups yet we are bombarded with child abuse stories and crimes as the adults continue to quarrel with them living in a world they did not make. Similar to the nonsense about having the most churches per square miles yet per square inch or towns and nation has crime and destitution spreads like an infection while only a few enjoy wealth and privilege. Yet again the refrain the more things change the more they stay the same is appropriate; we ought to have way better improvements and a reduction in atrocities yet things are going in the opposite direction. There must come a point when enough is enough. Oh the monotony. The few things that do work are often not replicated or starved of resources to make them expand with little interest.

Women’s rights seem in stagnation these days with pretty announcements as usual from gender specialists and ministers of government, I have announcement-itis these days, lofty aspirational goes yet blah! Where is that sexual harassment bill that has been sitting on the order paper of the house for so long? Where is the real equality in terms of equal pay or breaking the proverbial glass ceiling? The week of day for recognising violence against women is here again and after the hash tags, social media awareness, what’s next, back to normal, especially the more impacted persons I suspect do not even visit the pages or have a smart phone for that matter. The grand partnership signing on Wednesday December 7 yet another event for smiles for the camera for social pages and media moment with a who’s who of rights personalities, politicians and such as the opposition was missing in a huff following their parliament walk out the day before as they are upset at their election loss on both fronts local and national while complaining about the name change of the partnership as if any party has copyright over words such as “progress”, semantics! I tell you so even in the signing moment the greater idealistic concern for rights and harmony is killed off in a sense and rights linked therein are overlooked. The PNP has convenient amnesia when they made name changes prior; remember the tagline in 2002 “Log on to Progress” subsequently renamed afterwards and then the 2011 partnership signing. The delivery on these partnerships or the lack thereof is the elephant in the room where rights are also directly intertwined. Whatever the thing is named and by whom just get the job done.

Who is really representing certain other issues such as continued HIV discrimination or persons with disabilities apart from the small genuinely concerned groups who are trying their utmost best as lolly voices in the wilderness; as disabilities awareness weeks ends the Executive Director of Disabilities Association of Jamaica lamented on a radio interview that society seems to have lost something as an uncaring nature is here with us again. She and others cite the public transportation complaints, access to thoroughfare, inability by some to pursue tertiary education namely the hearing impaired as institutions have no sign language capacities to disseminate the courses. World AIDS Day just ended and amidst the elegant presentations, radio interviews, online and social media runs were on the up and up but as the hype cools down the issues raised are still there even after so called improvements, it makes one start to wonder what is the point of it is all then? Itty bitty achievements are not enough in my eyes, ARVs for example are cheaper and supposedly more readily available yet shortages interrupt persons’ adherence schedules, or persons forced to travel long distances out of parish to wait in long lines for prescriptions to be filled while a plethora of groups break out like an infection mostly on social media and not actually in the real world engaging real people.

The Public Defender for example seems like many other outfits that need resources are lacking in them if not deliberately starved and rights get caught up in that as well, apart from the pursuit for natural justice for aggrieved persons the office is swamped with complaints from the public seeking redress for rights breaches by agents of the state or government and the cases linger, yet in the midst of it all we hear of flowery aspirational goals of Human Rights Institutes and training which all sound so up in the air yet somehow cannot materialise. The previous administration launched the thrust for the institute but it seemed stuck in the quicksand somewhere and if it dares wiggle or too much is said on it, it may very well get swallowed up as other matters take precedence. The Human Rights for All campaign seems to be more about cake cutting events and experts meeting for shindigs than about actual reaching a way larger percentage of real people.

The Independent Commission, INDECOM standoff with the police high command and by extension the Director of Public Prosecution, DPP only serves to obscure the processes of Justice, clearly some police have not unlearnt the old ways or the ‘squaddie’ mentality yet people who want to be honest are exposed by the very same shady cops in the system and then made to be targeted as informers in their communities so people see wrongs and simply shut up. When family members of victims who speak out but who are harassed by the very police who did the harm in the first place it leaves one wondering yet again what is the point of it all? Groups such as Jamaicans for Justice have been at it on a stretch and yet the more things change the more they stay the same. Honest police are afraid to speak out openly as repercussions can apply, that video episode with an alleged police man living aboard brought that front and center; albeit so many years after the particular issue he was passionate about, whether he was truthful is one thing but to release such a footage warrants serious contemplation.

How do persons can get motivated to stand up?

The fight continues no doubt but the cloudiness that impedes it is of concern.

Peace & tolerance

H

also see:

Human Rights Day: LGBT Stand in the morning, theocratic concert in the evening 

Human Rights Day 2012 ....... My Voice, My Right, My Voice Counts

Switching course, Gilead markets HIV drug for prevention ..........

Gilead Sciences Inc has begun marketing its HIV treatment Truvada in a way thousands of consumers already use it – to prevent infection with the virus that causes AIDS.

The company introduced Truvada to the U.S. market in 2004 for HIV treatment. In 2012, Gilead won approval to market it for prevention after two large, peer-reviewed studies showed it also was effective at preventing infections in healthy people.

But the company decided against promoting the drug as a preventative treatment, deferring to patient advocates who feared it could encourage promiscuity and unsafe practices, such as having sex without condoms.

Even without Gilead's help, many consumers learned Truvada was more than 90 percent effective in tests at preventing HIV infection. In 2014, the U.S. Centers for Disease Control and Prevention recommended it as an option for people at high risk for HIV infection.

As many as 90,000 people in the United States used the drug for prevention, or pre-exposure prophylaxis (PrEP), last quarter. That's up from 60,000 to 70,000 earlier this year, the company said. Usage also is growing in France, where about 2,000 people have been prescribed Truvada for prevention since January.

In July, the drugmaker began marketing Truvada for PrEP to doctors through professional publications, digital advertising and other channels, including the website PreventHIV.com.

And this fall, the drugmaker began marketing directly to consumers with print advertisements in publications geared toward the lesbian, gay, bisexual and transgender community, including OUT, Advocate and SWERV. It plans soon to expand to social media and digital.

Gilead said it wants to reach people whose doctors are either unaware or reluctant to prescribe Truvada for prevention.

The marketing "is primarily driven by demand by patients," said David Piontkowsky, Gilead's vice president of HIV Medical Affairs, in an interview.

Attitudes toward Truvada started to change a couple years ago as doctors, AIDS activists and potential users saw its effectiveness, he said. The "criticism now is we're not saying enough."

Truvada is helping bolster Gilead's profits as sales of its biggest moneymakers – treatments for hepatitis C – decline.

U.S. net product sales of Truvada for the first nine months of 2016 were $1.8 billion compared with $1.5 billion for the same period in 2015. The company said in its earnings report that the gain was driven by price increases as well as "increased usage of Truvada for PrEP."

"We expect PrEP to continue to be a significant part of Gilead's growth in HIV going forward, particularly in the U.S.," Gilead Chief Operating Officer Kevin Young recently told investors.

The new Truvada campaign has been well received, even by those who once opposed promoting the drug for prevention. They include David Duran, a writer and HIV advocate, who helped popularize the term "Truvada Whore" in a 2012 article describing his fear that it would encourage people to have sex without condoms.

Duran began rethinking that concern about a year later in light of newer research showing that PrEP helped prevent more cases of HIV, without a rise in other sexually transmitted disease, which suggested people were using condoms.

"I'm thrilled they are starting to pump some money into marketing and awareness," Duran said. "There is a solid base of folks who know about PrEP, but it's still not a topic the country as a whole knows about."

GROWTH POTENTIAL

As a preventive measure, the blue Truvada pill is taken once daily. Some people experience nausea, vomiting or headaches during the first few weeks on the drug.

Users must be tested every three months to ensure they don't have HIV or other sexually transmitted diseases and to monitor kidney function and bone density.

Some Medicaid programs and most private insurance cover the treatment, which lists for $1,500 a month before any negotiated discounts. With greater awareness and favorable coverage for preventative treatments, the number of Americans using Truvada could rise, said the company and healthcare providers.

An estimated 50,000 new U.S. HIV infections are diagnosed each year.

The CDC estimated in 2015 that about 1.2 million Americans were at substantial risk of HIV infection and could benefit from PrEP.

That includes men who have sex with men, transgender women who have sex with men, partners of people who are HIV-positive and intravenous drug users who share needles.

The number of high risk groups "is much broader than one might think," said Dr. Jennifer Childs-Roshak, president and CEO of Planned Parenthood League of Massachusetts. "It is not just men with multiple partners. There are a whole host of folks who could benefit."

At least 15 patients have gone on Truvada for prevention since Planned Parenthood's six Massachusetts clinics began offering it this fall. Planned Parenthood of New York City plans to offer the treatment to all of its 50,000 patients, said Julia Sullivan, associate director of quality management.

Wider use also could buffer Gilead when Truvada, the only drug currently approved in the United States for PrEP, loses patent protection in 2021. Gilead has a successor treatment in the works. The once-daily F/TAF (emtricitabine/tenofovir alafenamide) has been approved for HIV treatment and is under study as a preventative.

"PrEP is indeed a significant part of Truvada," said Leerink Partners analyst Geoffrey Porges. "It can certainly keep Truvada relatively flat but the key question is, when will they show that TAF works for PrEP?"

In the meantime, the concept of taking an HIV drug to prevent infection is making inroads in popular U.S. culture. It came up in an episode of "Transparent," the Emmy award-winning Amazon series about a family with a transgender parent, when a character was contemplating sex with an HIV-positive partner.

"We were trying to make the conversation reflect what happens in real life," said a writer on the show who works under the name Our Lady J. "PrEP is a big part of that conversation. As an HIV positive person, I'm struck with the level of ignorance around PrEP."

(Reporting By Jilian Mincer; Editing by Michele Gershberg and Lisa Girion)