Posts Tagged ‘physician’
Thursday, December 29th, 2016
Here’s some news that might make our transition into the new year a little more satisfying.
Richard Larison, the embattled chief executive officer of Chase Brexton, Baltimore’s largest provider of health care to the city’s most vulnerable communities, has resigned after months of upheaval and staff discontent. It is a clear victory for community activists who have demanded his resignation, even while more work must be done to reform the agency.
Larison, who began his tenure in 2012, has chosen not to renew his contract. His last day as CEO is December 31st. He will remain in an “advisory role” while an executive search is conducted.
Staff and community confidence in Larison suffered from his efforts to block an employee unionization effort in early summer, leading to his firing of five management level employees. The dismissals were largely viewed as an act of intimidation to dissuade employees from voting to unionize.
Chase Brexton employees answered management’s resistance by voting overwhelmingly to join United Healthcare Workers in August.
The manager firings outraged LGBT community activists, culminating in protests at Chase Brexton’s Mount Vernon location and at the annual Chase Brexton Charm Ball, where an event patron was thrown out after speaking to protesters.
Of greatest concern to community members was the expertise in LGBT issues, including HIV care and transgender care, that was represented among the dismissed employees. Several of them had enjoyed long and distinguished careers with the agency, which was founded in 1978 as a STD clinic primarily serving gay men.
“I am deeply concerned about Chase Brexton’s commitment to the LGBT community,” said longtime community activist and Chase Brexton patient Doug Rose, who has been among the most vocal critics of Larison’s leadership. “As a result of the manager firings, hundreds of LGBT clients have had to find new providers, including transgender clients in the midst of their transition process. It doesn’t look good.”
A Chase Brexton statement about Larison’s resignation heralded his accomplishments while leading the agency, including the creation of their LGBT Resource Center. Ironically, Bethany Henderson, a program manager in the LGBT Resource Center, was among the managers fired during the union organizing conflict.
Joseph Lavelle, the recently hired interim president of operations, will handle day-to-day operations at Chase Brexton while the organization conducts its search for a new CEO.
Advocacy efforts to “save Chase Brexton” are not over, however. “The CEO’s departure is a welcome first step,” wrote Emily Sachs, wife of fired manager Jill Crank, in a Baltimore OUTLoud editorial this week, “but until Chase Brexton leadership can demonstrate an unqualified commitment to integrity and responsible management, we will call on federal grantors, elected officials, and donors to withhold funding and shift their support to other organizations with the capacity to better serve our community.”
Ongoing advocacy to make certain the Chase Brexton Board of Directors remain true to their mission will continue into 2017. But all of us involved in the efforts of the last year should take heart in victories along the way. And there’s no doubt in my mind that a man is cleaning out his office right now because of the united, powerful voices of Chase Brexton patients and allies.
Job well done.
Thursday, December 15th, 2016
Image detail from AIDES France Révélation campaign about being undetectable.
“We are not dirty, we are not a threat, and we are not disease vectors. In fact, we are the solution. People living with HIV who achieve viral suppression, who become undetectable, are the solution to the end of new HIV infections in the United States… When we look back 20 years from now we’re going to judge ourselves in terms of how well we responded to this opportunity.”
— Dr. Rich Wolitski, person living with HIV and Acting Director for the Office for HIV/AIDS and Infectious Disease Policy at the U.S. Department of Health and Human Services
When Dr. Wolitski delivered his speech at the closing plenary of the 2016 United States Conference on AIDS (USCA), he received a standing ovation. He was referring to this year’s newest findings of HPTN 052 and the PARTNER study, which showed that people living with HIV who are undetectable are not transmitting the virus to their negative partners.
How wonderful that something many of us have assumed for years has been proven to be true. So now we can spread the news and encourage people with HIV to seek treatment and stick with it. And hey, there’s nothing like a little intercourse a la natural with your partner to reward yourself for being undetectable, am I right?
Not so fast. There is some strong resistance to a message that equates undetectable to untransmittable, and it’s not coming from where you might think.
Here are five reasons why this breakthrough message matters.
1. The science is solid.
The PARTNER Study has recorded 58,000 acts of penetrative sex without condoms between 1,000 positive/negative couples, in which the HIV positive partner had an undetectable viral load. There were no infections between the couples. Not a single one. The same results were reported in the HPTN 052 study and the empirical evidence to date. As Dr. Wolitiski said in his USCA speech, “this is a game-changing moment in the history of the HIV epidemic.”
Resistance to the conclusion that undetectable people pose no risk of infection has been either a matter of scientific data scrutiny or a fear that people may not actually be undetectable when they think they are. Let’s break that down.
A review of the argument against saying “zero risk” is enough to make you cross-eyed. It is based on the premise that nothing, really, is without risk. Detractors of the non-infectious message will calmly explain the perils of placing any risk at zero and then hypnotize you with statistical origami. Suffice it to say that proving zero risk is statistically impossible. You risked electrocution by turning on your device to read this article.
There will always be somebody who claims a terminally unique HIV infection, even if the precise circumstances of their claim may be murky. Weird things happen. Some folks are convinced that people who drink alcohol sometimes spontaneously combust. But you don’t see warning labels about it slapped on every bottle of Wild Turkey by overzealous worrywarts.
And yes, there is the possibility that someone might develop a viral load if they are not adherent to treatment and then transmit the virus. But the message here is that people who are undetectable cannot transmit HIV. If you stay on treatment and are undetectable you will not transmit HIV. Can we please celebrate this simple fact without remote qualifiers?
It is also important to note that a Canadian consensus statement concluded that any “viral blips” or sexually transmitted infections (STIs) were “not significant” to HIV transmission when someone is undetectable.
2. Major health experts are on board (but not all community leaders).
Public health leaders, from the New York Department of Health to the National Institutes of Health (NIH), have embraced these findings and its meaning to people with HIV, while community advocates and organizations have been reluctant to get on board, citing a theoretical risk of infection. Or maybe they consider changing their fact sheets and web sites an enormous bother.
The Prevention Action Campaign and their seminal message “U=U” (undetectable equals untransmittable) was founded on the energetic efforts of a man named Bruce Richman. He entered the HIV advocacy scene a few years ago, seemingly out of nowhere, carrying aloft the banner of undetectability. Richman gathered signatures of health experts the world over for a consensus statement about the research, while cajoling every U.S. HIV organization in sight to adopt language that removes the stigma of infectiousness from people who are undetectable.
My review of the web sites and statements from major HIV organizations includes no strong language about undetectable people not transmitting HIV. Worse, some exaggerate the risk from those who are undetectable. How could such a new research breakthrough be met with such ignorance and apathy by our own leaders? I will defer shaming anyone by name while they take a little time to update their official language. (Notable exceptions to this sad rule include work going on in the United Kingdom and France that flatly states that undetectable means non-infectious.)
This skepticism from our own community reduces people with HIV, again, to a problem that must be managed. It suggests that those of us who have achieved undetectability don’t have the judgment to keep taking our medications or to see our physician regularly to be sure our treatment plan is still effective. It keeps us in the role of untrustworthy victims unable to make decisions that will keep the rest of you safe from us. What infuriating, stigmatizing nonsense.
3. This is about HIV. Only HIV.
Auxiliary issues often creep into this debate that may be well-meaning but only muddy the waters, such as the fear that promoting the message of non-infectiousness will lead to more sexually transmitted infections (STIs) because of the freedom it allows (see also: critics of PrEP, the birth control pill, and any other vehicle that might lead to unbridled sexual pleasure).
Rates of STIs — which were on the rise before the advent of PrEP or news from the PARTNER Study — are deeply concerning but ultimately tangential. We are in desperate need of comprehensive sexual health programs, to be sure, but in this instance I feel compelled to “kill the alligator closest to the boat.” This is about being HIV undetectable, not syphilis impermeable. Being undetectable will not prevent other infections or address promiscuity or remove stubborn stains.
Advocates are also sensitive to the continued compartmentalization of our community, between those who are positive or not, who is on PrEP or not, and now, between those with HIV who are able to achieve viral suppression and those who cannot, despite their best efforts. I sympathize with this new divide among HIV positive people but believe the greater good – removing shame and stigma from those who are not capable of transmitting – shouldn’t be downplayed. All HIV positive people of good will can and should celebrate this development, regardless of their own viral load.
4. This is a major victory for HIV criminalization reform.
Terribly important work is being done to repeal and reform HIV criminalization laws that prosecute people with HIV for not disclosing their status to a sexual partner. Our defense is often led by all of this growing science showing that the defendant never posed a risk to their partner in the first place, due to their use of protection or the fact the defendant was undetectable and therefore rendered harmless.
Continued assertions that undetectable people might pose a risk to others could be used in the courtroom against people with HIV. Imagine the glee with which prosecutors might explain to a jury that “zero risk” is impossible and defendant Joe Positive posed a threat, however small, to his sexual partner and should be jailed for it. Put obscure doubts into the heads of a jury, and another person with HIV gets a 30-year sentence for daring to have sex at all.
5. This profoundly changes how people with HIV view themselves.
Internalizing the fact that I cannot transmit HIV to anyone has had an effect on me that is difficult to describe. I can only liken it to the day the Supreme Court voted for marriage equality. Intellectually, I knew I was a gay man and a worthy human being. But on the day of the court’s decision I walked through the streets of my neighborhood with my head held higher. Something had changed. I felt whole.
In my thirty-five years living with HIV, I have never felt exactly that way. I deserve to. And so do millions of other people with HIV.
Of all the arguments to adopt the message that undetectable people cannot transmit HIV, that enhanced feeling of self-worth may be the most important reason of them all.
(And now, only days after the posting of this piece, Housing Works has become the first HIV organization in the U.S. to come out explicitly with a #UequalsU message. It is just the kind of leadership I have come to expect from Housing Works.)
Have you seen the My Fabulous Disease Holiday Spectacular? I love to share it each year, just like the Grinch and Charlie Brown television specials. Not only does this video blog have Santa and cookies and even a touch of drag, it introduces you to most of my family, who discuss candidly what it has been like to love someone living with HIV. You’ll laugh, you’ll cry, it’s like a warm visit home. Check it out on Youtube here.
Tags: advocacy, aids, barebacking, criminalization, culture, gay, hiv, physician, politics, PrEP, research, serosorting, Sexuality, stigma, testing
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 8 Comments »
Thursday, December 8th, 2016
The making of the new short documentary, HIV Criminalization: Masking Fear and Discrimination, began in exactly the right place: with people living with HIV themselves, and their personal stories of being prosecuted because of their HIV status.
Sean Strub, founder of The Sero Project, had taped interviews with nearly a dozen people from across the country who had been accused of violating State statutes about HIV disclosure. Some had served time. One of them is in jail, serving a sentence of thirty years.
It was my privilege to assist documentary filmmaker Christopher King (no relation) in creating this short film, with the interviews with people with HIV as a starting point. Masking Fear and Discrimination is an excellent primer on the issue. Please watch it.
HIV criminalization feels very much like unfinished business for me as an HIV advocate. How in the world can we turn our backs on those who face jail time because they live in a society in which they are so feared and stigmatized that they find it difficult to disclose their status to their partner? And if they pose no risk to their sexual partners – because they are not having risky sex, or are using protection, or are undetectable and therefore non-infectious – why are there laws commanding them to disclose their status anyway?
People often have a visceral reaction to this issue, and I get that. But the more people know about the way in which these laws are being applied – as a tool of racism and homophobia, and to prevent people with HIV from daring to have sex at all – then the more likely they are to support the repeal of these laws.
Watch the film. Decide for yourself. And please share your views.
Thanks for watching, and please be well.
Masking Fear and Discrimination was made possible through the support of the H. van Ameringen Foundation, Broadway Cares/Equity Fights AIDS, the Elton John AIDS Foundation, and the Gill Foundation.
The short film features Cecilia Chung, SERO’s board chair and senior strategist at the Transgender Law Center (San Francisco, CA), Venita Ray, attorney and advocate at Legacy Community Health Services (Houston, TX), Anthony Mills, MD (Los Angeles, CA), and Justin Rush, director of public policy at the True Colors Fund and formerly a manager of policy and legislative affairs at the National Alliance of State and Territorial AIDS Directors (Washington, DC).
Tags: advocacy, barebacking, criminalization, culture, hiv, physician, politics, research, serosorting, Sexuality, stigma, testing
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 1 Comment »
Monday, November 28th, 2016
In the towering new novel Christodora, author Tim Murphy harnesses decades of personal and professional experience as an HIV journalist into a story that sweeps back and forth between the last several decades and beyond. It has the scope of great literature, but Christodora is also a deeply personal chronicle from a man who knows his terrain.
The book’s namesake is a century-old apartment building in New York City’s East Village, silently weathering the indignities of time, economics, and social change that is mirrored in a host of characters connected to the building through the years. They include a privileged young couple, both of them artists, their adopted child, revelers of the gay dance clubs in the village, social activists and fledgling health department professionals. Since the story takes root in the 1980s, we know our characters are poised to confront something they can never imagine.
Yes, there are AIDS horrors here, of the multitudes who die around the edges of the book’s pages. But Murphy’s lens is more interested in close-ups, in the intimate impact of calamity, in various forms, on the lives of his characters. He also writes with the distance and maturity to know that AIDS wasn’t the only crisis in town for New Yorkers during this period, and even within it, AIDS greedily intersected with numerous other social ills and personal struggles.
With hardly a false move, Murphy glides effortlessly among the worlds of addiction and recovery, the academic art scene, AIDS activism, and the darkened corners of mental illness.
It is a gift for any writer to find the interior voice of a character – the cyclical doubts and fears, the ongoing internal debates in which we all engage that propel our lives and choices – and so it is with Murphy, who has multiplied the feat by populating the novel with an astounding number of flesh-and-blood people who behave with all the faults and courageousness that humanity allows.
Murphy is coy about providing too many historical names and places. The inner workings of ACT UP and its more establishment-friendly offspring, Treatment Action Group, are dramatized at great length but the groups are never mentioned by name. It releases Murphy from the job of shackling his story to actual people and organizations; this is not historical autobiography in the vein of Sean Strub’s Body Counts or Cleve Jones’ upcoming When We Rise. The emerging AIDS activism scene is portrayed, Murphy has us feel, because some of his characters happen to be there. They come first.
That said, anyone familiar with the gay New York City scene from this era will enjoy the parlor game of spotting the real people who inspired several major characters. Some are transparent, others not. Christodora had me Googling the names and affiliations of my guesses more than once.
The most searing passages in Christodora deal with the wreckage of drugs and those engulfed by them, calibrated for maximum heartbreak. For any of us who turned to substance abuse during or after the plague years, who live with the confusion and guilt of having survived a public health emergency only to surrender ourselves to small baggies of crystalized catastrophe, Murphy knows us, and he intimately (and sometimes explicitly) offers us front row seats to the destruction of major characters. The brutality of addiction cannot be divorced from the story of AIDS.
Christodora even has the audacity to look beyond the present, providing glimpses into years we have not yet seen. Audacious, because Murphy knows there is no AIDS survivor among us who hasn’t considered what lies ahead, as the crisis years continue to fade from view, and he delicately provides an answer that is rooted in the personal destinies of his characters.
Ultimately, Murphy glides the reader to a gentle landing spot. After all the fury of AIDS activism, broken families and lifelong resentments, the flawed and sometimes flailing characters of Christodora are provided with a lovely parting gift. To all of this rancor, Murphy calls a kind of merciful truce.
The final notes of charity in Christodora are all the more bittersweet given they were written by an HIV journalist who, one suspects, longs for moments of healing grace every bit as wistfully as we do.
(Christodora would make an ideal gift to yourself for this World AIDS Day, or a great Kindle stuffer for someone you love – or for someone who could use a better understanding of the impact of these last thirty years. Check it out on Amazon here.)
Tags: A Place Like This, advocacy, Aging, aids, culture, gay, hiv, meth, physician, politics, recovery, Recreation, research, Sexuality
Posted in Book Review, Gay Life, Living with HIV/AIDS, Meth and Recovery, My Fabulous Disease, News | No Comments »
Tuesday, September 27th, 2016
The Centers for Disease Control and Prevention (CDC) has produced a music video that joyfully educates gay men about HIV prevention options. And it is foot-stomping fabulous.
The song, “Collect My Love,” was released by The Knocks and it features vocals by Alex Newell, the young gender-bending singer who rose to fame by stealing season three of the television series, Glee (his rendition of “Boogie Shoes” on that show is a one-way ticket to my happy place).
In the CDC music video released today, Newell performs the song in a crowded, gay-friendly dance club. The atmosphere is ebullient and cruisy, with gay men making connections left and right. That’s where HIV prevention comes in.
Gay couples meeting at the club are shown later, as their relationships develop. There is a condom negotiation, a man shown taking PrEP, and even a character who discloses he is HIV positive and undetectable. The CDC has filled the video with every prevention method available, and they do it in a sex-positive, non-judgmental atmosphere. The video was created as part of the “Start Talking. Stop HIV.” campaign that reaches out to men who have sex with men (MSM), particularly African-American and Latino gay men.
In an exclusive interview with Alberto Santana of the CDC’s Division of HIV/AIDS Prevention and Manny Rodriguez, part of the creative team at agency FHI360, both men made clear that solid research was their guide.
“This is an authentic campaign,” said Rodriguez, “with gay men involved in both the campaign staff and creative team. Our goal was to marry CDC research with something that is accessible and enjoyable to watch.”
“We know that having conversations about HIV can increase good health outcomes and strengthen relationships,” said Santana. “We also wanted to playfully connect to pop culture. We are putting out important information, and doing it outside the normal means.”
The CDC is exceedingly careful to provide scientifically accurate messages, but has certainly never delivered these messages in such an innovative and entertaining way. The video incorporates both PrEP and the fact people with HIV can become undetectable — two important and often misunderstood issues being heavily discussed among the gay community right this minute.
The men featured in the video are youthful and attractive, but blessedly, they look like young men you might actually meet in a club, not unattainable icons from the pages of Men’s Fitness. In fact, there’s a plus-sized bear seen tearing up the dance floor who walks away with the video during his few seconds on camera. In my mind’s eye, that jubilant, self-possessed man is not going home alone.
Sure, the world conjured in the CDC video may not reflect all interactions among gay men as we know them to be. Stigma and judgment still exist and are practiced nightly in clubs throughout the country. But I wholeheartedly support this alternative, aspirational world, where gay men live joyfully and play responsibly. That’s the world I want to live in.
The video will be shared on social media and through CDC’s community partners. But why wait? Check it out, and share it with your networks. Discuss it. Start a conversation about the ways we can protect ourselves and our community.
And put on your dancing shoes.
Tags: acting, advocacy, culture, gay, hiv, physician, PrEP, Recreation, research, serosorting, Sexuality, stigma, testing
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 4 Comments »
Thursday, September 22nd, 2016
Amidst the happy haze of good news about the efficacy of PrEP in preventing new HIV infections and the growing consensus that people living with HIV who are undetectable are not infectious, there is troubling news from the CDC in two new reports about the golden oldies of sexually transmitted infections (STI’s): rates of syphilis are on the rise and antibiotics to treat gonorrhea may be nearing the end of their usefulness.
The news underscores a simmering tension between those of us who celebrate the lowered risk of HIV infection – and the diminishing role condoms might play in HIV prevention during this new era of PrEP and being undetectable – and the rise in reported cases of syphilis and gonorrhea. And I don’t mind being the first to call myself out.
RETHINKING MY GONORRHEA NOSTALGIA
In my cheeky post from last year, “My Gonorrhea Nostalgia,” I argued that what was once a simple rite of passage for many gay men – finding yourself at a clinic with the clap – has been judged and scorned so harshly these days that it has “raised the bar” on what we consider to be acceptable gay sexual behavior. From that piece:
When did avoiding every possible STI become the new goal for gay sexual behavior? Syphilis, chlamydia, and gonorrhea are all easily treated and cured. Scary campfire tales of a spreading superbug impervious to all treatment have failed to materialize. The very idea of getting The Clap again just makes me feel nostalgic.
No longer is avoiding HIV the prime objective; we must also now use a condom every time so that we are never exposed to, well, whatever. How many hoops must we jump through in order to fuck in a pleasurable way? We can’t win for losing.
While I stand by the basic tenants of my rant – gay men are held to a higher standard because we are viewed as sexual outlaws – new data runs counter to my assertion that STI’s are “easily treated and cured.”
“If current trends continue, strains of gonorrhea could become resistant to all available antibiotics, putting the 800,000 Americans who contract the sexually transmitted infection (STI) annually at risk of an untreatable case,” writes Ben Ryan for POZ, citing a new CDC report. He goes on to explain that at least one cluster of gonorrhea cases has begun to evade our current treatment arsenal and that’s why the CDC is sounding the alarm about it.
While gonorrhea remains universally treatable, there is evidence of a weakening of current treatments, and there are no other approved medications in the wings. Should untreatable strains begin to circulate, we may soon find ourselves without an effective solution, although a new drug in clinical trials is showing some promise.
Meanwhile, yet another new CDC report, this one charting syphilis cases by State, reinforces data that syphilis cases have spiked 15%. In the State-by-State comparison, a CDC graph shows the largest increases are mostly located – you guessed it – in the South (congrats on your win, North Carolina, although your victory is a hollow one since Georgia, the perennial favorite State for syphilis, is not included for lack of reporting data). The data also indicates an increase in syphilis diagnosis among gay men that has persisted since the year 2000.
It isn’t clear from the CDC report whether an increase in syphilis screening might account for the increase in reported syphilis cases. But still. “Although we have been treating syphilis effectively with penicillin for decades,” said CDC epidemiologist Cyprian Wejnert, the presenter of the screening data, “the risks of not being treated include visual impairment, damage to the nervous system, and stroke.”
TWO HIV ADVOCACY CAMPS OFTEN AT ODDS
And herein lies the tension. There are two distinct schools of thought on modern gay sexual politics and HIV, and too often they are loathe to overlap.
First, there are those, like me, who are thrilled that after a generation of mortal fear there are now ways for us to have pleasurable sex without condoms that does not pose a risk of HIV infection. It is just that sense of liberation that has propelled much of my writing, such as “Your Mother Liked It Bareback,” and it has led to a welcome increase in conversations about the value of sexual pleasure.
And then, there are those who have been more cautious, pointing out the risk of STI’s in general and among those using PrEP in particular. This has led to some acrimony. POZ science writer Ben Ryan, who has written quite a lot about PrEP, was blocked from the highly influential “PrEP Facts” Facebook page earlier this year for not adhering to group guidelines. Ryan had previously posted numerous articles that have taken a more circumspect view of PrEP or have reported on the prevalence of STI’s, and his work continues to be posted and discussed in the group.
The new CDC articles on gonorrhea and syphilis do not correlate the increase in STI’s to those using PrEP or to those who may have eschewed condoms because they are HIV undetectable. But that doesn’t mean that people on both sides of a widening chasm between the cautious and the sex-positive won’t try to score points from the CDC report or attempt to dissect its accuracy. Advocates trying to adhere to a singular message can be touchy. Been there, wrote that.
As for me, I’ll switch to the combination platter, thanks. While I will continue to celebrate the breakthroughs that have given us more options to “fuck without fear,” as the notable and quotable PrEP advocate Damon Jacobs likes to say, I’m going to dial back my cavalier posture about the risk of being infected with an STI. In light of mounting data on STI’s, some of my own past writing makes me cringe.
The only constant in the world of HIV is change. I remember when taking an HIV test was politically incorrect, when I took AZT every four hours and, more recently, when I believed a simple case of gonorrhea was worthy of clever mirth. I’ve had an attitude adjustment.
While catching the clap might have once been an amusing rite of passage to me, it can have real and very serious consequences for someone else.
Tags: advocacy, aids, barebacking, gay, hiv, physician, politics, PrEP, research, serosorting, Sexuality, stigma, testing
Posted in Gay Life, Living with HIV/AIDS, My Fabulous Disease, News, Prevention and Policy | 1 Comment »
Monday, September 19th, 2016
When this blogger chose to join protesters at Chase Brexton’s annual “Charm Ball” to voice concern over the direction of Baltimore’s largest healthcare provider to the LGBT community, there was little doubt there would be some tension at the elegant affair.
Sure enough, urgent concerns were ignored and belongings were policed. There were stern warnings from security and more than one intimidating confrontation.
And that’s only what happened between Chase Brexton and their own guests. Really. The organization can’t seem to make a gracious move these days, even on their most elegant night of the year.
About thirty protesters, most of them patients of Chase Brexton, gathered outside Baltimore’s Railroad Museum on Saturday night, waving signs to cars as they entered a private parking area. As guests made their way toward the entrance, protesters called out “Rehire! Reform! Replace!” in reference to rehiring the five managers who were fired in an effort to intimidate remaining staff out of joining a union, and to replace CEO Richard Larison for creating an atmosphere of embarrassment and distrust at the health center.
Soon, event organizers installed a black paneled curtain to partially block the guests’ view of protesters. It was a terribly ironic sight, watching Chase Brexton’s attempt to literally blot out their own patients from view, but we’re dealing with an agency that has been tone deaf to community concerns for many months now.
Itta Englander, a Baltimore City resident who attended the event with her wife, had donned a lovely black gown for the Charm Ball, and even indulged in high heels, despite her pregnancy. She wanted to look great for her wife and for others at their table, all of whom were associated with a company that donates to Chase Brexton.
“I’ve been reading about what has been going on with the firings of managers there,” Englander said in an exclusive interview. “We saw the protesters when we were driving in, and I wanted to talk to them. I know the situation has been really, really tough.”
So, after being seated at her table and enjoying some of the program, Englander strolled out of the venue to have a chat with protesters. She listened to the concerns of several patients and met the wife of fired nurse practitioner Jill Crank, who spoke emotionally about the personal toll of the firings. Englander accepted a few printed flyers about the controversy and took some baked cookies to share with her table.
Those few minutes, and her sympathetic chat, would have harsh consequences.
When she attempted to re-enter the Charm Ball, Englander was stopped by organizers. “They wanted to know my name and my table number and see my ticket, all of which I produced. Then they said I was a ‘disruptive influence’ and they would not let me back in.”
Itta Englander was treated as if her time with protesters had exposed her to something terrible, a fast-spreading stomach virus perhaps, and nothing short of immediate quarantine would protect the other guests from heaving their soup course onto reams of black taffeta.
Without her phone or car keys, Englander asked that word be sent to her wife that she had been barred from coming back inside. That’s when event security decided to intimidate a second Charm Ball guest.
According to Englander’s wife, who asked not to be identified, security came to her table and removed her from her seat for a tense chat. She was told that Englander had attempted to re-enter the Charm Ball “with contraband,” and that she had “gone with the protesters.”
Englander’s wife could not have been more flabbergasted if she had been told that her partner had left the Charm Ball to join the traveling circus. But security wasn’t done with her. “They wanted to know if I was going to cause a scene,” Englander’s wife said, “and they wanted assurance I would not be disruptive before they would allow me to return to my seat. They never told me Itta was waiting for me outside.”
And yet she was. For more than thirty minutes, Englander uncomfortably stood in her heels on the sidewalk outside, waiting anxiously for her wife and finding nowhere to sit in her gown and rest. When she attempted to speak to Charm Ball organizers about her plight, they found her presence so noxious they literally turned their backs and walked away.
She eventually received help from the protesters, one of whom lent Englander a cell phone to contact her wife, who promptly came outside. The two of them left immediately.
“I know there are always two sides to an issue,” Englander said about her charmless evening, “but when one side is so guarded and paranoid, they just come off as unwilling to listen, and even uncivil — even to their own donors or people who are part of your core group. There were a number of ways the whole situation could have been handled better.”
There are few sights this blogger has witnessed in 30 years of HIV activism as outrageous as an organization literally constructing a curtain to hide their own, already marginalized patients from the view of donors. Or the smug smiles on their faces as they did it. I will not soon forget it, and neither should you.
It brings back memories of a generation ago, when HIV was new and ignorance was king, when fear and self-protection prevented the self-serving from hearing the facts of the matter, when the diseased unfortunates were hidden and ignored, when small-minded people simply turned their backs on needful voices.
But as has been clearly established, that kind of irony is lost on the leadership of Chase Brexton Health Services.
Thursday, September 15th, 2016
The five managers who were abruptly fired last month without notice by Chase Brexton, Baltimore’s largest healthcare provider to the city’s most vulnerable populations, met for lunch earlier this week. It was the first in-person meeting of the group since their dismissal in early August.
They traded job search updates and mutual empathy. A couple of them had tentative leads, but finding positions with an HIV or LGBT component, areas in which they are all uniquely qualified, has been a challenge.
They were hopeful during their lunch, sharing laughs and maybe a little gossip about their former employer, but the shock of the last month still registered on their faces. They all know they may never have the opportunity to serve the kind of clients they adored during their tenure at Chase Brexton.
During an internal battle this summer over an effort by their healthcare practitioners to unionize, Chase Brexton leadership did something unthinkable for an agency founded as a community clinic for gay men. They fired the five management-level employees, two of whom had worked for the agency for more than twenty years, in a transparent attempt to intimidate employees into rebuking the union. The cynical move backfired miserably when, a few weeks later, healthcare practitioners voted 87-9 in favor of joining the union.
The fired managers were Jill Crank, Catherine Fowler, Warren Conner, Bethany Henderson, and Ken Ruby. They received no severance pay beyond vacation days owed them. Their crucial expertise included serving LGBT people facing addiction, HIV, and medical issues surrounding gender transition. They all claim without hesitation that nothing in their personal records warranted their dismissal. None of their positions have been replaced.
During their lunch together, amidst moments of good humor, feelings of confusion and abandonment ran high. “I feel as if I have suffered a major loss in my life,” said Catherine Fowler. “In one moment my job, my team, my co-workers, my work with patients, was all taken away from me. It was a shocking, devastating event.”
“My initial reaction was to run away from Baltimore because I felt like I was being kicked out of my own LGBTQ community,” said Bethany Henderson. It has only been the support of her former staff, friends, and the community that has kept her spirits lifted.
Without exception, the former managers support the vote to unionize. But they know that these developments have lulled the community into a sense that leadership problems at Chase Brexton have been resolved – or that their personal struggles since being caught in the crossfire of the conflict will be forgotten.
“The biggest impact has been emotional, to be honest,” said Warren Conner, who met his husband at Chase Brexton during his twenty-year tenure there. The couple recently bought a new home, intensifying the urgency for Warren to find work. All of their life plans have been put on hold. “I’ve had a job since I was 14 years old. I have never not worked and being unemployed really plays with my self-confidence.” At lunch, Warren’s salad sat in front of him, untouched. “My anxiety has flared up quite a bit,” he explained.
Even with their personal trials, the impact on their former patients weighs heavily on the fired managers. “We cannot forget that the people who will suffer the most in the end are not those of us who were fired,” said Jill Crank. “It’s the patients who lost their most precious health care advocates.”
Since mounting a large protest in front of Chase Brexton’s Mt Vernon location after the firings, local activists, including many associated with a dozen LGBT agencies that signed an open letter critical of Chase Brexton leadership, have continued to discuss further activism. Their demands include the reinstatement of the managers and the removal of Richard Larison, the mercurial CEO largely viewed as the architect of the anti-union efforts. His four-year tenure, according to staff reports, has been littered with vindictive firings and a high level of distrust.
Whatever the outcome of ongoing community pressure for change at Chase Brexton, it may have little impact on five lives that are forever changed — and on those they served with heart and dedication.
“I am trying to see the positives in this experience,” said Catherine Fowler, “but at the end of the day it was a life-changing event that has been tremendously difficult.”
Posing for a photo together following lunch, the five former managers initially seemed unsure of the emotion they wanted to project. One or two smiled at first, and then thought better of it. A moment later, independent of one another, they all settled into strikingly similar expressions.
Their faces were unified in defiance and pride. Only their eyes, caught in the worry of an uncertain future, betrayed them.
Monday, August 22nd, 2016
TO: Richard Larison, CEO, Chase Brexton
FROM: Your Executive Assistant
RE: Five points about the recent unpleasantness
I know you’ve asked me not to disturb you when you are sealed in your hyperbaric chamber. Regrettably, it has been days since you have emerged and there are developments. (Note to self: throw something over Mr. Larison’s glass tomb before leaving office; the housekeeping staff is complaining again; use some of those stored AIDS Quilt panels Mr. Larison found “needlessly depressing.”)
Your termination of the five managers here at Chase Brexton appears to have had an unintended effect. Rather than frighten the indentured ungrateful uppity low-level employees into rejecting their own unionizing effort, the firings appear to have emboldened them. It would appear they do, in fact, have minds of their own. And this, only days before their vote to unionize on August 25th.
At the risk of upsetting you again (I have replaced your shattered “World’s Greatest Boss” coffee mug and cleaned the stains; my injuries were minor), allow me to enumerate five key developments of the last week.
1. A protest was held Friday. They don’t like us.
Since I don’t believe you can hear from within your sealed chamber (and if so, I swear to you that the existential cries of “why me?” and “what cruel hell is this?” were not coming from my cubicle), allow me to share the unsettling news that the protest against our union-busting efforts was spirited and well attended. It also included many members of the gay, lesbian, and transgender community for whom this agency was founded, which explains why no one in the executive offices has any idea who they are.
The media has caught wind of all this, I regret to say. Lots of stories that present our actions accurately in unfavorable light, including an Op-Ed in the Baltimore Sun by two of our own medical physicians (the doctors actually spill the beans on our efforts to limit doctor-patient time and cut salaries). A #SaveChaseBrexton web page with photo and videos exists, and the protestors and speakers look, well, empowered, although I know how you despise that word.
2. It appears we are screwing with the wrong people.
It was reasonable to expect that the recent terminations would be as uneventful as the past (two hundred? three?) firings during your four-year reign occupation tenure (I have prepared your weekly “Chopping Block” list; we can go alphabetically, pick someone at random, or I believe you enjoyed tossing darts at names). However, these recent firings appear to have galvanized employees, volunteers, and clinic patients alike.
The protest was attended by several elected officials, such as Maryland delegate Cheryl Glenn, who delivered a rousing indictment of our union-busting efforts. She also ended with a song that sounded communist to me; I can plant social media comments to that effect if you think it would be helpful.
3. Those union-busting advisors we hired might be actual criminals.
Yes, I know the three of you bonded over your shared love of hunting endangered species, but I have misgivings. It would appear that the two gentlemen who conducted our intimidation misinformation educational session about unions for employees, Martin Dreiss and Jon J. Burress, have faced charges between them ranging from fraud and conspiracy to embezzlement. I understand you find this endearing, sir, but we might consider avoiding these “union avoidance” fellows in the future. We have our own foggy legalities to negotiate, such as…
4. They found out we faked that letter to the patients of the nurse you fired.
You know that letter we sent to the patients of infidel sacrificial lamb nurse practitioner Jill Crank, making it look like she left all by herself and we totally, absolutely had nothing to do with it? Turns out people actually read the damn thing. They quickly deciphered the fact it wasn’t she who sent it, probably due to the multiple spelling and grammatical errors.
We’re not completely certain that faking a letter from Ms. Crank without her consent is precisely legal, but that ethical ship has sailed, I think you will agree.
Speaking of which, sir, may I add how delightful it is to conduct ourselves so freely, unmoored from complex concepts such as integrity or loyalty to Chase Brexton’s community legacy! This is all a direct result of your terrifying brave leadership, Mr. Larison.
5. Our new committee to “rebuild trust” has people laughing. A great deal.
Regrettably, the new President of Operations position you announced carries the moniker of POO, which is a fair assessment of the resume of this new hire, if we’re being honest. As vexing as you find the need for relevant experience, it appears that Mr. Joseph Lavelle, hired to smooth over staff conflict, has no LGBT-focused background, has no experience in a community-based clinical setting, and worked for gargantuan medical conglomerates that got sued a lot. But that’s not the funny part.
If you venture beyond your nesting place office, you may hear giggling coming from “the minimals,” as you call them. It seems that the staff email from Board Chair Carolyn Kennedy announcing the formation of an ad-hoc committee has been met with derision, if not sustained guffaws. The phrase “rebuild your trust” appears to be the big punch line. One might even say we are closing the barn door after the unfair labor practices horses have left, but I know you find popular expressions that do not end with “therefore improving our bottom line” to be most disagreeable.
Lastly, much of the attention now appears to be focused on removing you as CEO. Should this abomination occur, rest assured I will follow you, hyperbaric chamber in tow. You frighten me, yes, and you have single-handedly crippled our reputation throughout Baltimore, but my personal value system is so damaged I am actually willing to trust your stewardship despite all evidence to the contrary.
Which, come to think of it, would make me an excellent member of the Board.
Your Executive Assistant
(In the latest non-satiric news: Victory (for now)! The first group of Chase Brexton employees eligible to join the union voted on August 25 IN FAVOR of joining SEIU1199. And get this: the margin was 87 to 9. Moire than ever, it appears the tactics of management have backfired. Management will almost certainly attempt to contest the results, and this struggle may drag on, continuing to destroy the reputation of Chase Brexton. For the moment, employees have real reason to celebrate. They are unified. — Mark)
Wednesday, August 17th, 2016
There’s no way of saying this without it sounding like a humble brag, at best, so I’m just going to come right out with it.
My Fabulous Disease has won the prestigious “Excellence in Blogging” award from the National Lesbian and Gay Journalists Association (NLGJA). This is the second time my blog has been honored with this award, having won in 2014, the year the category was created. So if you’re keeping score, that’s two for three.
Evidently I’m too excited to do the humble part of the brag. My apologies!
The award is part of the annual Excellence in Journalism Awards, sponsored by NLGJA. They actually wield enormous influence, with members from outlets as varied as CNN to The New York Times to POZ Magazine and, well, little guys like myself. As stated in their press release this morning, “The NLGJA Excellence in Journalism Awards were established in 1993 to foster, recognize and reward excellence in journalism on issues related to the LGBTQ community.”
One of the judges had this to say in awarding My Fabulous Disease their honor:
Mark S. King is one of the few people still doing blogging in the traditional sense, and he does it quite well. There’s news, there’s context, there’s personal input and it’s compelling and accessible. For example, his coverage of the ways Charlie Sheen was discussing HIV were spot on and unrivaled and I was delighted to revisit it as part of his nominated material. King displays excellence in HIV coverage year after year.
But ultimately, this is really about you, my readers and those involved in HIV advocacy, because you are usually the topic of my writing. Whereas my blog was almost strictly personality-driven in its early years, I have enjoyed, more and more, shining a spotlight on the work of other people. Yes, I am still capable of an opinionated rant (and how I so love writing those), but it is clear to me that my blog’s success it tied to the work of people just like you.
Just as exciting is the fact that HIV coverage was well represented this year, across the map of categories.
Placing second in the Excellence in Radio award was an important story from Jim Burress of WABE-FM, “Fulton County Doesn’t Spend, Loses HIV Prevention Money,” about the misuse (or non-use) of crucial HIV prevention dollars.
The amazingly prolific Ben Ryan (the “nearly naked AIDS advocate” I profiled a few months ago), was awarded second place for his POZ Magazine piece, “When Can We Expect PrEP 2.0?” It’s a topic that is still very much on his mind.
“PrEP is a fast-moving train in the United States, with use rising dramatically in major cities,” Ben told me about his win. “It’s been exciting to cover the science behind this new prevention tool, from a molecular to a public health and sociological level. The news will likely keep getting better as new forms of PrEP hit the market in the future, offering a long-term injectable form and less toxic oral drugs. A major concern I have, however, is that PrEP is largely being used by white gay men in a select handful of major cities, such as New York, San Francisco, LA and Seattle. I anticipate that PrEP will effectively widen racial disparities in HIV rates in the coming years. If people wind up proclaiming victory due to a collapsed HIV rate among white gay men, what will happen to minorities? Will people lose interest in the HIV fight?”
Bisexual writer Heather Boerner (her sexuality bears mentioning, considering how “invisible” the B in LGBT can be) took top honors in the HIV/AIDS Coverage category, for her “Ongoing HIV Prevention/Treatment Coverage” for The Daily Beast and TheBody.com.
“I started my career in the LGBT press, writing for the now-defunct New York Blade,” Heather told me, “so to win an award from NLGJA is especially meaningful to me. But it’s also meaningful to me because the stories I submitted were all about HIV/AIDS, yes, but they weren’t only about HIV/AIDS from an LGBT perspective. I will say that there’s still so much to say and do and write about HIV–even more so now that more and more research is proving what some couples have known for years, which is that treatment really can prevent transmission, and there’s no reason to be afraid of the virus.”
Following Heather is second place in that category is Daniel Villarreal and Topher Williams for “‘Trust Him?’: Why Are The Images Debating PrEP Use So Consistently Shitty?” for Daniel’s site, UnicornBooty.com.
And in an embarrassment of hardware riches, I also won second place in the Feature/Editorial Writing category, for my POZ Magazine essay, “Surviving Life Itself,” chronicling my life as a long-time HIV survivor. That particular piece was a real high point for me as a writer, and I am grateful as always to editor Oriol Gutierrez for his shepherding of my work.
Let’s just consider this another opportunity for me to thank my literary colleagues, including many sites and editors who have supported the voices of people living with HIV.
Let’s keep speaking up, y’all.