AIDS Action Committee’s Blog

At AIDS Action, I let people know about HIV treatment advances and new approaches to prevent the spread of the virus. As exciting as these developments can be, it’s also essential to recognize the critical importance of support services for persons living with HIV.

There is extensive evidence that a person’s housing status – whether stably housed or homeless – has a huge impact on their health. The latest addition to this growing body of research is a special supplement to this month’s AIDS and Behavior journal. The supplement contains 18 peer-reviewed articles focusing on the relationship between housing status and a range of HIV-related health outcomes.

Several of these studies found that having stable housing reduces the likelihood that persons will engage in behaviors – such as sharing needles, having unprotected sex, or exchanging sex for drugs – that place them at high risk for becoming infected with HIV or transmitting the virus to others.

A group of Canadian researchers reviewed nearly 30 studies evaluating the effects of housing on health-related outcomes. These studies showed that, in addition to reducing risk behavior, stable housing helps HIV+ persons:

• Enter medical care and remain in care
• Access social services, including mental health and substance use programs
• Take their medications more consistently (better adherence)

Researchers in Chicago and San Francisco have found that programs providing stable housing for chronically homeless persons significantly reduce the number of emergency room visits and hospitalizations, as well as the length of time people spend in hospitals or nursing homes.

Taken together, these studies support the contention that housing itself independently reduces the risk of acquiring or transmitting HIV infection and improves the health of persons living with HIV.

“The findings reported here suggest that the condition of homelessness, and not simply traits of homeless individuals, influences risk behaviors and health care utilization,” according to Dr. Angela Aidala of the Columbia University Mailman School of Public Health. “This points to housing as a strategic target for intervention – a potentially exciting new tool to end the AIDS epidemic in America.”

Well it seems the evangelicals have finally found a way to bring AIDS into their special fold of Christian charity—they skip the part about gay men. Apparently, if AIDS is contracted by drug use or unsafe sex between heterosexuals, or better still a transfusion or perhaps maternal-child transmission, God not only permits but encourages ministering to its victims. And, there’s the international waiver—if you’re outside the USA, preferably in some poor benighted African country, it doesn’t matter how you contract it. There’s room for all in the fold. But there still doesn’t seem to be any room at the inn for gay men in the United States.

Sadly, that seems to be a pretty accurate description of this administration’s position as well. Restrictions on proven interventions have essentially read the gay community out of prevention efforts and have resulted in–drum roll please–an increase of infections in gay men! Of course I’m sure that when the CDC does finally, officially, release its increased estimates of annual HIV infection we won’t hear anything about that—but I predict there will be much conversation about the refusal of gay men to abandon their “ways” and significant hand-wringing over their unwillingness to become heterosexuals. Unspoken, perhaps, will be the phrase “Serves them right,” but many of us will hear it nonetheless.

A week after saluting our fallen soldiers on Veterans Day, and days before food and football feasting on Thanksgiving, we honor and reflect on our murdered transgender brothers and sisters on the International Transgender Day of Remembrance (TDOR) on Nov. 20.For some, it’s a day on the calendar. For me, it’s a day of vivid, visceral feeling because I know one thing: that on any day of any year, as a transsexual Latino man, I could be among those killed. I could, like too many others—remembered or forgotten—be attacked by someone with no regard for my life, someone who may not face responsibility for his or her brutal act of violence. TDOR remembers our dead and celebrates our lives.

The penalties for killing or firing someone like me are topics of debate in the halls of Congress, in the media and at people’s dinner tables. It’s troubling to realize that the protections most of us take for granted must be justified for the transgender community—we must convince people of our humanity. Those attitudes are humbling in their cruelty and destructive potential.

When I was five, I told my parents that I was “born wrong.” I didn’t have other language for it, but I knew I felt like a boy, despite being born female. My mother embraced me and showed me a magazine cover featuring Christine Jorgensen, then the most visible transsexual woman. She held me and told me it would be okay. Like every mother, I’m sure that she wished her embrace could protect and keep me safe in the world. But it couldn’t and it can’t.

In the trans community, experiences like mine are rare. Life has treated me gently and kindly. I was dually socialized. Mom gave me lessons for girls. Dad gave me tools to be a wise gentleman. I studied hard, enjoyed people, sports and music and built a successful career. I’ve reached my 50th birthday. So many of us are murdered well before our prime. That’s humbling, too.

In 1998, a transgender woman named Rita Hester was murdered in Massachusetts—a crime that remains unsolved. It was in Rita’s honor that Gwen Smith of San Francisco began a tradition of taking a day to reflect upon the lives lost to hate violence, which is today known as the Transgender Day of Remembrance. I sat with Kathleen Hester, Rita’s mother, at Boston’s TDOR. I gained the courage to endure the pain of lives mercilessly taken when I saw her eyes and heard her speak of Rita with love and longing.

While I spent the first part of my career in Fortune 100s, the second is about social justice and healthcare access. Today at AIDS Action and the AIDS Action Committee of Massachusetts, I take on the thinking that trans people are less than human, undeserving of the rights and access to which other people are entitled. I challenge health insurers with policies that explicitly deny trans people coverage. I fight to eradicate discrimination against trans people in employment, public accommodations, credit and housing. And I battle the ignorance and fear that puts our community at risk of violence. Murder is the most blatant expression of hate and intolerance toward transgender people. But there are subtler forces at play that slowly do harm to the lives of transgender people—discrimination and stigma.

We transgender and transsexual people rely on each other, on allies, on biological or created families, and on society’s rules to embrace us. TDOR allows others to stand beside us and to mourn those we have lost. Each year, I spend TDOR with Ethan St. Pierre, a trans activist, web radio host, and nephew of Debra Forte, another murdered transgender woman. For us, it’s personal.

My work gives me a unique perspective on policy’s impact and people’s power. There is hope—small victories matter. This year, the Italian Parliament will recognize TDOR, following the election of its first transgender member, Vladimir Luxuria. For the first time, both houses of Congress have approved a fully-inclusive hate crimes law that would expand protections to cover violence based on a victim’s sexual orientation and gender identity.

This year there were 63 TDOR vigils in seven countries. Take the time to educate yourself about the issues surrounding TDOR. Your support matters. More information on TDOR is available at www.RememberingOurDead.org. Showing your humanity affirms that we are equally human.

Last year, the Commonwealth passed a law that requires all residents of Massachusetts 18 and older to have health insurance, if an affordable plan is available to them. Everyone must be signed up for coverage by December 31, 2007 to avoid financial penalties.

This means the deadline to sign up for coverage is quickly approaching. Because coverage for most insurance plans begins at the beginning of the month, the state is encouraging all eligible citizens to sign up for plans by November 15, 2007. Since it usually takes a few weeks to process an application, the 11/15 date should ensure that people are covered sometime after 12/1/07 but well before the 12/31/07 cut off date.

Massachusetts will be enforcing this law through personal income taxes. People will be given a special form with their state income tax form to prove that they had coverage as of December 31, 2007. The penalty for non-compliance is the loss of the personal income tax exemption, which is about $219.00. Beginning in January of 2008, the penalty will go up. People will be fined for every month they do not have coverage.

To get help figuring out if you need insurance, what kind of insurance you can get, and how much that may cost you, check out these resources:

More information from AIDS Action
The Health Connector customer hotline: 1-877-MA ENROLL (623-7655)
The Health Connector website: http://www.mahealthconnector.org/
Health Care For All health reform hotline: 800-272-4232