COVID-19 is Exacerbating Existing Epidemics

By: Connie Reese, Founder & Executive Director, Simply Amazing You Are

As a domestic violence survivor, and advocate for survivors of domestic violence and intimate partner violence ("DV/ IPV"), it is important to recognize that people are less likely (and less able) to seek help. Isolation by an abuser or shame often prevent it. The COVID19 public health crisis has left even some of the longest standing integrated courts, designed to deal with protection orders and victim assistance, scrambling to cope with modernizing, introducing technology and restructuring interpreter services. 

In unincorporated Miami-Dade, DV/IPV cases increased nearly 20 percent in April 2020, during the COVID "shelter-in-place" orders (The Women’s Fund Miami-Dade, 2020). While amazing local organizations, like the Women's Fund Miami-Dade, have focused awareness campaigns, it has been the experience of our organization, Simply Amazing You Are ("SAYA"), that these campaigns are most effective for those already connected to services with mandated reporters and close relationships with systems of justice. 

Photo Source: USC Suzanne Dworak-Peck School of Social Work

Due to lack of investment in stable, transitional housing (MiamiDade.gov lists only 2 transitional housing providers and 2 emergency shelters – of which congregate living risks in the time of COVID make them even less safe), much of the community needing the most help are at a loss or the system doesn't move fast enough to provide adequate interventions and in some cases are now no longer accessible at all due to victim/survivors' lack of broadband access. As much as some pundits bemoaned smartphones as a tool subsidized by anti-poverty programing, for many of my clients, those phones are the difference between life and death by way of a simple internet connection. 

Complicating considerations for at risk communities, the Center for Disease Control & Prevention ("CDC") recognizes "...studies suggest that IPV can be both a risk factor for HIV, and a consequence of HIV" (CDC, 2014). With Miami-Dade's historically high rate of new HIV diagnoses, reduced access for community-based HIV testing, and lack of investment in areas like Brownsville and Liberty City as a matter of geographic segregation and ghettoization, the area is poised to be an example of how public policy fails to address intersections of health.

Advocates and funders would do well to consider the most good can be achieved by making remarkable investments in local community-based organizations, rooted in neighborhood-oriented community outreach and "shoe leather" service provision. Much of the local community can't meaningfully enjoy the temporary flexibility for telehealth and linkage to care and services because the very entities providing these services were not prepared or supported in becoming prepared for such modernizations. And Miami is not unique.

Across the nation, deeply impoverished neighborhoods experience the same barriers to care.

We are quickly running out of time to change the inevitable course of increased domestic violence, deaths from domestic violence, more cases of COVID-19, more HIV diagnoses, less care, and less public trust in these entities meant to serve us and keep us safe. That's the core of this need, as our systems show just how fragile they are, as we see existing disparities become exacerbated, communities getting fewer of their needs met will ultimately come to trust us, all of us, less and less. The time to act, the time to make unprecedented, bold moves, is now.

About Simply Amazing Your Are. SAYA is an empowerment focused intimate partner violence prevention and intervention non-profit organization in Miami, FL. SAYA's programming includes direct assistance like escape planning and protective order assistance, as well as policy advocacy campaigns, referral for support services, and linkage to care and victim services navigation. SAYA currently relies on a word-of-mouth model in order to ensure the safety of our clients. Through the COVID pandemic, SAYA has also partnered with Panera Bread end night donations to provide to IPV survivors facing homelessness or the risk of homeless. Donate to Simply Amazing You Are.

References: 

• Centers for Disease Control & Prevention (February 2014). Intersection of Intimate Partner Violence and HIV in Women. U.S. Department of Health & Human Services. Retrieved online at https://www.cdc.gov/violenceprevention/pdf/ipv/13_243567_green_aag-a.pdf?response_type=embed#:~:text=Studies%20of%20HIV%2DPositive%20Women,and%20a%20consequence%20of%20HIV.
• Women’s Fund Miami-Dade (2020, July 17). The Women’s Fund Miami-Dade Launches Domestic Violence Awareness Campaign. PRWeb.com. Retrieved online at https://www.prweb.com/releases/the_womens_fund_miami_dade_launches_domestic_violence_awareness_campaign/prweb17265119.htm. 

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

During COVID-19, Strength is Knowing that its Okay Not to be Okay

By: Khadijah Abdullah, Founder & Executive Director, Reaching All HIV+ Muslims in America

In May, my Uncle passed away from COVID-19. Grief hit our family hard, especially his youngest daughter, my cousin Erica. She had just lost her older brother to a heart attack a year prior. She felt the weight of their deaths on her shoulders. 

Unfortunately just a couple weeks ago, on October 9th she unexpectedly passed away as well. She leaves behind a 4 year old son who is a cancer survivor and requires special care. As you can imagine my family is devastated. 

Grief hits differently when it is someone you love. We never know the day nor the hour, but we know we will all die someday. But when it happens, it still hurts.

When COVID-19 first hit, many of us did not understand its severity until we lost someone close and/or the numbers increased drastically over a short period of time. The news constantly fed us information about COVID-19 and many retreated to their homes and sealed their front doors shut.

But what about Black, Brown and Indigenous people?

We are hit the hardest by COVID-19.

According to the Centers for Disease Control and Prevention (CDC), factors that contribute to risk of us getting sick with COVID-19 are: discrimination, healthcare access and utlization, occupation, educational, income, wealth gaps, and housing. 

Many of us do not have the luxury of sheltering in place. If we did, we would not be able to eat or feed our families. We have to keep a roof over our heads. We can’t afford to just simply not work. We don’t have the luxury of wealth. Essential workers often times falls on the backs of Black, Brown and Indigenous Folx.

COVID-19 has had and continues to have an impact on many families across the world, including my own. In the US alone, over 8 million people tested positive for COVID-19 thus far. As the Executive Director of Reaching All HIV+ Muslims In America (RAHMA), I have seen the effects it has on those we serve as well, including our team. Moving to a virtual world without warning has caused Zoom fatigue and attempting to find balance in a constantly changing world. Mental health is of the utmost importance and we just strive to do the best we can. Sometimes this looks like taking time off to regroup and that’s okay. 

Strength is knowing that its okay not to be okay. We are human.

We have also taken a few steps to provide relief and support to Black, Indigenous and People of Color (BIPOC) affected by COVID-19. In recognition of National Faith HIV & AIDS Awareness Day (NFHAAD), we led a town hall titled: “Get out and Vote: HIV & COVID-19 are on the Ballot.” This town hall covered the importance of voting, how our lives depend on it and why we must appoint elected officials who actually value our lives. We invited speakers from the Black AIDS Institute, Positive Women’s Network, Dr. Abdul El-Sayed and more.

Due to my personal experiences with COVID-19 and wanting to help amplify prevention efforts as much as I can, I have also become a Faith Ambassador with the COVID-19 Prevention Network. Our goal is to collaborate with BIPOC faith communities, address the effects COVID-19 has on us, disparities, prevention efforts and how we can respond effectively.  

COVID-19 is not going anywhere anytime soon. This is a harsh reality we have to face. In order for us to come out of this alive, we have to take care of self. COVID-19 is an invisible force to be reckoned with and we have to be equipped with knowledge to defend ourselves. 

Our lives depend on it. 

About Reaching All HIV+ Muslims in America: RAHMA addresses HIV, AIDS, Female Genital Mutilation/Cutting (FGM/C), Sexual Health and Gender-Based Violence (GBV) in faith communities through education, advocacy, and empowerment. Their programs include a retreat for HIV+ Muslims and their allies, sexual health & HIV trainings and development og a virtual FGM/C toolkit for survivors and health care providers, created in collaboration with the George Washington University, Milken School of Public Health hosted at https://fgmtoolkit.gwu.edu. RAHMA is also the founder of National Faith HIV & AIDS Awareness Day, which unites Muslim, Christian, Jewish, Buddhist, Sikh, Hindu and Baha'i faiths to take a stand against stigma in their congregations and raise awareness on HIV and AIDS. Donate to Reaching All HIV+ Muslims in America.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

Love in the Time of COVID-19

By: Riley Johnson, Executive Director, RAD Remedy

As many readers may know, COVID-19 is a novel coronavirus for which there is currently no vaccine available in the United States. But what folks may not know is that many state public health departments managing COVID-19 do not collect data on sexual orientation and gender identity, meaning there is minimal public health data available about the impact of COVID-19 on transgender people, including trans folks living with HIV. Like non-pandemic times though, trans organizations are able to provide an understanding of not only the ways in which trans folks are impacted but also how grassroots mutual aid efforts continue to sustain us.

Trans Lifeline recently reported that between March and July 2020, they experienced a 40% increase in calls, and that number continues to climb (Fowers, 2018). Outside of COVID-19, trans people already experienced mental health issues at nearly four times the rate of the general population (Wanta, 2019). In addition, trans people can face increased risk for COVID-19 due to several issues: trans communities’ higher rate of smoking - 50% higher than the general population (National LGBT Cancer Network, 2020) - access to care barriers leave us less likely to get medical care, and existing health disparities mean more of us live in a state of compromised health, which can leave us more vulnerable to COVID-19 infection. Trans people also at times use binders and/or corsets which, while helpful presenting aids, can restrict breathing. Trans folks have also faced unexpected consequences of hospitals and surgical centers trying to cope with COVID-19. Transition surgeries have been classified as non-emergency and have been cancelled after trans patients have already waited months or even years, causing even more stress and depression. Trans Lifeline counselors also report many callers have talked of being forced to quarantine with families or partners who were unsupportive or abusive. Prior to COVID-19, many trans people engaged in sex work and street economies due to stigma and underemployment, and with the onset of the pandemic, many are continuing to do so to meet survival needs despite the increased risk of COVID-19 transmission due to lack of social distancing. And not insignificantly, many trans people are also reporting an increase in misgendering due to the use of masks for COVID-19, which, while helpful for prevention, may limit gendered visual cues such as facial hair and make-up.

At the same time, trans folks also have been targeted politically like never before, including a reinstatement of the trans military ban, an attempt to remove nondiscrimination protections in Section 1557 of the Affordable Care Act which would allow medical personnel to refuse to care for trans patients, proposed regulations that would all but ban LGBTQ asylum seekers, and proposed modifications to the Housing and Urban Development’s Equal Access Rule that would require trans folks who are houseless to stay in shelters associated with their assigned sex at birth. To be honest, dear reader, all of this oppression on top of the pandemic has been a bit much even for me.

So I began to ask myself - what does love and resilience look like in a time of COVID-19?

From a self-care and community care perspective, many trans people are looking after each other by reminding each other to unplug from social media and news cycles, to drink water and eat, and sharing quality goat and puppy content and curbside drop-offs of food. These small graces remind us that while the pandemic is ongoing and the world seems to be on fire, there is goodness, kindness, and adaptation too. Like we have for decades, trans people are still thriving and resilient in the face of uncertainty. On September 2, 2020, a federal district court issued an injunction which immediately blocks the Department of Health and Human Services’ attempt to allow discrimination against LGBTQ people on religious grounds. Grassroots mutual aid projects have also blossomed all over the U.S., including the TGNC Peoples COVID Crisis Fund of Louisiana, the Okra Project, and the Heavenly Angel Fund which assists Black trans women in getting tested for COVID-19 and provides care packages for those who have been tested. These are just a sample of the many efforts by and for trans people to uplift each other and help those who need it most. For a truly fantastic deep rabbit hole of mutual aid during COVID-19, check out COVID-19 Collective Care (http://bit.ly/covid19collectivecare). As Vivian Topping, a peer support facilitator at Trans Lifeline puts it, “Trans folks push really hard to support our people and be resilient. There’s still beauty. There’s still joy. There’s still a life to keep looking forward to .”

I’d like to leave you with a quote from Dr. Lourdes Ashley Hunter, Executive Director of Trans Women of Color Collective: “Every breath a trans person takes is an act of revolution. Everyday, you will wake up in a world designed to destroy you, invalidate you and tell you that you don’t belong and that you have to assimilate to be accepted. Everyday you will also wake up with great purpose to dismantle that shit. Ashé.” Breathe deeply, sanitize, and mask up, friends. Whether it’s a pandemic or policy designed to oppress us, we are resolute, resourceful, and stronger than we know. 

About RAD Remedy: RAD Remedy is a national grassroots organization dedicated to connecting trans, gender non-conforming, intersex, and queer (TGIQ) folks to accurate, safe, respectful, and comprehensive care. The Referral Aggregator Database (RAD) is a comprehensive and nationally-collaborative database that combines the referral lists of trusted community organizations and the detailed reviews of TGIQ clients. In addition to the organization's database activities, RAD Remedy provides community-informed policy and practice guidance and consulting to organizations, agencies, and individual providers looking to help TGIQ communities thrive. Donate to RAD Remedy.

References:

• Fowers, Alyssa, and William Wan (2020, August 18). "The volume has been turned up on everything': Pandemic places alarming pressure on transgender mental health. Washington Post. Retrieved online at https://www.washingtonpost.com/health/2020/08/18/coronavirus-transgender/?arc404=true.
• National LGBT Cancer Network (2020). Coronavirus Information. Retrieved online at https://cancer-network.org/coronavirus-2019-lgbtq-info/.
• Wanta, Jonathan, et. al. (2019). Mental Health Diagnoses Among Transgender Patients in the Clinical Setting: An All-Payer Electronic Health Record Study. Transgender Health. Retrieved online at https://www.liebertpub.com/doi/pdf/10.1089/trgh.2019.0029.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

COVID-19's Impact on Older Adults Living with HIV & Long-Term Survivors

By: Tez Anderson, HIV Long-Term Survivor & Founder of Let's Kick ASS—AIDS Survivor Syndrome 

COVID-19 is having a significant impact on the social and mental health of older adults with HIV and long-term survivors, according to a recent study by HIV+Aging Research Project—Palm Springs (HARP-PS).

Half of the HARP-PS study participants reported increased frustration, boredom, sleep disruptions, and not getting enough exercise. There’s no doubt that some of the stress is from social distancing on a population already facing a crisis of isolation. 

But there is something else going on. For months, I’ve been beating myself up because the simplest tasks seem insurmountable. I can’t seem to get motivated or to stay focused. I thought it was just me, so I asked around. I am not the only one having these problems. Everyone I talk with is struggling with the same issues.

While there are very few similarities between AIDS and COVID 19, but another deadly pandemic triggers old trauma from another time when we faced another inescapable invisible enemy. When stress has no endpoint, it is more challenging to cope, mentally, and physically. In the early AIDS epidemic, we could at least forge a community response. We could gather and demand action. Now we are told to keep our distance because social distancing is unique to COVID 19. It is also more contagious so being in a group is dangerous. Zoom calls have replaced face time, and while it is the only option, the difference of being behind a screen is a poor imitation of being together.

AIDS Survivors Summit - 2014

The threat of COVID 19 is enormous and probably foremost on our minds. But there is more weighing on all of us. We are weeks away from the most critical election in history.

The threat of COVID 19 is against the backdrop of the rage we feel that COVID 19 did not have to be this bad. America’s response to the coronavirus pandemic is the worst in the world because of a lack of leadership. We have an anti-science president who failed to create an early cohesive national strategy to bend the curve. Other nations did it, and are living is more tolerable. Trump politicized the virus, mocked mask-wearing as a sign of weakness, and undermined public health experts’ recommendations. The current occupant of the White House uses COVID 19 to divide an already splintered nation. We have audio proof that the president knew how deadly it COVID 19 was and downplayed the danger. He lied instead of lead.

We all want things “to go back to normal” to a time before COVID 19 turned our world upside down. We need to accept the reality that COVID 19 will be a threat for years. The presidential promises of “it will end soon” and that we will have a vaccine before election day is more lies. 

For the sake of our sanity, we must ignore everything Trump says. Instead, listen to the public health expert we trust. Dr. Anthony Fauci is the only reliable source of information for navigating this pandemic. In a recent interview, Fauci corrected Trump’s lie, “If you’re talking about getting back to a degree of normality before COVID, it’s going to be well into 2021, towards the end of 2021.” 

This coronavirus rollercoaster we’re on has no end in sight. Those of us aging with HIV will be the last ones to get off the COVID-19 rollercoaster because we do not want to risk our lives.

Not Our First Pandemic was the 2020 theme for HIV Long-Term Survivors Awareness on June 5. This one is proving to have resonance. Coming together has always been our strength. Now we are forced to gather virtually. Let’s Kick ASS has a closed, moderated Facebook Group called the HIV Long-Term Survivors League, where we have conversations about these extraordinary times. It is a chance to converse with other survivors in a safe space. 

Approximately 1.2 million people are living with HIV and AIDS in the US. Sixty percent of HIV-positive women and men over age fifty and 25 percent have lived with the virus before 1996. That’s 720,000 who are the first-generation aging with HIV and 300,000 HIV longest-term survivors facing deadly stress. A population who mostly live in poverty with social networks shredded by AIDS and aging. 

As we have for decades, we must persevere, know that we are not alone, and are an untapped resource. Do not allow discrimination based on age, or ageism, rob us of our voices. And be sensible about the threat of COVID 19. We’ve survived with HIV for decades let’s ensure we take all precautions to prevent catching COVID 19. Wear a mask, wash your hands, keep your physical distance but remain emotionally connected even if it is virtual. And vote like our lives depends on it.

These are surreal times, but you are not alone.

About Let's Kick ASS — AIDS Survivor Syndrome: Let's Kick ASS — AIDS Survivor Syndrome has been empowering HIV Long-Term Survivors to thrive since 2013. They are an all-volunteer, grassroots movement, united in compassion, committed to action, and insisting on visibility. Let's Kick ASS started by and for people living longest with HIV/AIDS to address an unmet need — addressing the present-day psychosocial ramifications of living in the aftermath of the early AIDS pandemic. They are the originator and lead sponsor of the June 5th "HIV Long-Term Survivors Awareness Day" #HLTSAD. Donate to Let's Kick ASS — AIDS Survivor Syndrome.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

COVID-19's Impact on Connecticut's Latinos

By: Madeline Rodriguez, Executive Director, Latino Community Services

According to the Connecticut Department of Public Health HIV Surveillance Program, Latinos are disproportionally impacted by HIV-infection in the state. Nearly half of the Latinos living with HIV/AIDS in Connecticut are now over the age 50, but our Latinx generation is being hard hit by new diagnosis. (CDPH, 2020)

Latino Community Services, Inc. (LCS) was founded in 1986 as Latinos/as Contra SIDA in response to the need for culturally and linguistically competent services for Latinos in Hartford who were infected with and affected by HIV/AIDS.  The mission of LCS is to reduce the further spread of HIV/AIDS among Latinos and other at-risk populations and improve the quality of life and health of people living with HIV/AIDS. The clients at Latino Community Services come from all walks of life and are diverse in age, race and gender. LCS is a devout ally of the LGBTQI community and staff is dedicated to providing the best possible services so that everyone feels safe and welcomed.

Many of the individuals we serve have plenty of common ground. From battling with depression and anxiety to living with HIV/AIDS, and/or Hepatitis C and other health issues. Our clients, who are mainly black and brown people, are consistently disproportionately burdened with poor outcomes across these health conditions which are now layered by COVID-19. 

These individuals many times rely on human interaction such as our support groups; however since the pandemic, our support groups are now held virtually resulting in clients not engaging consistently .  The HIV/AIDS virus compromises the body's immune system which allows for common colds to be magnified due to the weakening of the clients' defense system (immune system). Meaning, a person who lives with HIV/AIDS has a greater chance of contracting coronavirus, hence many of our clients resorting to complete isolation as a precautionary measure. In turn, this has brought to light the impact that mitigation strategies such as social distancing are having on their health, mental health, access to HIV treatment and basic needs. 

As one strategy to bring some relief to the community,  LCS has been delivering food to the individuals who have self-quarantined. The organization has experienced a significant influx of families and individuals utilizing the service particularly due to being unemployed with by lay off or the business being shut down permanently additionally, homelessness that was partially due to the pandemic. A survey was conducted which concluded that many of the individuals utilizing the food pantry identified as black and brown people with underlying health issuesm mainly HIV/AIDS. LCS' food pantry also provides other basic needs essentials which include but are not limited to toilet paper, shampoo & conditioner, body soap, laundry detergent and pet food.Since March of 2020, Latino Community Services have served 419 unduplicated families.  Lastly, recent funding has afforded Latino Community Services with the resources to provide personal protective equipment.

About Latino Community Services: Founded in the City of Hartford, CT, in 1986, LCS provides culturally responsive care and prevention services to people living with HIV/AIDS and their communities. Beginning it's operations in the height of the HIV/AIDS epidemic,  LCS is the only Latino led organization with it's experience providing direct services to marginalized PLWH and other underrepresented populations of color throughout Hartford, Middlesex and Tolland Counties. Latino Community Services recognizes the challenges posed by COVID-19 and the impact that the virus has had worldwide. Throughout these challenging times, they remain committed to their clients and the public as they continue to adapt and evolve throughout the outbreak and recovery phases. Donate to Latino Community Services.  

References:

• Connecticut Department of Public Health HIV Surveillance Program. Rate of Newly Diagnosed HIV Cases by Race/ethnicity, Connecticut, 2014-2018. Retrieved online at https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/AIDS--Chronic-Diseases/Surveillance/statewide/CT_rate_hiv_race.pdf.
• Connecticut Department of Public Health HIV Surveillance Program. Hispanic/Latino People Living with HIV Infection by Sex, Race, and Risk, Connecticut, 2018. Retrieved online at https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/AIDS--Chronic-Diseases/Surveillance/statewide/CT_plwhivaids_table_cur_hispanic.pdf.
• Connecticut Department of Public Health HIV Surveillance Program. Rate of Newly Diagnosed HIV Cases by Age at Diagnosis, Connecticut, 2014-2018. Retrieved online at https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/AIDS--Chronic-Diseases/Surveillance/statewide/CT_rate_hiv_age.pdf. 

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.