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LGBTQ Posts

Manny’s Pride Story

by Steven Henke

The Emotional Wellness Journey of Coming Out with Pride: A Personal Reflection

For many LGBTQ+ individuals, coming out is a profound, transformative experience that deeply impacts emotional health.

As a Latino gay man who grew up in a conservative religious household and attended an all-boys Catholic school, I understand the emotional toll of hiding one’s true self. The pressure to conform to societal and familial expectations forced me to suppress who I really was. For years, I lived in fear of rejection, constantly battling an internal struggle between the person I was and the person I pretended to be.

This dual existence took a heavy toll on my emotional well-being. I never felt comfortable in my own skin and always felt like an outsider in my own life. The stress of hiding my true identity led to feelings of isolation, anxiety, and depression. I wasn’t living—I was merely existing.

Coming out changed everything. The moment I decided to embrace who I truly was, my life began to shift in unimaginable ways. The weight of secrecy and fear was lifted, and for the first time, I felt a sense of freedom and peace. By living authentically, I was able to create my own path, find love, and build a family that supports and celebrates me for who I am.

One of the most empowering experiences after coming out was attending my first Pride parade. I vividly remember the overwhelming sense of belonging as I stood among the crowds, surrounded by people who were proudly and unapologetically themselves. It was the first time I truly felt seen and heard, and it affirmed my decision to live openly. That day, I realized I wasn’t alone—that there was a whole community ready to embrace me. It was a moment of hope, inclusion, and safety that I had longed for my entire life.

Today, at DAP Health, I’m motivated by my journey to create change and make an impact in the lives of others. I understand the importance of emotional wellness in the process of coming out, and I’m committed to fostering an environment where individuals can feel safe, supported, and empowered to be their authentic selves.

Pride is a reminder that living authentically is not just about revealing one’s sexual orientation or gender identity; it’s about reclaiming your emotional well-being. It’s about shedding the layers of fear and shame, and stepping into a life that is true to who you are. By doing so, we not only improve our own emotional health but also inspire others to do the same.

As we celebrate Pride, let’s remember that the journey to emotional wellness begins with the courage to be ourselves. For those who might still be waiting for that feeling of inclusion, safety, and hope—I encourage you to connect with us at Pride. Together, we can create a world where everyone can live openly, freely, and authentically.

Is an Injectable HIV Med For You?

by Daniel Vaillancourt

Everything You Ever Wanted to Know About the Long-Acting Injectable HIV Medication Cabenuva

Words by Daniel Hirsch

 

For many, living with HIV has meant living with daily pills. However, the January 2021 FDA approval of Cabenuva radically changed antiretroviral HIV treatment.

 

Cabenuva is the first long-acting, injectable HIV medication. It is typically administered every eight weeks. However, there are instances where it must be provided every four weeks, depending on the treatment plan decided by the health care provider and the patient’s specific needs. The regimen involves two injections — one of cabotegravir and one of rilpivirine — given on the same day.

 

To understand the pros and cons of Cabenuva, I spoke with DAP Health Director of Specialty Programs Dr. Jason Halperin. As a longtime advocate for better and more accessible HIV care, Dr. Halperin considers himself a Cabenuva proponent.

 

Who is Cabenuva for?

It’s really for anyone living with HIV who is interested in injectable medication. There are a lot of patients who meet the criteria for Cabenuva. It’s much fewer who don’t. I would say to people living with HIV, “Don’t be afraid to ask your provider if you think injectables might be right for you.”

 

What makes an injectable drug preferable to an oral medication?

I’d first say that we are at such an amazing place in terms of HIV medications — they’re incredibly effective and well-tolerated. Typically, one pill per day is all that most people living with HIV require. That said, though oral medication is well-tolerated, I often hear patients complain about nausea. And you have no nausea at all from the injectable medication. Other than occasional reaction or soreness at the injection site, there are fewer side effects.

 

And you don’t have to worry about forgetting to take a daily pill, correct?

A missed pill here and there is never going to lead to resistance. The barrier to resistance for our newer medications is extremely high. But yes, you don’t need to worry about that at all with the injectable.

 

In fact, we have our first trial population where injectable outperformed oral medication. This was in a population that has struggled taking oral medication before — 50% struggling with substance use, almost 40% were unhoused. They were randomized to either start an injectable or continue with oral medication. Those who were randomized to the injectable did so much better that the study was stopped early because it was considered unethical to continue [with patients on oral medication].

 

I’ll often have a patient come in and say, “I’ve been missing medicine,” “I’ve lost a job,” “I’m struggling with methamphetamine use,” or “I’m having difficulty with housing.” Before this study, I would’ve said, “Let’s get you back on oral and get you stabilized.” I’m really going the other way now. I’m telling my patients, “If a lot is happening in your life, injectables might be the right decision for you today.”

 

Can anyone who wants it access Cabenuva? Does insurance cover it?

Our insurance system in California has been very supportive. It’s very rare that I cannot get approval from insurance companies for Cabenuva for my patients. However, we are seeing equity issues around the country. We’re seeing that higher-income patients — those more likely to be White and to self-identify as a gay man — being started on Cabenuva over other populations.

 

Besides having to get poked with a needle, are there downsides to Cabenuva?

The one frustrating thing for me with this medication is it was not approved for self-administration. It has to be administered within the clinic setting. Oral medication does allow for more flexibility.

 

Also, let’s say one of my HIV patients moves to Los Angeles. They may not be able to just see another provider there and seamlessly start back on their injectable medication at that new clinic with that new provider. It’s not impossible, but it’s difficult. Cabenuva uncovers the layers of how disjointed our insurance system is. We really just need to have a health system where people are insured at all times and can access medical care at all times.

 

If you would like to investigate HIV treatment with Cabenuva, please speak to your DAP Health clinician. If you are not yet a patient at DAP Health, and would like to become one, click this link.

July 28 is World Hepatitis Day

by Daniel Vaillancourt

The ABCDEs of Hepatitis

Words by Daniel Hirsch

 

Every year, World Hepatitis Day is marked on July 28. It’s an occasion to raise awareness about the spread and prevention of the disease. Given that the World Health Organization (WHO) reports that more than 354 million people live with either hepatitis B or C, and that roughly 4.5 million premature deaths could be prevented by 2030 through education, vaccination, testing, and treatment, it’s a very good thing to know about.

 

I spoke with DAP Health Director of Infectious Diseases Dr. Shubha Kerkar about what can be done to slow the spread of hepatitis, and why some forms of it are dubbed “the silent killer.” With three decades of experience fighting infectious disease, Dr. Kerkar is intimate with the complex factors involved in ending pandemics.

 

Why is hepatitis serious?

Untreated viral hepatitis B or C causes three things: liver failure, liver cirrhosis (permanent liver scarring), and liver cancer. Almost always, the number one reason for liver cancer or liver transplant in the U.S. — up until very recently — was hepatitis C-related cirrhosis. Untreated, hepatitis B or C can be fatal.

 

There are many types of hepatitis — A, B, C, D, E — why focus on types B and C?

Since 1982, hepatitis B has been preventable via a vaccine administered to children before they are two years of age. Still, we have 254 million people living with hepatitis B today. There are certain medicines to control it, but it can still lead to liver cancer. We need to get more people vaccinated, but people have developed tremendous distrust in vaccines over the last few years, so there are challenges.

 

Hepatitis C was a bigger pandemic until 2015 or so. We are now rapidly able to cure hepatitis C. The burden went down, but currently, 50 million people still live with hepatitis C.

 

So, of these two viruses, C is curable, and B is preventable. That’s the bottom line.

 

How does hepatitis C spread?

Primarily through contact with infected blood, which means intravenous drug users are at especially high risk.

 

However, about 50 to 60% of people who have hepatitis C may not even know it because they’ve never been tested — and there are often no symptoms initially. Over two to four decades, it then slowly scars the liver. Symptoms of liver failure occur when the liver decompensates, and a cure may not save the need for transplant. That’s why it’s known as “the silent killer.”

 

Because the test was only developed in 1992, hepatitis C has spread all over the world. So regardless of risk factors, baby boomers have a five-fold higher risk of unknowingly having hepatitis C. They need to get tested to see if they have it. Then, we can cure them.

 

The other thing about hepatitis C is that you can get reinfected after being cured, so it’s important to learn how to stay cured by managing risk factors and avoiding exposure, which led to the infection in the first place.

 

And hepatitis B?

Hepatitis B is mainly transmitted through sexual contact, but can also spread through contaminated food or water. Most importantly, pregnant-mother-to-child transmission can occur during labor.

 

What can be done to stop the spread?

I have been treating and trying to cure hepatitis C since 1996. From 1996 to 2015, there was a 35 to 45 % cure rate. However, since the newer medications — which are easy to tolerate without any side effects — the cure rate is nearly 100%. So, the easiest part of treating hepatitis C is getting people tested so they know they have it, then linking them to care.

 

Hepatitis B is preventable via vaccine, yet I do manage several patients who have hepatitis B. It is treatable but prevention is best.

 

To eliminate viral hepatitis, we need education, prevention, screening, and linkage to care. Here in the Coachella Valley, DAP Health has been doing a lot of free testing.

 

For both hepatitis B and C, elimination and cure are the goals. Eliminate hep B by vaccination. Eliminate hep C by widespread testing and linkage to care, and cure those who have it with treatment.

 

For free hepatitis C testing, please contact one of DAP Health's three sexual wellness clinics, in Palm Springs, Cathedral City, or Indio.

 

To be tested for other forms of the disease, for vaccination, or for treatment, please see your primary care physician — at DAP Health or elsewhere.

 

And to learn more about individual types of the disease, read below.

 

The ABCDEs of Hepatitis

 

Each type of hepatitis has unique transmission methods, symptoms, potential for chronic infection, and prevention strategies. Read on…

 

Hepatitis A (HAV)

 

  • Transmission: Fecal-oral route, often through contaminated food or water.
  • Symptoms: Acute illness with jaundice, fatigue, abdominal pain, and fever.
  • Chronicity: Does not become chronic.
  • Prevention: Vaccination and good hygiene.

 

Hepatitis B (HBV)

  • Transmission: Blood, sexual contact, and from mother to child during childbirth.
  • Symptoms: Acute and chronic liver disease. Can lead to cirrhosis or liver cancer.
  • Chronicity: Can become chronic.
  • Prevention: Vaccination prevents infection

 

Hepatitis C (HCV)

  • Transmission: Blood, primarily through sharing needles or blood transfusions. Tattoos
  • Symptoms: Often asymptomatic initially, it can lead to chronic liver disease.
  • Chronicity: Often becomes chronic.
  • Prevention: No vaccine but avoid sharing needles and ensure safe blood products.
  • Cure: Can be easily cured, but cure does not give immunity.

 

Hepatitis D (HDV)

  • Transmission: Blood, similar to HBV; requires HBV for replication.
  • Symptoms: Similar to HBV but more severe liver disease.
  • Chronicity: Can become chronic.
  • Prevention: HBV vaccination (since HDV requires HBV to propagate).

 

Hepatitis E (HEV)

  • Transmission: Fecal-oral route, similar to HAV, often through contaminated water.
  • Symptoms: Acute liver disease with jaundice, fever, and abdominal pain.
  • Chronicity: Rarely becomes chronic.
  • Prevention: Good sanitation and hygiene practices; vaccination

One Day at a Time

by Daniel Vaillancourt

One Day at a Time

DAP Health Chief of Brand Marketing Steven Henke lives the lyrics of Miss Diana Ross: “There’s a new me coming out. And I just had to live. And I wanna give. I’m completely positive.”

Words by Kay Kudukis

 

“I literally grew up on the prairie,” says DAP Health Chief of Brand Marketing Steven Henke. “The prairie I remember? Very dry, hot winds, and a very open space with sky as far as my child’s eyes could see, unbroken by hills or trees. Not a lot of detail.”

 

Bismarck, North Dakota — where Henke spent 18 years — is the capital of a state so non-populous that one area code suffices all 70,704 square miles. “There were no museums, no theaters where touring shows would come in, so there were no real cultural input or influence,” he laments.  

Television filled that gap. From the comfort of his lime green bean bag chair, Turner Classic Movies brought Henke the all-around perfection of Roz Russell as “Auntie Mame,” while “Mr. Smith Goes to Washington” introduced him to social justice. CNN’s fashion segment “Style With Elsa Klensch” took him away from his forced reality of North Dakotan nonexistent fashion sensibility, allowing him to dream of a future rife with glamorous possibility — and free of bullies.

 

Dad made a good living selling radio ads. Mom was a homemaker until economic challenges required extra income. Henke was in fourth grade, his younger brother in second, when she started taking them to work at the local roller rink on weekend nights. For the last hour, the skates came off, the polyester went on, and the rink transformed into a disco party. “The music was dramatic — they’ve left their cake out in the rain — everyone was dancing to some of the saddest music in the world.” It was perfect. 

 

“She works hard for the money” ~ Donna Summer 

At 13, Henke got his first job as a hotel busboy — because fashion wasn’t cheap, and Henke wanted to have style. In fact, he says, everyone in town knew he was gay before he knew what a sexual orientation even was. If they were aware, his parents never mentioned anything, but other adults whispered, and the classrooms were full of kids parroting their parents’ sentiments in the schoolyard.  

In 1985, there was one high school boy Henke never met but by whom he was inexplicably inspired. There was just something about his style, his clothes, his hair. “I said, ‘If I just knew him, my life would be better,’” Henke recalls, laughing. “I knew magical thinking was weird, but I was forever looking for a sign, and that gave me hope.”

At 16, Henke got a job at the Bismarck Target, where he stayed through his freshman year at North Dakota State, abandoning that post for the upgrade of employment as a DJ at the aforementioned roller rink. He transferred to University of Minnesota-Moorhead his sophomore year, supporting himself as a phone solicitor, working retail at Kmart, and one summer, working for the highway department, “where I would go out with the crew and hold that thing in the weeds so they could see if the road was flat or whatever. I didn’t even know what I was doing. By the end of that summer, I really thought my name was ‘Dumbass.’”

 

“Tumble out of bed, stumble to the kitchen, pour myself a cup of ambition” ~ Dolly Parton 

Henke chose mass communications and political science as a major. “I thought at that point I would end up working in politics or journalism. Then I did an internship with a U.S. senator. For a number of reasons, it didn’t align with who I wanted to be and the change I wanted to make in the world.”

When he graduated, Target corporate hired him, and over the next 10 years, he rose to senior product manager, sourcing and developing collections overseas. His future husband also worked at Target, but they’d never met until a random meeting at a local coffee shop whilst each was on his way to the same matinée of “The Little Mermaid.” Life is oddly beautiful like that. They’ve been together 27 years.

Activism wasn’t new to Henke — his parents were engaged Democrats — but 1993 was his first personal foray. He and some friends took a bus to Washington, D.C., for the LGBT Equal Rights March.

 

“It was the first time I felt empowered as a gay man. The first time I was able to really use my voice not just for myself. I was able to actually see how we are all interconnected, we all are intersectional in that sort of oppression, and how we have to come together, work together, and lift all of ourselves together, up and out.  

“If we are divided or if we aren’t thinking about each other, if we believe in that system of lack, where we have to grab it all because there’s not enough for that other group, that doesn’t work, because that’s how the system keeps people in that space. It’s a sense of competitiveness that shouldn’t exist.” 

The company Sphere Trending took him around the world for three years of macro and micro trend analysis, plus retail intelligence, before Hanover Accessories snapped him up as vice president of design and development.   

 

“I myself was made entirely of flaws stitched together by good intentions.” ~ Augusten Burroughs

Henke’s proud sobriety came at 39, more than 15 years ago. When he walked into his first AA meeting, right there leading it was that elusive kid from high school. The one who’d held Henke’s teenage fascination. The one he believed would make his life better. Henke smiles at the serendipity of it all. “He became my sponsor for my first five years. There are no mistakes in life. Everything happens for our benefit. Everything.” Life is oddly beautiful like that. 

But “everything” includes a very bad day at Hanover. “We got sold, and a new president came in who did not like gay people. I was walked out. It was a punch in my gut. To me, it was a validation of my lifelong belief that I didn’t belong. That I didn’t have value. It really, really threw me.” 

 

“I was a free man in Paris, I felt unfettered and alive.” ~ Joni Mitchell 

Henke took off for a safe space: his and his husband’s vacation home in Palm Springs. He saw a job posting for Gannett in sales, and got it. “I was terrible,” Henke admits, adding they did recognize his creativity and ability to craft strategy. They soon switched his role to marketing manager. For those five years, he also volunteered on the Palm Springs Chamber of Commerce’s board, where he’d eventually become president.

“He’s that creative, full-of-energy, big personality person for me,” says Nona Watson, chamber CEO since 2010. “He understands the chamber really well, and he understands the city really well. He’s really good at helping me find things that haven’t been done before.” 

Back on the Gannett side, DAP Health’s own chain of resale stores, Revivals, was a client. His innovative ideas did not go unnoticed. The nonprofit sought him out as a consultant, then in short order offered him a permanent position as director of marketing, overseeing all communications and marketing strategy for its Resource Development department and Revivals. The year was 2017.

 

His hard work and long list of successes since then were recently recognized with a promotion to chief of brand marketing. His role? Stewarding the brand across the entire organization, which he says is a perfect mission match for the impact he hopes to continue to make.

“I care deeply about this organization and its work in health care,” he says. “I take our team’s responsibility — to do it right — very seriously.” 

Above all, Henke believes life is filled with second chances for people — like him — in recovery. “I want my experience to give that next person walking through the doors of an AA meeting for the first time a reason to believe anyone can stay sober,” he says. “Where there’s breath, there’s hope.”

Because, as Augusten Burroughs wrote in his sobriety journey memoir “Dry,” “When you have your health, you have everything. When you do not have your health, nothing else matters at all.”

July is National UV Safety Month

by Daniel Vaillancourt

The Vital Role of UV Protection

Summertime in the Southland means fun in the sun. But shielding your skin from harmful UV rays is paramount.

Words by Maggie Downs

 

Life in Southern California has its perks: picturesque landscapes, clear skies, and an abundance of sunshine. Unfortunately, the relentless sun also brings an invisible threat — ultraviolet (UV) radiation.

Protecting your skin from UV rays is crucial, not just for maintaining youthful looks, but for safeguarding your health. By embracing a multifaceted approach to sun safety, you can enjoy the outdoors while minimizing your risk of skin damage and cancer.

Did you know July is National UV Safety Month — a U.S. Department of Health and Human Services initiative whose goal is to raise awareness about the dangers of UV rays to the skin and eyes? This issue is especially important for all of us living in Southern California. So please, read on…

 

The Perils of UV Radiation

UV radiation, primarily from the sun, consists of UVA and UVB rays. UVA rays penetrate deeply into the skin, causing premature aging and wrinkles. UVB rays, on the other hand, are responsible for sunburn.

Both types can damage the DNA in skin cells, potentially leading to skin cancer. Our sun-drenched climate means increased exposure, making UV protection a daily necessity, says Dr. Silas Gyimah, associate chief medical officer at DAP Health.

 

Sunscreen: Your First Line of Defense

Sunscreen is a vital tool in your UV protection arsenal. Dr. Gyimah recommends using a broad-spectrum sunscreen with an SPF (sun protection factor) of at least 50, reapplied every two hours, or more often if swimming or sweating.

Broad-spectrum sunscreens shield your skin from both UVA and UVB rays, providing comprehensive protection. It’s important to apply sunscreen to all exposed skin, including often-missed areas like the ears, back of the neck, and tops of the feet.

Parenting an infant? Sunscreen should be avoided in children younger than six months, says Dr. Gyimah, but alternate methods of protection — like dressing the baby in loose clothing that covers the skin, and staying in the shade — will suffice.

 

Sun Protection for All Skin Tones

A common misconception is that people with darker skin tones don’t need sun protection, which is dangerously misleading, says Dr. Gyimah. While it’s true that higher levels of melanin in darker skin provide some natural protection against UV radiation, it is not sufficient to prevent UV damage.

“Because of that mindset, we tend to see a lot of skin cancers in Black folks more than other populations,” he says. “Everyone should be going through the basic protection mechanisms from the sun.”

Also note that there are special formulations of broad-spectrum sunscreen especially made for those with darker skin. Meaning, the product won’t leave a white residue.

 

Comprehensive UV Protection Strategies

While sunscreen is essential, it shouldn’t be your only line of defense. To fully safeguard your skin, combine several UV protection strategies. Seek shade during peak sun hours — typically between 10:00 a.m. and 4:00 p.m. — when the sun’s rays are the strongest. And use UV-blocking window film or shades in your home and car to reduce indoor UV exposure.

Wearing protective clothing — such as long-sleeved shirts, wide-brimmed hats, and UV-blocking sunglasses — can also significantly reduce your exposure. Many outdoor enthusiasts in Southern California opt for clothing specifically designed with built-in UV protection.

“Keep in mind that protection is necessary even on overcast days and indoors,” says Dr. Gyimah. “Any protection is better than none.”

 

The Role of Regular Skin Checks

In addition to preventive measures, regular skin checks are crucial. Perform monthly self-examinations to look for new or changing moles or spots, talk to your doctor about any concerns, and schedule annual skin exams with a dermatologist.

Early detection of skin changes can significantly improve the prognosis if skin cancer does develop.

Have a happy — and safe — sunny summer!

Meet DAP Health Chief Transformation Off …

by Daniel Vaillancourt

Climb Every Mountain

Through eight promotions in nine years, DAP Health’s Chief Transformation Officer C.J. Tobe emerges with the biggest, best job of his still-young career.

Words by Kay Kudukis

 

The inherited first name didn’t enthuse his pregnant mother, but when his paternal grandfather died three months before her baby’s birth on January 1, 1986, she acquiesced and wrote “Cletus Joseph Tobe III” on the birth certificate. One caveat: “We’re calling him C.J.”

They lived in Fort Recovery, Ohio. Population 1,273. With their clan making up a good portion of that number. Tobe has over 70 first cousins on just one side of his family, plus a younger brother and sister, so childhood was really fun. But when he was 13, Mom got cancer, and he was the only one cheerleading through the mastectomy, chemo, radiation, and bone marrow transplant, rocking “Tubthumping” by Chumbawumba — “I get knocked down, but I get up again” — until she finally did. Today, Mom is cancer free and, unsurprisingly, divorced.

When he wasn’t in class, Tobe tutored, and served on the student council. On the field and on the court, he was a total jock, and like many of that ilk, broke many a girl’s heart. Academically he was all about history, but he did well in all classes. To anyone on the outside, he was crushing it. On the inside? He didn’t fit in. Maybe when he had his own life and family, he thought, things would click.

 

It Only Hurts When I’m Breathing ~ Shania Twain

“I was going to Wright State University in Dayton to be a special ed teacher and coach sports,” Tobe recalls. “I was also tutoring a group of kids with autism, and working retail making seven bucks an hour.” He felt the aforementioned click when he met his first boyfriend. He casually told Mom, who was very much not OK. So, he moved out — and in with the boyfriend — continuing college while coaching basketball. The once unbreakable bond between mother and son teetered between strained and vanished.

In 2009, Tobe woke up deaf. He was 23.

The ER put him on steroids, suggesting he follow up with his primary care physician. Many insurance hoops later, a specialist put him on antiviral meds, shot his ears full of steroids, and restored 20% of his hearing in his right ear. Nothing helped his left. Most mysteriously, no one had any idea why. His only other symptom was a headache.

When he eventually got shingles, and started losing weight, a friend working at the local AIDS service organization tested him at his dining room table. Tobe had AIDS.

 Mystery solved. Studies have now shown 14 - 49% of HIV-positive patients have hearing impairment.

 

Abandoned by Almost Everybody

Within 90 days of starting lifesaving treatment, Tobe’s diagnosis was downgraded (or upgraded, depending on your outlook) to HIV-positive, where it has remained ever since. But the first 30 days were not only terrifying but emotionally devastating. “Everybody found out my status,” says Tobe, adding he’d granted no permission. “I pretty much lost my entire social network, except for my two best friends, who remain my besties today.”

Mom was there tubthumping, as he had for her 11 years prior, but it took a referral to Dr. Stephen Emerick, a psychologist and certified advanced grief counselor, to help him hear the part about getting up again. “He saved my life,” Tobe says, voice full of gratitude. “He had me sign an ‘I will not complete suicide contract’ with my mom and him. He led me to grieve and heal and take control of my life through Native American teachings.”

In 2013, at 27, Tobe and his dog took a plane to Palm Springs. They had $20, didn’t know a soul, and didn’t care. Tobe just wanted to live where he was accepted. Ruth Hardy Park was the bedroom he sometimes occupied with other unhoused people, until an Ohio friend also moved to Palm Springs and upgraded Tobe to his spare bedroom.

Later, a boyfriend Tobe was living with got a job in Grand Junction, Colorado, and so Tobe and the pup went too. He was already looking for work when he went to Western Colorado Health Network, the town’s AIDS service organization, to become a client. His case worker heard his story and encouraged him to apply for a case worker position. After rigorous interviewing, he got the job.

 

Never be Bitter. Be better ~ Stephen Emerick, MD, PhD

Helping those like him — those living with HIV and AIDS — turned out to be his jam. It lit a fire in his soul, gave him passion, imbued him with purpose. He knew without a doubt that this was what he wanted to do. But man, he missed Palm Springs.

So, when Senior Director of Social Services Zayda Welden, at what was then still known as Desert AIDS Project, responded to Tobe’s unsolicited resume with a Zoom request to interview for a medical case manager position, Tobe instead said, “I’ll be right there.” He got the job. It was 2015. He was a year shy of 30.

Within six years, he was promoted to a) clinic case manager, b) community health intervention and education manager, c) community health prevention programs manager, d) interim director of community health, e) director of community health, and f) director of community health and sexual wellness — all while furthering his education online.

Tobe earned his bachelor’s from Arizona State University, graduated with honors in health care management at California Primary Care Association (CPCA), and received his master’s in organizational leadership from Gonzaga University. In late 2023, he was promoted a seventh time, to chief of community health.

 

Jumping Into Executive Leadership

During subsequent staff and senior leadership meetings, Chief Operating Officer Corina Velasquez observed Tobe’s energy and hunger. “What I’ve always seen in C.J. is his drive, and his strong sense of mission for everyone — just doing the right thing,” she says. But what really got her attention was the way he recently took on a “monster project” of process-mapping (AKA bringing groups together). Seeing gaps in things or identifying where there’s overlap. He nailed the assignment.

Curious, she asked him what filled his cup. Is DAP Health where he saw himself in five years? From that conversation, she recognized his strong passion for developing people and teams. “It prompted me to start conversations with [CEO David Brinkman] and other executive team members,” Velasquez notes.

Tobe was tasked to build his own “honey do” list, and presented 15 pressing processes he’d like to strengthen. The executive leadership team (ELT) chose three to start: partnering with compliance and operations to improve access and quality care for patients (including transportation), maximizing in-house pharmacies to increase patient access, and unbooked appointments (making sure patients are on a wellness track by utilizing clinics to operating capacity). In early June of 2024, Tobe ascended an eighth time, to the newly created role of chief transformation officer. He now has a seat on DAP Health's aforementioned ELT. For the record, he’s still only 38.

“It’s really the next step in our integration,” Tobe explains, referring to the nonprofit’s absorption of the Borrego Health system almost a year ago. “Coming together as one, creating synergy by inspiring people, and making sure we have the right people at the table. It’s about making sure communication is happening, playing to people’s strengths, building that culture, and embodying and simplifying our values, which all leads to greater patient access.”

Tobe claims the scope of this new position allows him to “address the things that keep me up at night.” He’s jazzed about eventually coauthoring solutions for them all. He smiles contentedly. “I just love my work.”

Everything You Ever Wanted to Know About …

by Daniel Vaillancourt

Everything You Ever Wanted to Know About Sobriety & Recovery

Words by Daniel Hirsch

 

Trend alert: non-alcoholic beverages. More Americans report they’re giving up alcohol or describing themselves as “sober curious.” This comes at a time when the impact of excessive drinking and drug use couldn’t be more acute. The CDC reports deaths from alcohol and drug use has been sharply climbing over the last two decades.

In a culture of prevalent drinking, getting sober is no small feat, but there’s help. I talked to DAP Health Peer Support Specialist Bill Bruner — who just celebrated 34 years sober himself — to find out what recovery looks like at the nonprofit.

 

What is sobriety? Is it different for different people?

I’m old school, so for me sobriety is absence of all mind-altering drugs and substances being ingested into your body. Recovery is more than that. Anybody can go into rehab and detox. Well, now what do you do? I tell people: All you have to do after you stop the drugs and the alcohol is change everything else about you.

 

How do you get sober? How do you start recovery?

The biggest thing is you ask for help. Can people do it on their own? Sure. But most people need some kind of foundation. You need somebody to guide you.

 

I’ve heard DAP Health offers something called SMART Recovery. How is this different from the traditional the 12-step program outlined by Alcoholics Anonymous (AA)?

SMART Recovery [Self-Management and Recovery Training] has a more scientific base than a traditional 12-step program. There’s no higher power, there’s no sponsorship. It offers tools for self-management and recovery training based on cognitive behavioral therapy. A lot of SMART recovery is open sharing in a support group. It’s being there for each other.

 

This question might be different for everyone, but why should someone get sober?

Because their life is falling apart. Thirty-four years ago, I weighed 120 pounds. I could barely walk and I was covered with open sores. I thought I was dying of AIDS. It turned out malnutrition and addiction were killing me. That’s why I got sober. All my other options were gone.

 

What recovery resources are available at DAP Health?

DAP Health offers 12-step groups as well as SMART Recovery groups on a weekly basis. The Everything A group is a mix of all the 12-step groups and has been meeting for over 10 years here. There is a CODA meeting, a 12-step group weekly also. This is for freedom from co-dependency and partners, with all the healing 12-step groups also.

Various 12-step groups have been in existence since the 1930s, starting with AA, and have been helping people with recovery ever since. In 2024, recovery groups have branched out with other forms of groups, including the three SMART Recovery groups offered here at DAP Health, as well as Dharma Recovery and Celebrate Recovery groups in our local community. Everything helps people. 

 

If someone is thinking about starting recovery, what should they know?

Things are going to change. Things will happen as you take control of your life. But things aren’t going to be perfect for the rest of your life because you don’t drink and use drugs anymore. It’s a journey. It’s not easy. It’s also not hard. And it’s really not easy. It’s not hard, because there are people like me to help. And it’s not easy, because it’s a big change.

June 27 is National HIV Testing Day

by Daniel Vaillancourt

The Enduring Importance of National HIV Testing Day

HIV is still a threat. Every year in the U.S., tens of thousands of people acquire the virus. And the only way HIV becomes a manageable disease is to find out you have it — and get treatment if you do.

 

Many people today mistakenly believe HIV/AIDS is no longer a concern. This misconception arises from the reduced visibility of the epidemic in media, successful prevention measure such as PEP and PrEP (daily oral and bimonthly long-lasting injectable), and the substantial progress made in medical treatments that allow those with HIV to live long, healthy lives.

However, HIV/AIDS remains a significant global health issue, with new infections occurring daily and many individuals unaware of their status. This ongoing challenge underscores the importance of National HIV Testing Day, observed annually on June 27.

Initiated in 1995 by the National Association of People with AIDS, this day serves as a critical reminder that knowing your HIV status is a crucial step in managing and preventing the spread of the virus. The day is marked by efforts from health care providers, community organizations, and public health entities — like DAP Health throughout Southern California — to make testing more accessible and to educate the public about the benefits of early detection.

 

Why Get Tested

There are several compelling reasons to get tested for HIV, whether it’s your first time or a routine checkup. First, early detection of HIV can significantly improve health outcomes. Modern antiretroviral therapy (ART) can suppress the virus to undetectable levels, preventing the progression to AIDS and allowing individuals to lead normal lives. Early treatment also reduces the likelihood of transmitting the virus to others, as those with an undetectable viral load have effectively no risk of sexually transmitting HIV to HIV-negative partners. Undetectable = Untransmittable. Or U = U.

Secondly, knowing your HIV status is empowering, as it enables you to make informed decisions about your health and take proactive measures. For those who test negative, it’s an opportunity to reinforce protective behaviors and consider preventive options such as pre-exposure prophylaxis (PrEP), a medication that not only significantly reduces the risk of contracting HIV, but that comes in a daily oral pill or a bimonthly, long-lasting injectable form.

HIV does not discriminate, and everyone who is sexually active should consider regular testing as part of their routine health care.

 

Reducing Stigma

National HIV Testing Day helps combat stigma by normalizing the conversation about HIV and encouraging a collective responsibility toward ending the epidemic.

At each of DAP Health’s three sexual wellness clinics (in Palm Springs, Cathedral City, and Indio), patients are guaranteed a stigma-and-shame-free experience when it comes to getting tested for HIV. If a patient receives a positive diagnosis, options for treatment are immediately discussed with them. And if they’re negative, there are PrEP navigators at the ready to discuss every HIV prevention option.

This year, in an effort to reduce societal stigma, DAP Health is encouraging people who choose to get tested to do so with a platonic friend or sexual partner. This buddy system is a form of support that doubles the impact of National HIV Testing Day.

 

How to Get a Free HIV Test at DAP Health

There are two ways to get an HIV test at no cost at DAP Health. The first is to visit one of our three sexual wellness clinics (in Palm Springs, Cathedral City, and Indio). The other is to request that an HIV self-test be discreetly mailed to your home.

Knowing one’s HIV status is still crucial. It is a step toward protecting one’s health and the health of others, contributing to the broader goal of ending the HIV epidemic.

Get tested with DAP Health on, before, or after National HIV Testing Day (June 27). And regularly thereafter. Protect yourself, protect others, and play a part in the global fight against HIV/AIDS.

 

Free Rapid HIV Testing at Walgreens Locations on June 27

Please note that DAP Health staff members will be offering free rapid HIV tests (blood draw; results in 20 minutes) at the six Walgreens locations below, from 9:00 a.m. to 4:00 p.m., on Thursday, June 27. No appointment necessary.

 

1700 East Vista Chino, Palm Springs, CA 92262

2465 East Palm Canyon Drive, Bldg. 14, Palm Springs, 92264

33975 Date Palm Drive, Cathedral City, CA 92234

72027 Dinah Shore Drive, Rancho Mirage, CA 92270

82955 Avenue 48, Bldg. B, Indio, CA 92201

8917 Trautwein Road, Riverside, CA 92508

TMVII: A New Sexually Transmitted Fungus

by suelowe

TMVII is a New Sexually Transmitted Fungus

 

Trichophyton Mentagrophytes Type VII (TMVII for short) is in the news, and you may have heard about it. It’s a rare fungus that causes a treatable rash on the skin. It was recently found in the U.S. for the first time. The patient is a male New Yorker in his 30s who traveled to California, England, and Greece, where he had sex with men.

He developed a red, itchy rash on his genitals, legs, and buttocks. Despite multiple oral antifungal treatments, it took more than four months for the rash to heal completely.

No one yet knows how TMVII will develop in this country. In France, 13 cases were reported last year, 12 of them in men who have sex with men.

For now, there is no need to panic. But there is a need for vigilance.

Since TMVII is spread through skin-to-skin contact, including during sex, it’s technically a sexually transmitted infection. And while the sole case in the U.S. has been in a man, the fungus can affect a person of any gender, gender identity, or sexual orientation. Stay informed, be aware, and know that seeing a doctor who can report the incidence helps with statistical data and research.

Also know that we are still seeing sporadic mpox cases, and that that poses a higher risk, especially for those who are immunocompromised. Please ensure you are fully vaccinated.

At DAP Health, we believe that good sex is good. Sex is healthy. Shame-and-stigma-free. Live your best sex life by going for regular STI testing, and learning about prevention measures such as DoxyPEP or DoxyPrEP for STI prevention, and PrEP or PEP for HIV prevention. If you’re HIV-positive, stay on your meds. Undetectable = Untransmittable.

 

More About TMVII

If you develop a new rash, please visit one of DAP Health’s three sexual wellness clinics (in Palm Springs, Cathedral City, or Indio), where our experts can see, diagnose, and treat you.

 

Symptoms

  • Appearance: TMVII infections typically present as red, itchy, and scaly rashes. The rashes often appear in ring-like patterns, which is characteristic of ringworm infections.
  • Affected Areas: Commonly affected areas include the groin, legs, buttocks, and other body parts. The rash can expand and may become more pronounced if left untreated.
  • Additional Symptoms: In some cases, the affected skin may blister, crack, or ooze. The infection can cause significant discomfort and may impact the quality of life due to persistent itching and irritation​.

Transmission

  • Direct Contact: TMVII is primarily transmitted through direct skin-to-skin contact with an infected individual. This can happen during close physical activities, including sexual contact.
  • Indirect Contact: The fungus can also spread through contact with contaminated objects such as towels, clothing, bedding, and surfaces.
  • Zoonotic Transmission: TMVII can be transmitted from animals to humans, particularly from pets like dogs and cats that may harbor the fungus​.

Prevention

  • Personal Hygiene: Maintaining good personal hygiene is crucial. Regularly washing and thoroughly drying the skin, especially after sweating or bathing, helps prevent fungal infections.
  • Avoiding Shared Items: Avoid sharing personal items like towels, clothing, and grooming tools with others.
  • Pet Care: Ensure pets are free from fungal infections by having them regularly checked by a veterinarian and treating any infections promptly.
  • Prompt Treatment: Treating fungal infections promptly in both humans and animals can prevent the spread of the fungus to others​.

Diagnosis

  • Clinical Examination: Clinicians typically diagnose TMVII through a clinical examination of the affected skin. The characteristic appearance of the rash often provides initial clues.
  • Laboratory Tests: Confirmation is done via laboratory tests, including:
    • Microscopic Examination: Skin scrapings from the affected area are examined under a microscope to detect fungal elements.

Treatment

  • Topical Antifungals: For mild infections, topical antifungal creams, lotions, or powders containing terbinafine, clotrimazole, or miconazole are often prescribed.
  • Oral Antifungals: In more severe or resistant cases, oral antifungal medications such as terbinafine, itraconazole, or fluconazole may be required. These medications have been effective, though resistance can complicate treatment​.
  • Combination Therapy: Combining topical and oral treatments may be necessary for persistent infections. Monitoring for side effects and interactions with other medications is important, especially with drugs like itraconazole, which can have significant side effects​.

Research and Future Directions

  • Ongoing research aims to better understand the genetic mutations that confer resistance to common antifungal treatments. International collaboration is crucial for tracking and managing the spread of TMVII and similar resistant strains​.

In the News:

What to know about rare sexually transmitted fungal infection TMVII via the Desert Sun

 

Pride-Themed Podcast Features Our Very O …

by Daniel Vaillancourt

DAP Health's Director of Gender Health & Wellness Mita Beach Shines in IEHP iHeart Media Pride-Themed Podcast

 

The latest episode of the IEHP podcast “Covering Your Health” launched on iHeart Media this morning. In celebration of Pride month, host Evelyn Erives sat down with DAP Health’s Director of Gender Health & Wellness Mita Beach. Together, they delved into the unique challenges faced by the LGBTQIA+ community when it comes to health and wellness. From mental health support to inclusive health care practices, Mita shared valuable insights and strategies for promoting well-being, including how to best be an ally. “Educate yourself,” urged Mita. “Ally is a verb.”

 

Click here to listen to the Pride-themed episode.

 

To learn more about DAP Health’s Gender Health & Wellness programs, click here.

 

For more on Mita, please read below.

 

Mita Beach, LBBP, is the director of Gender Health & Wellness at DAP Health. In this role, Mita is leading the strategic development and implementation of health and wraparound services for trans and gender-diverse patients.

With an impressive background that includes serving as the manager of Gender Health & Wellness at DAP Health, Mita has a proven track record of enhancing program development and delivering comprehensive health services. Their experience extends to working as a trans health navigator at Borrego Health, where they conducted patient assessments and facilitated support groups.

Mita brings over 20 years of corporate leadership experience and 15 years of consulting expertise in LGBTQ+ rights, sexual health, and sexuality education. They have designed and facilitated numerous workshops across various sectors, demonstrating a commitment to fostering inclusive and supportive environments. 

Mita is an active member of several professional organizations, including the World Professional Association for Transgender Health (WPATH), the Association of Medical Professionals with Hearing Loss (AMPHL), the National Association of Lesbian, Gay, Bisexual, Transgender Addiction Professionals and Their Allies (NALGAP), and the National Coalition for Sexual Freedom (NCSF).