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Vote for your health in California’ …

Vote for your health in California's recall election 

By Robert Hopwood 

A person's health impacts whether or not they vote, and those who do vote shape the state's health care policy. This cycle can hurt marginalized communities if those with poor health vote less often than healthier citizens, which they do. 

"Voting and health are associated, namely people with worse health tend to be less likely to engage in voting," according to a 2020 study in Public Health Review. "Differences in voter participation due to social, economic, and health inequities have been shown to have large effects on electoral outcomes." 

Health policy encompasses much more than health insurance regulations and prescription drug prices. While those issues are important, many other policy decisions determine whether or not people live healthy, fulfilling lives. 

Those issues, known as the social determinants of health, encompass the conditions in places where people live, learn, work, and play that affect a wide range of health and quality-of-life risks and outcomes, according to the Centers for Disease Control and Prevention. 

The determinants of health include housing economic stability, education access and quality, health care access and quality, neighborhood and the built environment and social and community context, according to the U.S. Office of Disease Prevention and Health Promotion. 

These are all issues DAP Health takes seriously, and those who mail in their ballots or show up to the polls are the people who will shape these policies for years to come. 

On Tuesday, Sept. 14, voters will be asked two questions. Should Gov. Gavin Newsom remain the governor of California? And who should replace Newsom if a majority of voters decide to remove him from office? 

More: More than a Little Respect – A Conversation with Erasure’s Andy Bell 

More: COVID-19 vaccine: A message from Dr. David Morris, DAP Health Chief Medical Officer

With 46 candidates vying to replace Newsom, we can only guess how the recall results will impact the state's health-related policies. Those candidates span the ideological spectrum. 

If Newsom avoids becoming the second governor in California history to be recalled, state policies that impact health — from housing to education — likely will stay the same. If he is recalled, state policies could change in unknown ways depending on who replaces him.  

And further complicating the guessing game about the potential direction of state policies after Tuesday is the state Legislature. 

Whoever wins will have to work with the legislative body, which controls the power of the purse. And it isn't changing after Tuesday. Together, the Assembly and Senate provide an essential check on every governor's power. 

Following the recall election, the state will continue focusing on the issues that impact every Californian's health and welfare. 

For example, as anyone who walks through downtown Palm Springs knows, the Golden State has a homeless crisis. Whoever wins Tuesday's recall will have to tackle the problem, directly impacting the lives of more than 150,000 people and the communities in which they live. 

Another issue facing the state is surprise billing. For example, when someone visits the emergency room, he/she/they may unknowingly get procedures done by providers who aren't covered by their insurance. They often have to deal with thousands of dollars in unanticipated and uncovered costs when the bill arrives. 

The people who vote in Tuesday's election will be the ones who decide who becomes or remains one of California's most influential persons. Those who stay home won't. 

More than a Little Respect – A Convers …

Photo Credit: Erika Wagner

More than a Little Respect  A Conversation with Erasure’s Andy Bell 

By Steven Henke 

As seen in The Standard Magazine

I caught up with Andy Bell via email to talk about his career, his new album "The View from Halfway Down," and his September 18 keynote address at the Aging Positively – Reunion Project HIV and aging conference. Bell shed some positive vibes on his life and the creative renaissance he is experiencing 

Bell is a founding member of Erasure. Formed in 1985, when former Depeche Mode and Yazoo member Vince Clarke advertised for a new singer, the duo became successful in the U.K., U.S., and other countries with hits like "Chains of Love," "A Little Respect," and "Oh L'Amour." 

Now, three decades into their career, they are considered one of the most adored and influential synth-pop bands, selling more than 25 million records. In 2019, Erasure released their 18th studio album, "The Neon." 

Question: Thank you for talking with us. It has been a crazy year. You split your time between London and Miami. Where are you today? 

Answer: Finally, after a year and seven months, I'm back in Miami with my hubby after quarantining for two weeks in Cancun. I feel a huge sense of relief. Everyone was beginning to question my sanity and whether our relationship was real or not, or if I had just woken up from a strange dream!  

Q: I read there was a time during the pandemic when you were in lockdown in London and your husband, Stephen, and dog were in Florida. How did the lockdown change you? Did you learn anything new about yourself? 

A: I learned for the first time in my life that I could actually live with myself and do things for myself. I may have been a bit smelly, and I may not have washed as frequently as I should have, but hey, what the hell. I never lived on my own since leaving home at 18 from a large family, and I was dependent on other people. It was great to do my laundry, wash up and go grocery shopping. I love TV, so I can be a real couch potato. There were quite a few Erasure-related things to do, having just finished our photo session and mixing right before the pandemic broke, so I had many Zoom meetings.  

Q:  Many members of the LGBTQ+ community struggled with isolation and mental health during the pandemic. How did you take care of yourself? 

A:  I must admit, I did go back into my shell somewhat and did not speak to people or my family up to the point that they would worry and text to see if I was OK! The worst thing was not knowing when it would end. Canceling four flights made me feel like the red tape was somehow gagging me. Eventually, I had friends over, got stoned and drunk, and had a complete bitch and conspiracy theory fest. It helped tremendously! I'm glad I'm slightly mad, and so are my friends, but I think the LGBTQ crew has to be somewhat to survive. In the U.K., we are fortunate to have the National Health Service, which the U.S. seems to be so frightened of. The word "socialism" is just a word. How can you be scared of a word? It's just about non-profit organizations helping other people. Humans need one another, not this constant bickering, blaming, and point scoring! I did revert to my childhood in many ways, ordering lots of licorice and ice pops. And I did some online counseling, but that lasted three sessions (too boring), plus I got a bit sick of celebs doing their survival blogs, etc. Not that I am bitter (hehehe)! 

Q: Despite the pandemic, you have been experiencing a creative renaissance, releasing a new album, "The Neon!" The album has been described as one of 2020s most elevating moments in an otherwise difficult year. Did you have a team with you, or was making this album a more solitary experience?   

A: As I said, it had already been recorded just in time the previous October. (And I have to admit, I was very sober making it.) It was so refreshing that Vince had already recorded the backing tracks and musical scores in Brooklyn, and I vocalized the top lines in his home studio. There was an excitement in the air. I felt a new appreciation for the new wave music I had listened to as a teenager, and it bled into our new songs.  

Q: Before the pandemic, you released Erasure's 18th album, "The Neon." The album had a feel-good dance vibe that was great for keeping our spirits up during the lockdown. How did you choose the name for that album?  

A: "The Neon" conveys to me the red-light district nightlife and memories of the fairground. I love soft mezcal neon against ancient stone! 

Q: Erasure's 1988 single "A Little Respect" was voted the "Ultimate Pride Anthem" in a new poll from radio station Virgin Radio Pride UK, beating out anthems by Xtina, Gaga, Cher, and Madonna. What did that feel like?  

A:  We were completely taken by surprise by it. I admire the Virgin brand, and two of our favorite DJs now work there, Chris Evans and Graham Norton. It is great to be in such esteemed company on the list, so to speak. I suppose these things are cyclical.  

Q: Take us back 36 years; what were you doing when you answered Vince Clarke's ad looking for a new singer? Is it true you were selling ladies' shoes while starting your singing career? 

A: Yes, and laughing hysterically when I got static electric shocks from the metal stands because of the nylon carpets.  

Q: Did you have any idea when you met Clarke that you would be making music together 36 years later? Is it still exciting to imagine new music together?   

A: Vince Clarke was THE person I dreamed of working with, so, it goes without saying, I think he was a straight man looking for a gay husband! Time has flown by and honestly has no meaning for me!  

Q: You were one of the first openly gay pop stars, and you famously used fashion to make bold statements. Was there a message you hoped to send to other members of the LGBTQ+ community when you wore your iconic outfits? To me, I saw a brave Gay man. Was everyone supportive, or did you face pushback?  

A: It was fine. I didn't want there to be any doubt in anyone's mind as to who I was, and the campiness was somewhat of an armor. When "Sometimes" took off in the mid-1980s, I wore a white T-shirt and jeans. The first few videos from "Wonderland" were so camp, MTV was not going to touch them. It wasn't a sophisticated look like it is today because of RuPaul (God bless him). However, when the airplay started to drop off somewhat, I remember someone saying, "oh, can't you just put a dress back on!" 

Q: In 2004, you announced that you had been HIV positive for six years. Tell me about the process of making that decision. Did you know it would inspire others to know their status?  

A: I was scared at the time, and it took a few years for me to process it. At that time, a witch hunt was in full flow in the U.K. press. This is something I will discuss further at the conference.  

Q: You've been open about being gay since the 1980s and about having HIV. That openness helped many of us in the LGBTQ+ community, and it helped allies understand what they could not experience. Are you able to appreciate the impact you made? Who encouraged or inspired you to be authentic? 

A: To be honest, I think you are born with it. My mother was also very instrumental because she's basically a punk at heart who doesn't give a shit! I don't think about it too much. I love to be free and enjoy myself. Also, I rejected religion at about age 11.  

Q: You are the keynote speaker at the September 18 HIV and aging conference. How does living with HIV impact your life today? 

A: I am so grateful to be alive and be a beneficiary of the cutting-edge science used to create our medications. I salute all of those who passed before us and the brave activists who still fight for us every day. Never take your "freedom" for granted, although to me, it is a God-given right. It can be taken away at the stroke of a pen, usually by the people who believe they love Jesus. (So do I!) Love CANNOT be offensive. It is a misguided conception. 

Q: Every life and career has its ups and downs. How do you find inspiration today to keep the process fresh and exciting for yourself? How do you walk through the downtimes?  

A: Stop listening to music for a while, do a play, forget who you are, and just mingle. Sometimes a good dance helps.  

Q: You have uniquely dedicated fans that look forward to hearing their favorite songs when you perform. Do you have a favorite song that you look forward to playing at every concert?   

A: "Blue Savannah."  

What: The Aging Positively — Reunion Project 6th annual HIV conference is a collaboration between the HIV+ Aging Research Project—Palm Springs and other nonprofit community partners. It will be a virtual conference consisting of a mix of facilitated discussions, panels, and presentations led by key researchers, advocates, and long-term survivors of HIV/AIDS.  

When:  The 6th Annual Aging Positively — Reunion Project virtual conference will be held 9 a.m. to 2 p.m. on Sept. 18, 2021. 

Where:  Attendees can attend the conference from the digital device of their choice.  In-person elements may be announced later.  

How: Registration is free and open on Eventbrite: https://www.eventbrite.com/e/hiv-aging-virtual-conference-tickets-162082616469

COVID-19 vaccine: A message from Dr. Dav …

 

COVID-19 vaccine: A message from Dr. David Morris, DAP Health Chief Medical Officer

Early in the coronavirus pandemic, DAP Health prioritized our immunocompromised and older patients to ensure they received COVID-19 vaccination in line with recommendations from the Centers for Disease Control and Prevention. 

The CDC has updated its clinical COVID-19 vaccination guidance to recommend that people who are moderately to severely immunocompromised -- including people with advanced or untreated HIV -- who received either the Pfizer-BioNTech or Moderna vaccines receive an additional (third) dose.

Many experts consider people with HIV (PWH) whose CD4 cell count is <200/mm3 or CD4 percentage is 14 or less to have advanced disease.

Today, the majority of our PWH are healthy and thriving because of the comprehensive care they receive, which includes access to life-saving medication that suppresses the HIV viral load.   

PWH should discuss their concerns or questions about a COVID-19 third shot with their clinicians. There may be compelling reasons beyond CD4 cell count that may warrant an additional (third)  dose.

For patients who are not immunocompromised, DAP Health continues to monitor the evolving CDC guidelines for booster shots and will be ready to provide these as recommended by CDC.  Until then, we do not believe there are any health benefits to getting the booster shot early. 

This Fall, the third vaccine shot (booster) will be recommended to those without impaired immunity who received either the Pfizer-BioNTech or Moderna vaccines if they are authorized by FDA and recommended by CDC. The FDA and CDC are evaluating Johnson & Johnson’s vaccines, but they have not made any recommendations at this time.

If you have questions about your care, please reach out to your clinician on MyChart. If you have questions pertaining to the vaccine booster or Delta variant, please call our COVID Clinic at (760) 992-0407

More resources

 
 
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‘Immediately call 911’: Bren …

'Immediately call 911': Brendan Burke on overdoses

By Robert Hopwood

Too many lives end in overdose, becoming a statistic in the nation's fight against illicit drugs and abused medications like opioids.

Since 1999, nearly 841,000 people have died from a drug overdose, according to the Centers for Disease Control and Prevention. In 2019 alone, 70,630 drug overdose deaths occurred in the United States. 

Behind every number is a face. Each digit is a person with dreams and heartache, who laughed and cried, who loved and was loved.

International Overdose Awareness Day on August 31 was created to remember those who have died over the years and to acknowledge the grief of their family and friends. It is a global day to shine a spotlight on overdoses.

To raise awareness about overdoses, we talked with Brendan Burke, a Substance Use Specialist at DAP Health. He is a registered counselor with a RADT I certification. Below is our discussion, edited for clarity and length.

Question: What can people overdose on?

Answer: When it comes to potentially abusing a substance, anything that can create some form of dependency typically leaves you higher at risk for overdose. So outside of illegal drugs, something like benzodiazepines — that is a very common substance that can be prescribed — can result in an overdose if it's not taken properly. It can also result in severe seizures when you do stop, when you go through withdrawal. And then something like opiates, like Oxycontin, are prescribed medications. Those can also be taken in excess where it can cause an overdose.

Question: What risk factors increase the chance of an overdose?

Answer: Taking any type of illicit substance in general and taking any type of prescribed medication outside of the confines of the way it's intended to be taken.

Question: How do you know if someone has overdosed?

Answer: It depends on the substance. The most common signs of overdose would be trouble breathing. You might notice the lips turning blue, the person not reacting, or the person not responding to you. The most common sign would be shallow breathing, and then if the person's non-responsive, if the person's skin is clammy or if you see someone having a seizure.

Question: What should you do if someone overdoses?

Answer: Immediately call 911. I would say if the person has Narcan with them, I would have someone call 911 while another person administers the Narcan. Or I would call 911 and, while on the phone, administer the Narcan. Even if the person comes to after the dose of Narcan, it is incredibly important that they have emergency services available.

More: Vaccines protect millions from disease, suffering, death

More: DAP Health magazine helps community members live their best life

Question: What can be done if someone overdoses?

Answer: A lot of treatment facilities will give out Narcan, a medication that can be prescribed, to its patients. If anyone has any type of opiate overdose, it's something where they would put it in the nose with one quick spritz release. That basically immediately blocks all the receptors in the brain that are responding to the opiate. And it basically throws the person into immediate withdrawal mode. So it's something that's very uncomfortable, but it can essentially save someone's life with something like an opiate. Narcan nasal spray is something that's fantastic to have if you're dealing with any type of opioid addiction. If there's an overdose from a stimulant, there's more risk of a heart attack or stroke. That would be something where you would want to immediately seek medical attention.

Question: Who is most at risk of overdosing?

Answer: The person that's abusing substances regularly. People in early recovery that are at risk for relapse. And anyone that regularly abuses a substance.

Question: Why do people put themselves at risk of overdosing?

Answer: It would be addiction. Addiction is something — and this is very important to know — that is recognized as a disease. It fits the disease model. It is a disease of compulsion. You know, everything to an individual tells them, "Hey, this is wrong." Yet, there's still this strong unmeasurable need for it. The more we become understanding of addiction, the better we understand overdose and realize this person doesn't have that intention. They're like a moth to a flame, in need of that substance.

Question: Can shame in marginalized groups lead to substance abuse?

Answer: There have been numerous studies that any marginalized or minority group, specifically the LGBTQ+ community, deal with a lot of shame. And shame gravely affects our behavioral health, our emotional, and our psychological health. And that leaves us far more susceptible to things like addiction, and in turn, leaves our community more at risk for things like an overdose.

Question: How do you overcome shame to get somebody into recovery or treatment?

Answer: That's a really hard one. I think it always needs to be an individualized approach. I would say when we approach the person with empathy, when we approach the person with understanding and when we approach the person with non-judgment, I would say those are the three primary ways to create a sense of bringing down the wall for a person. And then we top it off with facts. You know, we let the person listen. We do a lot in therapy in behavioral health. We gently lift the mirror up to them so they can start seeing the reflection. But the only way someone will be receptive to the mirror is if we approach them with empathy, with understanding, and with the facts.

Question: What role does depression play in overdoses?

Answer: Depression is the internal siren telling us something's wrong, whether there is a chemical imbalance or whether something has been experienced that's just too overwhelming, and we have a hard time coping with it. Depression and anxiety are very loud, blaring red emergency sirens that tell us, "Hey, there's a problem. Listen to it." I'd say the best advice when we experience depression is to listen to it, see what it needs. That means exploring different treatment options or taking care of ourselves if the depression is a little bit more situational. And when we do that, we don't start leaning towards areas that are higher risk to escape it. When we use substances to try and avoid depression, we're running from it. We want to do the opposite. We want to listen to it. There's a reason why depression hurts. It's to call our attention to it, just like if you or I broke our arm, it would sting like a mother. That is the arm's way of telling the nerves to be cautious and to be mindful, and to treat it. When we experience discomfort from anxiety or depression, it's part of ourselves that is asking to be treated.

Vaccines protect millions from disease, …

New York City's Municipal Lodging House vaccinates homeless tenants in 1910. On the wall is a poster stating the rules of the shelter.
New York City's Municipal Lodging House vaccinates homeless tenants in 1910. On the wall is a poster stating the rules of the shelter.

Vaccines protect millions from disease, suffering, death

By Robert Hopwood

Smallpox is almost always mentioned when people talk about the benefits humanity has achieved from vaccines.

There is a good reason for that.

The smallpox vaccine, developed by Britain’s Dr. Edward Jenner in 1798, was the first one created to inoculate people against an infections disease.

Smallpox was awful. It was a scourge that stalked humanity across the globe for at least 3,000 years, spreading from India or Africa to Europe and then to the Americas.

Up to 30% of those who contracted smallpox died of the disease, according to the World Health Organization. Just like with COVID-19, many of those who survived suffered from lifelong complications. And no cure or treatments existed.

In the 1950s, about 50 million people across the globe contracted smallpox. By 1967, it threatened 60% of the world’s population, killed every fourth victim, scarred or blinded most survivors, and eluded any form of treatment, according to the WHO.

In the 1970s, the WHO redoubled its efforts to eradicate the disease. By the end of the decade, a disease that at one time killed every 10th child in France was wiped out, according to the WHO. Since 1980, no one has contracted smallpox.

“Many people consider smallpox eradication to be the biggest achievement in international public health,” says the Centers for Disease Control and Prevention in Atlanta.

Successful vaccine strategies have largely eradicated some of Earth’s other deadly infections, including polio and measles, says Dr. Shubha Kerkar, Director of Infectious Diseases at DAP Health.

Today we have vaccines against many diseases, as every school-age child knows. They protect against polio, chickenpox, shingles, mumps, rubella, whooping cough, bacterial meningitis, COVID-19, and many more diseases.

Thanks to the incredible advances in health science since Jenner gave “lymph fluid” obtained from a milkmaid who had cowpox to James Phipps, doctors across the planet can protect scores of people against untold suffering and death.

Many vaccines contain small parts of the germ. Those bits of the germ are weakened or killed during the manufacture of the vaccine and don’t make people sick, says Dr. Tulika Singh, Director of Research and Associate-Chief Medical Officer at DAP Health.

When the vaccine is administered, the small bits of germ stimulate our immune system to create antibodies, Singh says.

The COVID-19 vaccines from Pfizer and Moderna are a little different. They use a novel platform using “messenger” RNA to create vaccines (mRNA), Kerkar says. They do not use the live virus or even any particle of a virus.

They do not affect or interact with our DNA in any way. mRNA never enters the nucleus of the cell, which is where our DNA is kept, Kerkar says. The cell breaks down and gets rid of the mRNA soon after it is finished using the instructions.

COVID-19 mRNA vaccines give our cells instructions to make a harmless piece of “spike protein,” which is found on the surface of the virus that causes COVID-19, she says.

“Vaccination prepares the human immune system to combat specific infections,” Kerkar says.

Once the body has created antibodies to a specific disease, it’s ready to fight a real infection, says Singh.

“Vaccines prevent disease; they don’t treat disease or cure disease,” Singh says. “They prevent your body from experiencing a real infection.”

Contrary to what some people may say on social media or whisper at dinner parties, vaccines are not dangerous, Singh says.

An old myth about vaccines is that they cause autism. That false belief started when people read articles by a bad researcher, says Singh. Multiple studies have been done that clearly show that vaccines do not cause autism.

Sometimes people may develop a reaction shortly after getting a vaccination, Singh says. That happens when their bodies react to the vaccine and begin creating antibodies.

“That is not a bad thing. It’s a good thing,” Singh says.

A myth about the COVID-19 vaccine is that it was rushed and therefore unsafe. That’s not true, Singh says.

It can take nearly a decade for a vaccine to get approved by the FDA, Singh says. But the COVID-19 vaccine took less than a year to develop. Singh says the vaccine was fast-tracked because the planet was in the grip of a pandemic, but it did go through rigorous study.

When a vaccine gets an emergency use authorization, the FDA still requires and studies its safety data, Singh says. Once they realized the COVID-19 vaccines in use today were safe, they OK’d them.

“The only reason many people are alive now is because the FDA approved the vaccine so quickly after looking at safety data,” Singh says.

DAP Health magazine helps community memb …

Steve Henke speaks with Sandie Newton about the first edition of DAP Health magazine, which is available at DAP Health clinics; Palm Springs Chamber of Commerce; Arenas Road; and Revivals stores in Palm Springs, Cathedral City, Palm Desert, and Indio.
Steve Henke speaks with Sandie Newton about the first edition of DAP Health magazine, which is available at DAP Health clinics; Palm Springs Chamber of Commerce; Arenas Road; and Revivals stores in Palm Springs, Cathedral City, Palm Desert, and Indio.

DAP Health magazine helps community members live their best life

By David Brinkman

DAP Health has published the first edition of our new magazine.

The publication is a gift to our community. We want to make it easier for you to find the information you need to live your best life. While we put a great deal of time into publishing content online, we know that many of you are making a greater effort to manage your screen time by unplugging and curling up with a great book or periodical. If you can relate to that kind of self-care, our new magazine is for you.

We've been committed to health care equity since our beginning in 1984. We've worked to remove the barriers to underserved communities that keep them from receiving the care they deserve. In the magazine’s first edition, we explore how shame and a deep sense of unworthiness prevent many from asking for help.

You'll find a nod to our history in our story about Les Dames, the drag duo that supported us in our early efforts to combat the AIDS crisis. Before the LGBTQ+ community had economic or political power, drag queens proudly lip-synced for dollars that were then donated to fund our community wellness program. Douglas Woodmansee and Marshall Pearcy are two such early heroes, and our new wellness lobby celebrates that history.

In the story "Take an Active Role in Your Health,' you'll learn more about the clinicians serving our community in a story photographed by Mark Davidson. He's the same photographer who created the images for the dozens of Les Dames posters hanging in our lobby.

And we've got news to share about Revivals, the resale and new furniture store that raises more than $1 million a year to help fund the comprehensive care provided at DAP Health.

Everyone deserves wellness, and we hope our new magazine is a tool you can use for better health today.

Pick up a copy today at DAP Health clinics; the Palm Springs Chamber of Commerce; Arenas Road in Palm Springs; and at Revivals stores in Palm Springs, Cathedral City, Palm Desert, and Indio.

Conversations about HIV and Aging Guille …

Conversations about HIV and Aging: Guillermo

Q: How did the U=U message shift your outlook on dating and connection?

A: After living years in fear and shame, I finally understood that I was not damaged and being loved was nothing I needed to beg for. Intimacy was always a fear based-rational process and not a human experience. Always worried to impact somebody’s life by passing an illness that will change their existence forever. Now I enjoy a healthier-intimate life experience where I am not afraid to explore but still, in a responsible way. 

Q: What's your goal for the future? What do you hope to be doing in the next 5-10 years personally or career-wise?

A: This is probably the most challenging aspect of my life since I never thought that I would live this long. My approach was always living in the present and not making plans for the future. After three decades of living a healthy life with HIV, I guess I am here to stay longer than I expected, but now, as an older man. It is hard to understand what is “typically” part of just aging and what is aging with HIV being on meds for more than 20 years. I am looking forward for a more adventurous life, working and producing income in a balanced and harmonious way, being free of shame … No more careers for me. Just the joy of working, earning a living, creating an impact and holding positions and opportunities that allow me to do so. There is so much more to give and share, but it takes others to see you and give you that platform. 

Q: What book or movie inspired you most? 

A: “A New Earth: Awakening Your Life's Purpose” by Eckhart Tolle. When this book came out in 2008, I remembered hearing about it through Oprah Winfrey when she decided to do a live cast (way before Zoom folks!) to read the book, one chapter every week with Eckhart. This book has been transformational for the way I see life and I apply its principles every day. 

Q: What's your personal mantra?

A: “It is not too complicated.” We tend to take life too seriously and the pressure of living a life following the society standards of happiness and success. None of that works for me, and I just want a non-complicated life because it is not complicated. We make it complicated. 

 

C.J. Tobe discusses how DAP Health is wo …

‘Latino men are not just going to walk into our doors’: Tobe discusses how DAP Health is working with Latino men

By Robert Hopwood, DAP Health

Across the nation, HIV cases have decreased in white men, but they have increased in Latino men.

In the Coachella Valley, DAP Health also has seen the number of HIV cases in Latino men under the age of 40 increase, says C.J. Tobe, Director of Community Health and Sexual Wellness Services at DAP Health.

Locally, since 2019, about 25% of new HIV cases have been Latino men under the age of 40, according to DAP Health data.

In light of Palm Springs' demographics, the fact that a quarter of new HIV cases are Latino men under the age of 40 is a lot, Tobe says.

Tobe says those numbers also result from DAP Health's work of engaging that community and ensuring they have access to education and testing specifically the new HIV self testing program where over 30% of self testers have been latino men.

DAP Health has found that while Latino men under the age of 40 may get diagnosed with HIV in a mobile clinic at a health fair in Indio, for example, they would have gone years without an HIV test, or even knowing they were living with HIV, if DAP Health had not brought services to them in the east valley, Tobe says.

"Latino men are not just going to walk into our doors until it's too late, Tobe says.

Social determinants of health like poverty are driving new HIV infections in the east valley, Tobe says.

More: C.J. Tobe: Success of DAP Health’s mobile clinic occurs every time it is in the community

Related: C.J. Tobe

Related: DAP Health’s Commitment to Health Equity

DAP Health can correlate HIV rates with poverty, he says. The majority of Latino men under 40 who are newly diagnosed with HIV live below 200% of the federal poverty level. For a single person, that is $25,760.

Poverty is a significant driver of everything to do with HIV, Tobe says. People with minimal or no income are not going to prioritize routine HIV testing or take preventative medication like PrEP (pre-exposure prophylaxis), or consistently use condoms.

"It also leads to people having survival sex. Sex for shelter, sex for food, or having sex to make money, to be able to afford those things they need, which also puts them at risk for HIV," Tobe says.

Another contributing factor to HIV infections is cultural, Tobe says. Sex is not something people talk about openly. Some men may still be in the closet, or they could be on the "down low” or “discreet.” It is challenging for men who have not accepted their fluid sexuality to acknowledge their sexual health should be a priority such as getting tested for HIV and STDS and take PrEP and consistently use condoms. 

Tobe says DAP Health is doing many things to reach this population, including:

  • Sending free self HIV test kits to anyone who requests one;
  • Advertising on bus shelters across the valley;
  • Confidentially providing people with education and community resources;
  • Setting up health tables in areas with Latino populations;
  • Providing support to Riverside County and their substance use and mental health departments;
  • Working with four recovery centers in the east valley;
  • Attending area events like The Flying Doctors, El Grito Festival, East Coachella Valley Pride, and the Indio Open Air Market;
  • California Care Force;
  • Working with the John J. Benoit Detention Center in Indio, the re-entry program, and the Coachella Valley Rescue Mission; and
  • Attending Latin Nights at Coachella Valley clubs.

‘It’s a very important element o …

‘It's a very important element of creating safe spaces’: Velasco talks about pronouns

By Robert Hopwood, DAP Health

Pronouns affirm the humanity of an individual and help reduce stigma and obstacles to health care. In short, they matter.

They create a safe space for patients.

"They are a simple and basic topic, but they have a big impact on many of our patients," says Anthony Velasco, Senior Nurse Practitioner Specialist at DAP Health.

Velasco provides comprehensive gender-affirming care at DAP Health, and he advocates for creating better access to safe and gender-affirming spaces for all. He also co-chairs DAP Health's Transgender Health Program.

One of the most important steps to creating a welcoming environment for transgender and gender-diverse people is to address patients using their preferred names and pronouns, according to the Centers for Disease Control and Prevention.

 

Velasco says that using the wrong pronoun to refer to someone is almost like calling somebody by a different name than the name they use.

A pronoun is a word that replaces a noun. For example, the words "it" or "that" are pronouns. Personal pronouns — he, her, they, etc. — are words that refer to a person.

They are a simple way of validating a person's gender identity, creating safe spaces for patients.

Sex is binary and assigned to a person at birth. Gender, on the other hand, is a social construct and is not necessarily the same as the person's sex that was assigned at birth. It isn't binary.

"When I introduce myself and introduce my pronouns to someone, it creates a signal for that particular individual that it is safe for them to discuss their gender identity with me and any gender-affirming needs they may have, especially during our visit," Velasco says.

The 2015 U.S. Transgender Survey — the largest survey ever devoted to the lives and experiences of trans people — surveyed nearly 28,000 people about discrimination, stigma, and health disparities among transgender and gender-diverse people.

They found that 33% of respondents reported having at least one stigma-related experience when they tried to access healthcare. Velasco says that the experience and expression of stigma includes verbal abuse, assault, or even refusal of care.

More: Transgender Care at DAP Is Here For You 

On YouTube: BORN TO BE: Panel discussion and Q&A

In the same study, they found that a significant number of transgender and gender-diverse adults avoided accessing health care services because of the stigma related to discrimination.

Velasco says that when somebody does not acknowledge their gender identity — by misgendering them or deadnaming them — that could be perceived as a form of discrimination.

In another recent study, Velasco mentioned, more than 90 percent of transgender and gender-diverse people in the Inland Empire had health insurance. But most of them didn't access care because they couldn't find a competent provider in providing gender-affirming care.

"One of those incompetencies or lack of knowledge and training would be not validating people, not using correct pronouns, not being aware of gender-affirming issues that transgender and gender diverse people need," Velasco says.

By doing simple, concrete things like making sure we have ways to identify people's pronouns and their chosen names, DAP Health can prevent those barriers to care, Velasco says.

"By us not using and acknowledging their gender identity, by us not using their chosen name — their pronouns — this could potentially limit their access to care," Velasco says.

He says other ways — beyond the use of pronouns — clinicians can let trans people know they provide affirming care is by:

  • Using gender-affirming and inclusive forms;
  • Using gender-affirming electronic medical records;
  • Making sure staff and clinicians are well-trained in how to provide gender-affirming care;
  • Providing gender-affirming hormone therapy;
  • Using trauma informed care;
  • Being aware of all the other things that involve gender affirmation for clients; and
  • Creating programs and interventions informed by the lived experienced of transgender and gender-diverse people. We do this by collaborating with the transgender and gender-diverse community in amplifying their voices to meet their health and social needs.

DAP Health works to create safe spaces for transgender people across the organization. Two simple ways they do that is by putting employees' pronouns in email signatures and on name tags.

"It's a simple but very important element of creating safe spaces for people of all sexes and gender identities in a very respectful manner," says Velasco.

Taking the time to use a person's preferred pronoun doesn't have to be just in a health care setting.

"In our daily language we use pronouns," Velasco says. "We have conversations with everybody. And if we don't respect and honor the names or pronouns they use, it's a way of disrespecting them."

Aging Positively — Reunion Project 202 …

HIV and Aging Conference Header Image

Contact: Steven Henke                                 
Director of Brand Marketing 
(612) 310-3047 
shenke@daphealth.org 

FOR IMMEDIATE RELEASE  

August 5 2021  

Local Organizations Collaborate on HIV & Aging Conference  

Aging Positively — Reunion Project Set September 18, 2021  

Aging Positively — Reunion Project, the annual Coachella Valley conference aimed at providing practical information and inspiration for those aging with HIV, will bring together community leaders to improve the lives of older adults living with HIV for a virtual conference on Sept. 18, 2021. The conference will feature an HIV research panel of top experts discussing HIV and aging issues in our community.   

September 18 is National HIV/AIDS and Aging Awareness Day — a day to call attention to the growing number of people living long and full lives with HIV and to aging-related challenges of HIV prevention, testing, treatment, and care.    

The virtual conference is free to attendees and open to the public. Presented by Eisenhower Health, this year's event is the result of a unique collaboration among local service providers and organizations focused on improving the shared experience of older adults living with HIV.  

People with HIV are living longer lives, thanks to advancements in scientific research and medical treatments; today, about half of HIV positive individuals in the U.S. are age 50 and above. Aging persons living with HIV have experienced tremendous loss, stigma, and discrimination throughout their lifetime and within the healthcare system.  In comparison to similar HIV-negative populations, individuals aging with HIV may experience an early onset of aging complications such as neurocognitive decline, impaired physical function, frailty, and falls.    

Karl Schmid, the entertainment reporter for ABC7 LA will speak on HIV and the media. The ABC reporter, who came out as HIV Positive in 2018, uses his multimedia platform, +Life, to educate and combat HIV stigma.  

At ABC7, Karl has been a regular contributor since 2013, joining the team as a correspondent and producer on the then-weekly and syndicated "On The Red Carpet." 

A passionate activist in the fight against HIV stigma, Schmid launched +Life (www.pluslifemedia.com) in 2019 online to help foster a new conversation around what it means for people living with HIV and to tackle the stigma still associated with the virus. +Life is also part of Localish TV on the newly launched Localish TV network. 

"HIV is not killing people but stigma is, and this is what needs to change," Schmid said in a statement. "We need to talk more about HIV and its advancements, about what U=U means, and we should not be stigmatized by society. 

"We need to have more information on mainstream media about how you contract HIV, prevention and treatments available so that people stop stigmatizing those that are positive and realize that anyone can have HIV and live a completely normal and healthy life."  

Since coming out as HIV-positive, Schmid has used his platform to educate and fight bias.  

Keynote speaker Andy Bell of Erasure fame will share his personal story. Bell is a founding member of Erasure.  Formed in 1985, when former Depeche Mode and Yazoo member Clarke advertised for a new singer. The duo quickly became enormously successful in the U.K., U.S., and several other countries with hits like “Chains of Love,” “A Little Respect,” and “Oh L’amour.” Now, three decades into their career, they are considered one of the most adored and influential synthpop bands selling more than 25 million records. In 2019, Erasure released their 18th studio album, The Neon. 

Bell has become an icon within the LGBTQ+ community for his honesty, compassion and support. Among his support of various LGBTQ+ causes, Bell has served as an ambassador for New York’s Hetrick-Martin Institute, and he is currently a patron of the Cambridge, England-based charity Diverse and of Above The Stag, London’s only LGBTQ+ theater. 

Topics and speakers:  

  •  Keynote speaker: Andy Bell from Erasure 
  • “Honoring Our Experience” with Gregg Cassin 
  • “KeeLee Meditation” with Dr. Daniel Lee, from the University of California, San Diego's Owen Clinic 
  • “HIV & The Media”: Karl Schmid is the entertainment reporter for ABC7 LA. He recently revealed his HIV status and has been an advocate for U=U as well as breaking down HIV stigma. 
  • HIV research update panel: 
    • Borrego Health: Valerio Iovino, i-Care 
    • DAP Health: Dr. Tulika Singh 
    • Eisenhower Health: Dr. Ken Lichtenstein 
    • Palmtree: Dr. Carlos Martinez 
    • HIV+ Aging Research Project-Palm Springs (HARP-PS): Jeff Taylor  
    • Caregiving with Perry Wiggins from The Center, end-of-life doula Alex Snell, and Richard Bass from PALS (Planning Ahead for LGBTQ Seniors)
    •  “Let’s Kick ASS”: Brian DeVries speaks about sustaining and making new friendships late in life 

What: The Aging Positively — Reunion Project 6th annual HIV conference is a collaboration between the HIV+ Aging Research Project—Palm Springs and other nonprofit community partners. It will be a virtual conference consisting of a mix of facilitated discussions, panels, and presentations led by key researchers, advocates, and long-term survivors of HIV/AIDS.  

When:  The 6th Annual Aging Positively — Reunion Project virtual conference will be held 9 a.m. to 2 p.m. on Sept. 18, 2021. 

Where:  Attendees can attend the conference from the digital device of their choice.  In-person elements may be announced later.  

How: Registration is free and open on Eventbrite: https://www.eventbrite.com/e/hiv-aging-virtual-conference-tickets-162082616469  

Collaborating Organizations:  

ANAC   

The Association of Nurses in AIDS Care (ANAC) is the leading health care organization responding to HIV/AIDS. Since its founding in 1987, ANAC has been meeting the needs of nurses and other healthcare professionals in HIV/AIDS care, research, prevention, and policy.  

 ANAC aims to promote the health and welfare of people affected by HIV/AIDS by:  

  • Creating an effective, engaged network of nurses in AIDS care. 
  • Studying, researching and exchanging information, experiences and ideas leading to improved care and prevention. 
  • Providing leadership to the nursing community in matters related to HIV/AIDS infection and its co-morbidities. 
  • Advocating for effective public policies and quality care for people living with HIV. 
  • Promoting social awareness concerning issues related to HIV/AIDS. 

Borrego Health   

Borrego Health provides high-quality, comprehensive, compassionate primary health care to the people in our communities, regardless of their ability to pay. They serve these communities and adjoining regions with respect, dignity, and cultural sensitivity as a medical home and safety net for essential health care and social services. Borrego Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and a Federal Tort Claims Act Deemed (FTCA) facility.  

DAP Health   

At DAP Health, no one wonders if they belong — they just feel it. People can rely on culturally competent and stigma-free care at DAP Health.    

DAP Health offers medical and mental healthcare tailored to patients and clients by clinicians who listen to them. DAP Health has been meeting the diverse needs or its community since 1984, and it offers culturally competent care with no stigma about a person’s race, being LGBTQ+, or living with HIV. By actively listening, we can offer people care and services that meet their unique needs.     

  • Sexual wellness — DAP Health’s Orange Clinic offers STI testing and treatment, Pre-Exposure Prophylaxis (PrEP), Post-Exposure Prophylaxis (PEP), and HIV and hepatitis C testing.
  •  Thriving with HIV and ending the epidemic — DAP Health helps patients living with HIV thrive by staying healthy, undetectable and untransmittable to others. They become part of DAP Health's family beginning with testing, linkage into care, and then being enrolled in medical and mental healthcare, dentistry, social services, and prescription access. 
  • Mental health services — DAP Health offers individual and group therapy and has a substance abuse program that emphasizes recovery and relapse prevention. Mental health is health — no stigma, no shame. It just takes seeing a person truly where he/she/they are in their personal journey. 
  • Ongoing primary care — Join more than 9,700 patients who enjoy culturally competent care from clinicians and care teams who become like family. DAP Health's team works with patients to coordinate their care and ensure they have everything they need to stay healthy.  

Eisenhower Health  

Eisenhower HIV Clinic: Recognizing the complex health care needs of the LGBTQ patient population, Eisenhower Medical Center offers a comprehensive range of clinical, research and education resources — starting with a team of dedicated primary care doctors who have exceptional experience and expertise.  

Eisenhower HIV Clinic Primary Care Services: Providing state-of-the-art care for HIV patients requires knowledge of the latest treatments and best practices in the detection and treatment of HIV. Eisenhower's HIV Primary Care program is focused on the overall health of each patient, including:  

  • Appropriate utilization of advances in HIV care to sustain the best possible quality of life, including appropriate STD and cancer screening as well as healthy aging  
  • Best practices to prevent the spread of HIV  
  •  Compassionate access to new medicines for highly drug-resistant patients  
  • Our team includes HIV primary care doctors Board Certified in Internal Medicine or Family Medicine, with an additional certification as an HIV specialist with the American Academy of HIV Medicine (AAHIVM).  
  • Eisenhower Health is proud to collaborate with many nonprofit organizations here in the Coachella Valley providing HIV and related healthcare services, through partnership connectivity of services, referrals, and education.  

HARP-PS   

The HIV+ Aging Research Project-Palm Springs is a grassroots community non-profit that conducts research and provides education to improve the quality of life for long-term HIV survivors in the Coachella Valley. They collaborate with academic partners throughout Southern California and nationally to conduct socio-behavioral research on issues like resiliency and COVID-19 affecting HIV survivors. They hold monthly provider events to provide education on HIV Treatment issues, and they held monthly COVID Rounds during the peak of the COVID-19 pandemic. They also provide the monthly Positive Life HIV education series with topics and speakers tailored to the unique needs of their HIV survivor community. They created the annual Reunion Project daylong regional seminar to bring together the HIV and aging community in Southern California. Last year they combined forces with DAP Health and other community partners on the Aging Positively-Reunion Project event, which is held each year on or around HIV and Aging Awareness Day on September 18.    

Jewish Family Service of the Desert 

Since its inception as part of the Jewish Federation of Palm Springs and Desert Area in 1982, JFS has grown—not just in size, but in its ability to serve the people of the Coachella Valley. Beginning as a small group of volunteers who checked in on seniors and disabled people who lived alone, JFS Desert has evolved into an organization of professionals and volunteers that provide a broad range of support and services to thousands of Coachella Valley residents each year.  

JFS Desert’s experienced case managers can assist in exploring potential resources. They will assess clients’ eligibility for services and programs and can help facilitate the application process to obtain benefits and support. JFS case managers are a resource for the Coachella Valley, providing emergency financial assistance to prevent homelessness. JFS also works with local and county organizations to advocate for the rights of seniors in the valley. The JFS case management team takes a holistic service approach, collaborating with internal departments to ensure clients’ needs are addressed. We are dedicated to making sure that mental health issues and affordable housing stay front and center for our valley citizens.   

Let’s Kick ASS Palm Springs 

Let’s Kick ASS Palm Springs is an inclusive social group seeking to reduce the stresses of AIDS Survivor Syndrome. They welcome members regardless of HIV status, race, gender, age, or sexuality, believing that the individual is the best judge of the impact of HIV on their life. LKAPS organizes social functions providing opportunities to develop friendships and community.  

They support education and advocacy to raise awareness of AIDS Survivor Syndrome, long-term survivors, and the challenges they face.  

People feel better when engaged in social activity. LKAPS helps long-term survivors overcome isolation by creating social opportunities. From their popular monthly potlucks, twice-monthly coffee socials, bowling team, and movie nights, to now-established annual events such as June 5's Long-term Survivors Day reception and the Thanksgiving Day feast, LKAPS benefits its members through engagement with their local community of HIV survivors.  

PALS  

PALS (Planning Ahead for LGBTQ Seniors) is a volunteer-led community initiative based in Palm Springs that helps LGBTQ+ adults and friends plan ahead before a health or other life-altering situation arises.   

Having a plan in place mitigates stress and anxiety, ensures that LGBTQ+ adults are in control of their future care and legacy, and relieves the burden on family and friends.  

The Center   

At The Center, they like to say they create vibrant community by helping LGBTQ+ people along their way, wherever they might be in life’s journey. Even better, The Center likes to live it, breathe it, and do it. If someone is looking to meet new friends, get resources, or enrich their life and their place in community, they have come to the right place.  

Based in the Coachella Valley, The Center serves people of all ages, totaling more than 70,000 visits annually. How do they attract so many people? They do it with meaningful, relevant and mission-focused programming that addresses three strategic initiatives:  

  •   Ending isolation and loneliness  
  •   Connecting people to resources and community  
  •   Enriching individual and collective experiences 

About DAP Health 

DAP Health is an advocacy-based health center in Palm Springs, Calif., serving more than 10,000 patients, offering medical and mental healthcare, STI testing and treatment, dentistry, pharmacy, and lab services. A variety of wraparound services enable patients to experience optimal health, including social services, support groups, alternative therapies, and other wellness services. Excellent HIV care is provided by the largest team of specialized clinicians in the area.      

DAP Health opened one of California’s first COVID clinics and hotlines to offer screening, testing, and treatment. DAP Health also is working to address the social determinants of health that are causing negative health outcomes during this pandemic, like food and housing insecurity, joblessness, isolation, and access to ongoing healthcare.  

DAP Health’s sexual health clinic offers STI testing and treatment, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP), and HIV and hepatitis C (HCV) testing. DAP Health has earned Charity Navigator’s highest rating for the twelfth consecutive year — landing DAP in the top 6% of nonprofits rated. The distinction recognizes that DAP Health exceeds industry standards in terms of financial health, accountability, and transparency.      

Visit www.daphealth.org to learn more.     

 

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