Uncategorised

/Uncategorised

Vancouver’s Elbow Room Cafe cofounder Bryan Searle dead at 87

  • null
  • Bryan Searle (right), with marriage partner Patrice Savoie in a scene from the short film “A Little Elbow Room” (written and directed by Mavreen David).NATIONAL SCREEN INSTITUTE

Bryan Searle, a founder and co-owner of Vancouver’s infamous Elbow Room Cafe, has died at age 87.

A sign on a window of the restaurant advised that Searle died last Thursday (December 14) at 10:15 p.m. A cause of death was not given.

The well-known Searle and his partner (in business and in marriage), Patrice (Patrick) Savoie, founded the popular brunch spot in its original West End location (720 Jervis Street, just north of Robson Street) in 1983. They moved to the current location at 560 Davie Street, between the West End and Yaletown, in 1996.

The Elbow Room was famous for its “big-ass” breakfasts and burgers and for liberal lashings of sarcastic banter (“Food and service is our name; abuse is our game!”) from its owners and employees. In its earliest days, failure to clean your plate could mean a “forced” donation to Oxfam to make up for the “wasted” food. For many years afterward, Searle and Savoie raised almost $100,000 for local charity A Loving Spoonful, which provides free healthy meals to people living with HIV and AIDS.

Searle, Savoie, or likeminded servers could unleash good-natured insults for any slight, real or imagined, but especially if a patron broke any of the restaurant’s “rules”. These included asking for water, a coffee refill, or inquiring how long it would be to receive your order.

Earlier this year, such banter may have led to an incident where a man entered the restaurant, sprayed pepper spray, and fled, leading to the evacuation of the premises and up to 16 customers being treated by emergency personnel on the sidewalk outside. No one was seriously injured.

The window notice, signed by “Elbow Room staff”, said: “There will be a celebration of life at a later time, when Patrick is ready for one. We will keep you informed.”

Earlier this year, Elbow Room Cafe: The Musical made its  debut at the York Theatre. In a Georgia Straight  preview of the show, playright Dave Devau referenced the restaurant’s founders and their eventual legacy. “Our focal point is Bryan and Patrick and the Elbow Room—and the notion of growing old, and what stamp we sort of leave on the world through the people or the things that we leave behind. As the real-life Bryan and Patrick are aging, that’s something they think about a lot. Will they be remembered? How might they be remembered?”

Cameron Mackenzie, director of Elbow Room Cafe: The Musical, helped answer that question when he told the Straight: “In our community, we often forget about our elders. AIDS wiped out a large, large portion of gay men that would otherwise have been a link between generations.…Young gay people don’t have the opportunity to learn about their history and the battles that came before them, because it’s hard to meet older queer people. So, for me, this is the interesting thing. For me, the café is the physical tie between generations—and that sort of represents the marginalized. It’s a story that we don’t often hear.”

by Martin Dunphy

Source: https://www.straight.com/food/1009351/elbow-room-cafe-cofounder-bryan-searle-dead-87

Blood Transfusion And HIV – What You Need To Know

What is a blood transfusion?

A blood transfusion is the transfer of blood or blood products from one person (donor) into another person’s bloodstream (recipient). This is usually done as a lifesaving manoeuvre to replace blood cells or blood products lost through severe bleeding, during surgery when blood loss occurs, or to increase the blood count in anaemic patient.

In the early days of the HIV epidemic, there was little information about which fluids contained the HI-virus. Although donated blood was screened, the methods did not accurately screen for HIV. At that time, there were many infections among people who received blood transfusions because of trauma or diseases. This was particularly high among haemophiliacs. The blood of people with haemophilia lacks various clotting factors, which means that they regularly require transfusions of blood or blood products.

If a person who is HIV-positive donates blood products such as an organ or tissue, the person who receives the blood product is likely to develop an HIV infection, too. To prevent this, blood products are tested for HIV before they are given to anyone.

Blood-testing guidelines

International guidelines state that all blood products must be tested for viruses such as HIV, therefore, over the years, many highly effective methods have been developed by blood transfusion services (BTS) to ensure HIV-free blood supplies. BTS also takes all possible precautions to ensure that nobody who is HIV-positive donates blood.

High-income countries test and screen all blood products which will identify those that need to be disposed of if they contain HIV.

Some low-income countries lack the equipment to test all blood, so there have been some examples of donated blood products containing HIV. However, this is still very rare and people who donate blood are often asked questions that will help determine if they have been at risk of HIV infection in the past.

In most cases, the blood product you are receiving is safe. However, if you are worried, it is your right to ask the health-care professional if it has been tested for HIV or not.

Persons who may be banned from donating blood

In some countries, certain groups of people are banned from donating blood products for a specific period of time because they are more likely to be HIV-positive. The main reason for the ban is that they may be infected with HIV, but it hasn’t shown up on a HIV test as yet (it can take up to three months after infection for HIV to show up on a test).

Groups of people that may be banned for some time, or for life, include men who have sex with men, sex workers, and people who inject drugs. Certain activities such as having a tattoo or body piercing, or if you are living with a certain health condition, may also mean you can’t donate blood for a while.

If you fall under one of these groups of people, tell a health-care professional and they can advise you whether it’s safe to donate blood or not.

There are also other factors that could contribute to someone not being able to donate blood, such as:

– Low HB (haemoglobin)

– Medication (presently being taken)

– Miscarriage (past six months)

– Recent skin piercing or tattoos

– Cancer

– Diabetes

Some people think that donating blood is a better way to learn their HIV status than asking their doctor for an HIV test or visiting a clinic. This is not true. You should not donate blood to find out if you are HIV-positive. Why? Because the HIV tests used to screen donor blood are highly accurate – but they aren’t perfect. If you have been infected with HIV recently, even the most sensitive test may not show it, and you can infect others if your blood is transfused to them.

If you have engaged in high-risk sexual or drug-taking behaviours, you should not donate blood. It is important, though, to learn your HIV status. You can get an HIV test at a number of places, including your local health department, public health clinic, doctor’s office or at many local AIDS service organisations or community-based organisations. By getting an HIV test, you can protect your own health, as well as the health of people who need blood. It is also possible to purchase a rapid home-use HIV test kit.

Note to donors

When donating blood, if you have concerns about how sterile the needle is that is being used, you don’t have to worry. The empty blood pack has its own needle, and when used it is dumped. The site of the venipuncture is then cleaned with a sterile solution. A brand new needle is used for each blood donation. Once it is used, the needle is destroyed.

If you suspect that the needle your health-care worker is using is not new or sterile, then ask them to change the needle before agreeing to give blood.

Blood transfusion facts

– Blood transfusions can be a life-saving measure.

– Volunteer donor blood usually is readily available, and, when properly tested, has a low incidence of adverse events.

– The likelihood of contracting infections from a blood transfusion is very low (varies with the infectious agent from one in 350,000 to one in one million), but can occur.

– Transfusion of your own blood (autologous) is the safest method but requires planning ahead, and not all patients are eligible. It is usually only an option for elective surgery.

– Directed donor blood allows the patient to receive blood from known donors.

– Blood-conserving techniques are an important aspect of limiting transfusion requirements.

– Blood banks are responsible for collecting, testing and storing blood.

– People with Type O negative blood are considered universal donors as it is safe to transfuse to nearly everyone.

– Most of the time a transfusion is not a ‘whole blood’ transfusion, but rather certain blood products, with red blood cells being the most common.

Source: http://jamaica-gleaner.com/article/health/20170705/blood-transfusion-and-hiv-what-you-need-know

 

SOUTHERN FORUM ADDRESSES HIV AMONG GAY AND BISEXUAL MEN OF COLOR

shary-jones_headshot

 

HIV continues to take a heavy toll in the southern United States. Southern states represent 33 percent of the U.S. population, but accounted for an estimated 44 percent of people living with an HIV diagnosis and 50 percent of new HIV diagnoses in 2014. Due to these persistent HIV-related disparities the prioritization of cost-effective, scalable interventions in the South is crucial.

Within the South, African Americans continue to be severely affected by HIV. According to the Centers for Disease Control and Prevention (CDC), African Americans accounted for 54% of new HIV diagnoses in the South in 2014, and Black gay, bisexual, and other men who have sex with men (MSM) accounted for 59% of all HIV diagnoses among African Americans in the South. In fact, more than 60% of Black MSM diagnosed with HIV in the United States in 2014 were living in the South.

In response to these challenges, the U.S. Department of Health and Human Services (HHS) HIV/AIDS Regional Resource Network Program (RRNP) held a forum focusing on racial and ethnic minority gay and bisexual men in the South. The regional forum brought together staff from state health departments in HHS Regions 3, 4, and 6 to identify opportunities to increase regional coordination of HIV prevention and treatment efforts focusing on MSM of color; share best and/or promising practices and lessons learned from efforts serving MSM of color; and discuss barriers to the planning, implementation, and delivery of HIV/AIDS services for MSM of color as well as strategies for overcoming them.

Among the key topics discussed by the participants were the need to increase the proportion of MSM of color living with HIV who achieve viral suppression, and the need to scale up pre-exposure prophylaxis – or PrEP – for those who are uninfected but at high risk for HIV. The participants also reinforced the ongoing need for workforce development, oral health care, food/nutrition services, and transportation to support people living with HIV to remain engaged in medical care.

There were excellent presentations to inform discussions on health equity and access to HIV services for racial and ethnic minority MSM in the South. These included an opening address by Dr. Arlene Lester, Region 4 Minority Health Consultant, about the National CLAS Standards and how they can help inform, guide, and facilitate culturally and linguistically appropriate health services for MSM of color, and a presentation by Dr. Peter DiMartino, Center Chief of HIV Prevention and Health Services for the Maryland Department of Health and Mental Hygiene, on the critical role that stable housing plays in helping individuals access HIV medical care and stay adherent to treatment.

Ms. Shante Miller and Ms. Regina Waits, the Regional Resource Coordinators in Regions 4 and 6, served as the forum’s co-organizers. “The gathering was highly interactive,” noted Ms. Miller. “Participants had the opportunity to hear from other health department representatives in states with similar issues and demographics so that they could learn from each other’s successes and avoid implementing efforts that have been shown to be ineffective.”

The southern forum was part of RRNP’s ongoing efforts to help achieve a more coordinated and effective national response to the HIV epidemic. Funded by the Secretary’s Minority AIDS Initiative Fund (SMAIF), the RRNP works at the regional level to provide technical assistance to HIV stakeholders to help increase access to HIV prevention and care services and improve health outcomes for racial and ethnic minority populations.

Source: https://blog.aids.gov/2016/12/southern-forum-addresses-hiv-among-gay-and-bisexual-men-of-color.html

JOB OPPORTUNITY: Indigenous Peer Navigator (Part Time On-going, contract with Positive Living BC)

Date Posted:                       October 25, 2016

Closing Date:                      until positions are filled

Employment Type:           Contract Part-Time (5-20 Hours/Week)

Location(s):                        Operating within the area covered under the Vancouver Coastal Health Authority

Employer:                            Positive Living Society of British Columbia

Salary Range:                      $20.86/hr

Send Cover Letter and Resume to: glenb@positivelivingbc.org or drop off in person at Positive Living BC Office – 803 E. Hastings St. Vancouver BC. V6A 1R8

Job Summary

The Positive Living Society of BC’s Peer Navigators, in conjunction with the member/participant, develop strategies to maintain or improve health and wellness needs and implement self-management skill-sets. Working collaboratively with other health care and wellness providers, the Peer Navigators provide direct health system navigation, health advocacy, education and linkage to relevant specialized health, social and emotional well-being and wellness resources related to HIV.  Peer Navigators network with front line service providers in order to promote the Positive Living Society’s Peer Navigation Services.

Schedule: 5-20 hours per week depending on availability and skills.

Qualities we are looking for in a Peer Navigator

  • You have a cell phone.
  • You are dependable, reliable and know how to use a day-planner.
  • You have strong emotional self-management skills.
    • The ability to keep your own feelings in check while helping someone else through theirs.
    • Able to creatively solve problems.
    • The ability to set firm boundaries and practice assertive communication.
    • The ability to put your own personal judgments, prejudice, and biases aside.
  • You are willing to be out about your HIV status to your peers, so are able to draw upon your own personal experiences with HIV, addiction, and shame to help others.
  • You are an intuitive listener.
  • Have a reputation for helping others.
  • A compassionate person with the ability to treat the person in front of you with dignity and respect.
  • You are outgoing and able to engage people who may not trust you at first.
  • You work independently, and as part of a team.
  • But, are not too proud to ask for help and able to take direction.
  • You have a strong, solid support group and/or active self-care regimen.
  • You have two years clean and sober.
  • You are comfortable communicating with health care professionals.
  • You have the ability to work within the harm reduction model of the society.

Part Time Peer Navigator Main Duties

As part of an interdisciplinary team:

  • Inform and educate the larger community about HIV testing sites and the value of testing.
  • Provide basic HIV101 information at outreach events, health fairs, community gatherings and at direct street outreach.
  • Ensures on-going support to participants by maintaining contact by way of in person drop-in, email, telephone calls, and accompaniments;
  • Assess member knowledge and self-management skill level in the areas of HIV disease including treatment, preventing disease progression, preventing transmission, self-care, emotional wellness, social support, disclosure and harm-reduction;
  • Help participants to develop self-management skills based on participant-identified needs and Clinic or Vancouver Coastal Health (VCH)Outreach Team recommendations;
  • Refer members to HIV related health and wellness services and/or other community services;
  • Accompany clients to clinics, community agencies or accompanying nurses to homes;
  • Attend patient consults at request of clinic or patient;
  • In consultation with a Supervisor, promote the Peer Navigation Program.
  • Maintain confidential and accurate files;
  • Comply with agency policies and procedures, including but not limited to maintaining confidentiality of participants and business operations in accordance with Society policies.

You would be working around people active in their drug or alcohol addiction. These are important points for you to consider before applying for this position.

NEW!! Registered Disability Savings Plan/Disability Tax Credit Program

 

NEW!! Registered Disability Savings Plan/Disability Tax Credit Program

Disability Alliance BC (DABC) is thrilled to announce a new province-wide program to help British Columbians with disabilities access the Registered Disability Savings Plan (RDSP). This new service has been made possible through the generous support of the Vancouver Foundation and will be provided in partnership with Plan Institute and the BC Aboriginal Network on Disability Society (BCANDS).

Through this new partnership, DABC advocates provide direct service by:

  • Helping people who are eligible for the RDSP to apply for the Disability Tax Credit (DTC), a pre-requisite for the RDSP.
  • Connecting individuals who have the DTC to Plan Institute or BCANDS who will help people open an RDSP.

In addition to direct assistance, DABC will travel to communities across BC to raise awareness about the program with a goal to increasing the number of people accessing the RDSP. We will provide information about the RDSP and DTC through workshops and one-on-one clinics, and will meet with community organizations, banks, and credit unions to promote the RDSP.

For more information about the DTC and RDSP or to request a workshop, please call Linda at DABC: 604-872-1298; 1-800-663-1278 or email rdsp@disabilityalliancebc.org

Plan Institute’s RDSP Helpline (1-844-311-7526) is a great resource for information about the RDSP and DTC. Plan will also be administering the Endowment 150 program, formally operated by the Vancouver Foundation.

More about the RDSP

The RDSP is a long-term savings plan designed to help Canadians with disabilities at all income levels save for their futures. One reason the RDSP is so unique is because eligible individuals who open RDSPs can receive federally administered grants and bonds worth as much as $90,000 during a person’s lifetime.

 

Source: Disability Alliance BC

Cancer Risk Comes with HIV-Hepatitis B,C Co-Infection

People who  have HIV are at higher risk of getting lymphoma, about 100 times greater than the general population. Even after they get antiretroviral therapy people who are HIV positive have a 10-fold higher risk of lymphoma.

A new study from Europe found that having HIV plus a hepatitis virus (B, C, or both) further adds to the risk of lymphoma, specifically non-Hodkgins lymphoma (NHL) .

But in a puzzling finding the researchers learned that these HIV positive co-infected patients do not have an increased NHL risk when co-infected with hepatitis unless they are getting antiiretroviral therapy.

Reporting in Annals of Internal Medicine , Andrea De Luca, MD and colleagues  from the Collaboration of Observational HIV Epidemiological Research Europe (COHERE) group did a cohort study based on medical records from more than 50,000 patients. The group all had HIV plus chronic hepatitis B virus (HBV) or hepatitis C virus (HCV).

All patients in the study were treatment naïve for HIV, that is they had not started ART.

There were 1,339 patients with HBV and 7,508 with HCV. Of those 210 had both viruses.

They found that ART-treated patients with chronic HBV or HCV infection were at increased risk for NHL.

The hazard ratios for NHL with HBV and HCV infection were 1.33 and 0.67 respectively in patients who had not started ART.

In patients who did start ART for their HIV infections, the hazard ratios were 1.74 for HBV and 1.73 for HCV.

“Estimates in ART-naïve patients were less certain, possibly due to the lower number of events, limited floow-up due to some patients initiating ART or other unmeasured competing factors masking the effects of chronic HBV and HCV infection.”

Early diagnosis and treatment of HIV infection in conjunction with routine screening for chronic HBV and HCV infection is essential to decrease NHL morbidity and mortality I HIV infected persons, the team concluded.

In an accompanying editorial, Charles Rabkin, MD and James Goedert, MD of the National Cancer Institute in Bethesda, MD said “this study highlights the urgent need to prevent HCV and HBV infection in people living with HIV and to trat those who are co-infected.”

 

Author: Gale Scott

Source: http://www.hcplive.com/medical-news/cancer-risk-comes-with-hiv-hepatitis-bc-co-infection

Broadly neutralizing HIV antibodies pave the way for vaccine

A small number of people infected with HIV produce antibodies with an amazing effect: Not only are the antibodies directed against the own virus strain, but also against different sub-types of HIV that circulate worldwide. Researchers from the University of Zurich and University Hospital Zurich now reveal which factors are responsible for the human body forming such broadly neutralizing HIV antibodies, thereby opening new avenues for the development of an HIV vaccine.

We know from HIV research that around one percent of people infected with HIV form antibodies that combat different virus strains. These broadly neutralizing HIV antibodies (bnAbs) bind to structures on the surface of the virus which barely change and are identical in different viral strains. Dubbed “spikes,” these sugar and protein complexes are the only surface structures that stem from the HIV virus itself and can be attacked by the immune system via antibodies. Due to their broad impact, these antibodies constitute a promising cornerstone for the development of an effective vaccine against HIV.

Virus load, virus diversity and duration of infection encourage antibody formation

A Switzerland-wide team of researchers headed by the University of Zurich and University Hospital Zurich conducted an extensive study on the factors responsible for the formation of broadly neutralizing antibodies against HIV. They examined around 4,500 people infected with HIV who are recorded in the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Study, and identified 239 people who form such antibodies.

Firstly, three disease-specific characteristics are important: the number of viruses present in the body, the diversity of the virus types found and the duration of an untreated HIV infection. “Our study enabled us to show for the first time that each of these three parameters — virus load, virus diversity and infection duration — influences the development of broadly neutralizing antibodies independently of each other,” explains Huldrych Günthard, professor of clinical infectious diseases at UZH. “So we don’t necessarily have to consider all three parameters in designing an HIV vaccine. This is especially important with regard to the length of vaccine administration — it wouldn’t be possible to imitate a longer untreated HIV infection with a vaccine.”

Black people form broadly neutralizing HIV antibodies more frequently

A second factor concerns ethnicity: Black HIV patients form broadly neutralizing antibodies more frequently than white people — irrespective of the other factors analyzed in the study. For Alexandra Trkola, a professor of medical virology at UZH, this surprising discovery needs to be studied more closely: “First of all, we need to understand more precisely what significance and impact the genetic, geographical and socio-economic factors of people from different ethnicities have on the formation of these antibodies.”

Different virus sub-types influence the antibodies’ binding site

The third factor involves the influence of the virus sub-type on antibody formation. While the frequency of the antibody production remains unaffected, the researchers showed that the virus sub-type has a strong influence on the antibody type formed. Sub-type B HIV viruses are more likely to lead to the production of antibodies directed against the region of the virus surface through which it binds to human immune cells (CD4 binding site). By contrast, non sub-type B virus favor the production of antibodies which bind to a sugar element of the virus spikes (V2 glycan). Specific structural features on the virus shell thus affect the antibodies’ binding specificity depending on the virus sub-type.

“Our results show how different factors boost the formation of antibodies that broadly combat different viral strains,” concludes Trkola. “This will pave the way for us to systematically push ahead with the development of an effective vaccine against HIV.

Swiss HIV Cohort Study

The Swiss HIV Cohort Study (SHCS) launched in 1988 contains data on more than 19,000 people infected with HIV in Switzerland. The network includes the five Swiss university hospitals, two larger cantonal hospitals, smaller hospitals and many private physicians who treat HIV patients. The SHCS also has a biobank with more than 1.5 million samples.

More than 9,000 individuals are currently being cared for within the SHCS — that’s around 75 percent of all people treated with antiretroviral therapies in Switzerland. Apart from high-quality treatment, the aim of the SHCS is to conduct integrated multidisciplinary research in both the basic and clinical sector.

Source: https://www.sciencedaily.com/releases/2016/09/160926142825.htm

 

‘Significant increase’ noted in syphilis cases, Toronto Public Health says

Toronto Public Health says it is aware of a “significant increase” in the number of infectious syphilis cases reported in the city last year and in the first six months of this year.

Dr. Rita Shahin, associate medical officer of health, said 394 cases were reported in Toronto up until the end of June 2016. A total of 690 cases were reported to public health officials last year, as compared to 590 cases in 2014.

Shahin said about 97 to 98 per cent of the cases in general are reported in men. Last year, 89 per cent of cases involved men who had sex with men. Forty-five per cent of all people infected with syphilis are also infected with HIV, she said.

“The last couple of years are the highest we’ve seen in a long time,” Shahin said. “It’s not something that’s unique to Toronto. It’s definitely happening in other Canadian jurisdictions and the U.S., as well.”

Toronto public health officials have not pinpointed a “specific cause” for the increase, although no condom use, especially for oral sex, is considered one of the factors contributing to the rise in the number of cases.

“There’s definitely some thought that there’s condom fatigue, particularly in people who are HIV positive,” she said.

Condom

Sexual partners not using condoms may be among the factors contributing to an increase in the number of syphilis cases in Toronto last year and in the first six months of this year. (Bazuki Muhammad/Reuters)

Other factors behind the growing numbers may be an increase in meeting people online, an increase in anonymous sexual partners as well as drug and alcohol use.

As well, she said an HIV treatment known as pre-exposure prophylaxis might also be a factor. That treatment, a daily pill to prevent infection, is used on people who do not have HIV, but are considered at risk of contracting it.

She said it significantly reduces the risk of HIV transmission but may also reduce condom use.

Early symptoms of syphilis include sores or ulcers but Shahin said they are often hard to spot. Shahin urged frequent testing..

According to an online “fact sheet” prepared by Toronto public health, infectious syphilis is a sexually transmitted infection caused by bacteria.

It can be spread through unprotected vaginal, anal or oral sex. It is passed on through direct contact with a syphilis sore. The bacteria can make its way into the bloodstream through a tear in the skin or mucous membrane.

Syphilis can also be spread through sharing of needles when injecting drugs. Pregnant women can pass syphilis on to their developing fetuses.

Toronto public health said a blood test is used to diagnose syphilis. It said it can take between two to 12 weeks for the infection to appear in the blood. The blood test needed to diagnose syphilis is not a routine one.

stethoscope

Syphilis can be diagnosed through a blood test, although not a routine one, and can be treated with antibiotics. (iStockphoto)

Toronto public health said it believes it is important to treat syphilis as soon as possible to prevent complications and to prevent the infection from being transmitted to another person. It said antibiotics will cure syphilis.

If not treated, syphilis can severely damage the heart, brain, liver, bones and eyes.

 

Author: Muriel Draaisma

Source: http://www.cbc.ca/news/canada/toronto/significant-increase-noted-in-syphilis-cases-toronto-public-health-says-1.3782899

The District’s HIV clinic was failing. This ‘old, straight white guy’ managed to save it.

Man in dress shirt sitting in front of large window

Don Blanchon

When Don Blanchon lingers too long in the lobby of this sleek, bright clinic with the bubblegum-pink-and-white cross in the window, patients will collar him.

They’ll share some news about their health. Or they’ll offer a bit of praise.

“Mmhmm, mmhm,” Blanchon says, leaning in so their voices don’t carry. Here in the entryway to one of the nation’s leading HIV-AIDS treatment clinics, discretion is a virtue.

Sometimes, a patient will ask him exactly how he expects them to pay for their medication.

On that point, Blanchon is firm. He tells them that they’ll have to make hard choices. Just like Whitman-Walker.

A decade ago, the clinic and the community that held it afloat through the AIDS crisis made a difficult choice of their own. The clinic was so deep in the red, it could no longer pay its workers. To save itself, it reached outside its network of advocates and activists for someone who could untangle its finances and then some. It hired Blanchon.

A managed-health guy. No-nonsense. Mindful of the bottom line. The kind of guy who would tell patients that they’ll have to find a way to pay. The kind of guy who seemed like he’d never get them.

Blanchon cops to this at the outset. “I’m not the typical leader for a place like this,” he says. “I’m an old, straight white guy.” He has never been diagnosed with HIV.

The LGBT community was aghast at the choice.

“There was a lot of dissension, a lot of angst,” recalls Jerry Filbin, a former HIV testing counselor and board member at Whitman-Walker. “There was a lot of fear, given who Don is, that, ‘Oh, this is not going to be an LGBT clinic anymore.’ ”

But Blanchon understood them more than they knew.

Fear swept the District before it swept America, before Ryan White and Magic Johnson, before the nation grasped how wildly indiscriminate the virus would be.

The gay men of Washington already knew. AIDS was killing them.

As the virus exploded, the clinic that began as the Gay Men’s VD Clinic in 1973 and became Whitman-Walker a handful of years later embraced the unenviable job of caring for patients who invariably would die.

Whitman-Walker became “the organization of last resort,” says Filbin. The AIDS crisis created a need for services that few had expected: The clinic added legal services for the painful business of drawing up wills and settling estates; boarded patients in clinic-owned properties when other landlords refused; operated a food bank; and offered drug and alcohol counseling.

The clinic was “thrust into expanding in a thousand different directions because no one could or would do it,” says Filbin.

Whitman-Walker became a shining example of how HIV-AIDS care could be humane and holistic.

It also became a case study in overreaching. Staff and operating costs ballooned, and by the mid-2000s, the financial picture was dire.

Though Blanchon had been working in managed care in Baltimore, he already knew of the clinic’s problems when a recruiter put a bug in his ear in 2005: Whitman-Walker was looking for a new leader.

“I laughingly said, ‘I don’t know any human being who would take this job,’ ” Blanchon recalls. “They had just missed payroll.”

Practical, managed-care guy that he is, Blanchon saw change — change in the city and change that was rapidly transforming HIV-AIDS treatment — and Whitman-Walker’s failure to adapt to it.

“The old model worked because there were no medications and no tests,” he says of the clinic’s operations through the 1980s and early ’90s. It did not account for new treatments that could help patients live for decades, or that soon, medicines known as PrEP (pre-exposure prophylaxis) would emerge to prevent the virus’s transmission.

“When people are living, what does it mean for an organization that’s set up to take care of people for three years before they die?” he says.

Eventually, the recruiter asked Blanchon if he wanted the job.

The nudge came from his wife, Sarah Ducich. It wasn’t just about whether he would be good for the clinic. The clinic might be good for him, she told Blanchon.

Managed health isn’t all that Blanchon knows, she says. He has incredible empathy for the circumstances under which patients walk through Whitman-Walker’s doors.

Eventually, he says, he, too, had a feeling of “fate, or karma.”

For young people today, he says, AIDS seems past-tense. But he has experienced it personally.

He grew up in Foxborough, Mass., a town now best known as the home of the New England Patriots. He jokes that he was “a Masshole, a townie,” from the sort of clan that would dub siblings “Johnny, Bonnie, Donny and Bobby.” Typical New England stuff, says Blanchon — that would be Donny — in an accent with hints of “Good Will Hunting.”

Of the siblings, Blanchon, 51, is the only brother left. Hours before he was to visit Blanchon more than 25 years ago, his eldest brother, John, was out for an early-morning bike ride when a dog ran into his path. John, 32, wasn’t wearing a helmet and would die from the injuries sustained in the resulting crash.

Then, as the Blanchon family was reeling from the loss, younger brother Robert, a conceptual artist, confessed a secret: He was positive.

“I’m in my early 20s,” Blanchon recalls thinking, “and my brothers are going to be gone.”

Robert succumbed to AIDS-related complications in 1999. He was 33.

Ducich recalls that when she met her husband, “he was brash and young and fearless. Losing his brothers put him in touch with loss, and he had to learn to live with loss and talk about loss and not ignore it.”

“But Don doesn’t drag Robert’s coffin around,” adds Filbin. “He remains moved by Robert’s presence in his life.”

Whitman-Walker hired Blanchon in the spring of 2006, by which time its programs and giant staff had contributed to a deficit so large that the clinic had hawked valuable downtown properties — some inherited from its former patients — simply to plug the dam.

Blanchon shut off the water.

He laid off staff, slashing the services that made Whitman-Walker so vital to the gay community in the worst times of illness, death and grief. D.C. Council members, including David A. Catania, who is gay, were so infuriated by the change that they called for his removal.

“The first couple of years here were brutal. It was way harder than I imagined,” says Blanchon, sitting in a waiting room on some high-up floor of the new Whitman-Walker building, with its floor-to-ceiling windows overlooking 14th Street.

Ducich recalled that at home, Blanchon was frank, laying out his fears in detail. “There were a few times he was like, ‘I don’t know if we’re going to make it,’ ” she recalls.

But Blanchon batted away the offers for Whitman-Walker’s chunk of primo real estate between R and S streets NW. Selling and rebooting in some poorer neighborhood, as Central Union Mission did, he argued, was self-defeating.
“Why can’t great services be in a neighborhood like this?” he asks, thumping a table to make his point. “When someone comes here, they feel dignified, respected. It’s changed the way people feel about themselves. They don’t get labeled, ‘Oh, you must have HIV.’ ”

Many patients don’t have HIV. Of the more than 15,000 the clinic served in 2015, 40 percent were negative, and nearly as many are straight as gay. The demographic continues to change, in part because under Blanchon the clinic has been serving more patients who have health insurance.

Walking the halls of the new clinic, open on a tony stretch of 14th Street for little more than a year, you pass brisk, clean waiting rooms, gender-neutral restrooms and wallpaper that shimmers with flecks of silver. There’s a studio for yoga and wellness classes, and a dental clinic.

Blanchon and his colleagues are already plotting more — sprawling new construction at Whitman-Walker’s drab, gray Elizabeth Taylor Medical Center at 14th and R streets and an expansion of its clinic and services in Anacostia.

And this summer, Blanchon marked a milestone: 10 years as Whitman-Walker’s executive director.

Late this spring, 50 people gathered to sip wine and celebrate the anniversary.

“Can you believe it’s been 10 years?” someone marveled to Ducich.

“I can’t believe it’s only been 10 years,” she whispered.

His slash-and-burn business strategy made Blanchon more than one enemy. But slowly, many grudgingly began to acknowledge that it has worked.

“It took Don three or four years to rebuild the trust of the LGBT community,” says Filbin.

Still, the feelings around Whitman-Walker’s changing demographic are “mixed,” he says. “Whitman-Walker was more than just a clinic to our community. It was the resource center. Whitman-Walker was counseling specifically in a gay and lesbian context.”

Filbin still sees it “as a place where any LGBT person can walk in and be comfortable and at home and be understood as a gay, lesbian, or transgender person.” What Blanchon saw was the future, he acknowledges.

“Don had this vision. He understood. He really did lead us when we didn’t know where to go.”

Author: Lavanya Ramanathan

Photo: Nikki Kahn/The Washington Post

Source: https://www.washingtonpost.com/lifestyle/style/the-districts-hiv-clinic-was-failing-this-old-straight-white-guy-managed-to-save-it/2016/08/19/6e56c588-49e8-11e6-bdb9-701687974517_story.html

 

Gilead’s new price hikes on HIV drugs anger AIDS activists

Crowd of people marching with banners and protesting raised drug prices

Advocates from AIDS Healthcare Foundation and other groups march and protest the high price of drugs, particularly Gilead’s AIDS drugs, after announcing the launch of a new ballot initiative in San Francisco to rein in drug prices on Thursday, Nov. 15, 2012. (John Storey/AP Images for AIDS Healthcare Foundation)

As part of a strategy to switch patients to newer HIV treatments, Gilead Sciences late last week raised prices on a pair of older HIV medications that face patent expiration. This sort of maneuver is often found in the pharmaceutical playbook, but is triggering still more criticism by AIDS activists of its overall pricing strategies.

Here’s what Gilead did: the company raised the wholesale acquisition cost, or list price, for the two older medicines — Complera and Stribild — by 7 percent, to $2,508 and $3,469 a month, respectively. This follows price hikes of 7 percent and 5 percent last January, which Cowen analyst Phil Nadeau noted is a deviation from the typical annual price hikes that Gilead takes on its HIV drugs.

Meanwhile, Gilead left intact prices for two much newer versions of these drugs — Odefsey and Genvoya – which remain priced at $2,346 and $2,578 per month. Nadeau, who first reported the changes in an investor note, pointed out that Odefsey is now priced at a premium to Complera, while the difference between Stribild and Genvoya has widened. A Gilead spokeswoman confirmed the new prices.

By boosting prices for the older HIV treatments twice in just six months, Gilead is clearly hoping that doctors will prescribe its newer drugs. And physicians have an added impetus for doing so: the newest Gilead medications are more potent and studies have indicated they are likely to cause fewer side effects.

This is because the older treatments contain a compound called tenofovir, or TDF, which until recently had been a cornerstone of the combination HIV treatments sold by Gilead. But the patent on TDF expires in December 2017 and Gilead is replacing it with a modified version known as TAF. The patent on TAF doesn’t expire until May 2022, and the added years of exclusive marketing is very valuable.

However, even though TAF is more potent and is less likely to cause bone damage and kidney toxicity, AIDS activists argue Gilead knew of these differences, but deliberately delayed testing TAF in humans for several years in order to extend patent protection for as long as possible on the best-selling older drugs. The allegations, which Gilead has denied, surfaced in a lawsuit filed earlier this year.

The most recent round of price hikes has angered AIDS activists, who say the higher prices reflect indifference to the ability of payers to absorb higher drug costs. Gilead already has been skewered over the cost of its very effective hepatitis C medicines. A US Senate investigation last winter claimed the company put profits ahead of patients, since payers complained the prices overwhelmed their budgets.

Bottom of Form

“This sort of behavior from Gilead, alas, is not surprising,” said James Krellenstein, a member of ACT UP New York. “As we saw with their practices in the development of TAF and the pricing of (Sovaldi, the first hepatitis C medicine that Gilead began selling in early 2014), patient choice and safety takes a back seat when it comes to the company’s bottom line.”

Moreover, the older drugs are still considered highly effective and safe for many people living with HIV, according to Tim Horn, HIV project director of the Treatment Action Group and a member of the Fair Pricing Coalition, two other activist organizations.

“With both public and private payers seriously struggling under the weight of drug price increases that are seriously out of lockstep with rates of inflation in the US — burdens that are ultimately felt by every American — the move should be to lower drug prices to provide a competitive edge,” he said. “Gilead, instead, is choosing to position TAF products in the most artificial and unflattering light possible, by inflating the costs of their older competitors.”

And the AIDS Healthcare Foundation believes the price hike is a good reason to push to invalidate Gilead patents. The non-profit, which operates 46 health centers in the US for which it purchases many medicines, filed a lawsuit earlier this year seeking to have the TAF patents invalidated. “The small savings from the cheaper new drugs pales in comparison to how cheap they would be if they went generic,” said AHF president Michael Weinstein in a statement.

A Gilead spokeswoman wrote us that the price hikes will not affect a price freeze the company offered state AIDS Drug Assistance Programs in 2008 and extended through this year. She added that about half of all patients taking Gilead’s HIV drugs receive them through federal programs at deeply discounted prices, although she did not provide figures. And the company, she said, continues to invest in HIV R&D.

Investors, meanwhile, are likely to view the price hikes favorably. As Nadeau wrote, the higher prices “ensure (the) durability of the HIV franchise,” which he estimated will generate $12 billion in sales this year, and such moves reinforce the “sustainability” of revenues more than investors appreciate, given ongoing controversy over hepatitis C drug costs.

Author: Ed Silverman

Photo: John Storey/AP Images for AIDS Healthcare Foundation)

Source: https://www.statnews.com/pharmalot/2016/07/05/gilead-hiv-aids-drug-prices/