World AIDS Day, December 1, 2017 National Aids Trust (NAT)
“World AIDS Day takes place on the 1st December each year. It’s an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first ever global health day.”
The theme of this year’s World AIDS Day, as promoted by NAT, is “Let’s End It.” This year, NAT is asking everyone to join the fight to end the negative impacts of HIV including isolation, stigma and HIV transmission. According to the World Health Organization (WHO), there were 36.7 million people living with HIV at the end of 2016 and 20.9 million people living with HIV were receiving antiretroviral therapy globally. This year, WHO is advocating for access to safe, effective, quality and affordable HIV services, medicines and and diagnostics other health commodities for all those in need with their slogan “Everybody counts.”
Please visit the World AIDS Day website for more information about the history of the day and how to get involved, support and show solidarity with the millions of people living with HIV.
I first stumbled upon the issue of palliative care during a particularly hard time in my life. I was twenty years old, and for the first time having to confront the realities of watching a loved one die. Up until then, death had been a decently abstract concept to me. My grandmother had passed away when I was a child, but I was too young to be exposed to any part of the process. My uncle had also passed away when I was a teenager, but due to the suddenness of the death and geographical distance, I did not play a role in the event. I had never attended a funeral, let alone seen a corpse. The case of Monica was very different. For the first time, I became intimately involved in the dying process; and through this, became aware of the workings of the hospice and palliative care system that has become incredibly common throughout the country.
Monica was my mother’s best friend, and a pseudo-mother to my sister and I. In 2007, doctors found a malignant tumor in her colon, leading to multiple surgeries and the administration of rounds of chemotherapy. After some years of remission, the cancer returned in 2011, spreading to more of her internal organs. Once again, different treatments were administered, with waves of optimism and pessimism. Ultimately, in the summer of 2015, after attempting a failed experimental treatment, she was told that there was no more the doctors could do, and that she probably only had a couple more weeks to live. Receiving this news, she opted for in-home hospice care, to be able to spend her last days comfortably with family and friends.
Hospice care is becoming an increasingly common end of life plan in the United States. In the past decade, the number of hospice patients has more than doubled. In 2009, 42 percent of all deaths were under the care of a hospice program.1 According to the National Hospice and Palliative Care Organization, hospice care “ involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support” to help allow the patient to succumb to death in best way possible.2 The phrase they use is that they are shifting the focus from curing to caring. Typically, this involves a family member serving as the primary caregiver, with members of the hospice staff making regular visits and providing 24 hour on-call assistance.2 Central to hospice care is the idea of palliative care, which makes sure the patient is able to die in the most pain-free and dignified manner.
For LGBT resources, please visit RELAY (Research and Education for LGBT and Allied Youth). RELAY is a project of Fordham University’s Center for Ethics Education which looks to advance the conversation about health for lesbian, gay, bisexual, and especially trans youth. Please also visit the resource page for creating an LGBTQ-inclusive classroom.
Trump’s Supreme Court Pick Could Shape Bioethics for Generations Neil Gorsuch, nominee for the US Supreme Court, has spent his career weighing matters of life and death. His views on life—that it is sacred and “intrinsically valuable”—are likely to shape court decisions in areas from abortion to assisted suicide for decades to come.
On Thursday, December 9th, the largest survey of transgender people ever conducted was published by The National Center for Transgender Equality. The anonymous online survey had nearly 28,000 participants and found transgender people are twice as likely to live in poverty and three times more likely to be unemployed, according to an article in TIME Magazine. Other findings included that one-third of respondents reported issues in finding healthcare and 42% reported higher rates of mistreatment by health care providers.
Fordham University Center for Ethics Education Director, Celia B. Fisher, Ph.D., lauded the recent national study highlighting the healthcare needs of transgender people in the United States. “More is needed on the health care experiences of transgender adolescents, especially their experiences with family physicians who often do not have the training to provide necessary gender affirming care,” she noted.
Fisher’s research with colleagues from Northwestern University, supported by the National Institute on Minority Health and Health Disparities (NIMHD), has highlighted the critical need for physicians who are trained and open to providing gender minority youth with not only transitioning information, but also gender and sexual orientation specific sexual health information and services to prevent HIV and related STIs.
For bisexual female adolescents, proper sexual healthcare is difficult to obtain due to healthcare providers’ judgmental attitudes and assumptions of patient heterosexuality, and lack of opportunities for HIV and sexually transmitted infections (STI) testing. Additionally, youth openness with healthcare providers is restricted due to stigma experienced within families of bisexual teen girls and concerns of confidentiality. These findings were published in LGBT Health, a Mary Ann Liebert, Inc. publication.
In addition to attitudes and assumptions of healthcare providers and stigma within families, the findings also included limited school-based sexual health education as an important factor contributing to insufficient health care for bisexual adolescent girls.
“The findings from our study are consistent with the unfortunate fact that sexual health care of adolescent girls has largely been absent or focused primarily on birth control tools that do not prevent risk of HIV and other STI – especially if male partners refuse to use condoms,” notes Fisher, Director of Fordham Center for Ethics Education, “and this problem is exacerbated for bisexual girls who may be unprepared for sexual experiences with male partners or who engage in such experiences to avoid social stigma.”
The researchers concluded that practitioners must improve standard sexual health practices involving female youth by integrating nonjudgmental questions regarding bisexuality. According to Fisher, the study “underscores the need for additional training of family physicians and gynecologists to engage in patient centered discussions that help to overcome bisexual invisibility and fears of medical discrimination that are barriers to bisexual girls sexual health.” In a recent article about the study, William Byne, MD, PhD of LGBT Health, adds, “Knowledge of a patient’s sexuality is essential to the biopsychosocial model of clinical practice.”
According to the study, other forms of support of bisexual health among adolescent girls include addressing stigma, increasing sensitivity to privacy and expansion of school-based sexual health education.
Read more about this research in the News Medical Life Sciences article as well as in LGBT Health.
For LGBT resources, please visit: RELAY – Research and Education for LGBT and Allied Youth is a project of the Fordham University Center for Ethics Education which looks to advance the conversation about health for lesbian, gay, bisexual, and especially trans youth.