HIV Is Coming to An Unprepared Rural America

Williamson, West Virginia.

Rural America has many problems facing it ranging from economic decline to scarce access to medical facilities to a mindset that in some that embraces ignorance and bigotry.  Now, as a column in the New York Times makes clear, some parts of rural America, including much of neighboring West Virginia is about to face an HIV crisis that it is ill prepared to deal with largely due to closed mindedness, the stigma attached to being gay and/or HIV positive and lack of access to progressive testing and medical treatment. Much of the increase in HIV positive residents come from drug use and shared needles yet, rather adopting policies that might reverse the trend, many localities are shuttering programs that might stem increased infections. Here are highlights from a very troubling column:

While there are still about a million people living with H.I.V. in the United States, in some of America’s largest cities, the news about H.I.V. and AIDS is surprisingly positive.

“New H.I.V. Diagnoses Fall to Historic Lows,” the New York City Department of Health announced on Nov. 22, reporting that the largest city in the United States had fewer new diagnoses of H.I.V. in 2018 than during any year since statistics were first kept in 2001. This was just a few weeks after Philadelphia’s Department of Public Health reported a 14 percent drop in the number of newly diagnosed H.I.V. infections overall, and a drop of more than one-third among black men who have sex with men — an especially vulnerable population.

San Francisco and Chicago have also seen their rates of new H.I.V. infections falling.

[I]n much of rural America, an opposite trend is emerging. There have of course always been cases of H.I.V. in sparsely populated parts of the country, but in these places far from cities, the conditions that lead to H.I.V. transmission are now intensifying — and rural America is not ready for the coming crisis.

Indeed, in Appalachian West Virginia, the crisis has already arrived. A cluster of 80 new H.I.V. infections has been diagnosed since early last year in Cabell County.

Unlike large urban areas that have dealt with similar health and substance crises in the past, and that have networks of service providers and consumers in place, small rural health jurisdictions often lack the infrastructure to confront the crisis and have little history of dealing with comparable health issues, she explained.

[W]hen prescription highs can’t be sustained, people often turn to using — and sharing — needles to inject heroin and then fentanyl, leading to hepatitis C and H.I.V. This avoidable crisis has been exacerbated by unemployment, declining coal mining production and economic pressures on regional press to act as effectively as a watchdog.

At the same time, health care is relatively inaccessible. “It’s not so easy to get to the nearest town to see a doctor,” Dr. Judith Feinberg, professor of medicine at West Virginia University, explained, pointing to a lack of transportation and stigma as the biggest barriers to testing and care. People living with H.I.V. are stigmatized everywhere, but those who live in large cities can get tested while feeling relatively anonymous in a clinic in ways rural dwellers cannot.

[T]he C.D.C. released a list of 220 counties similarly vulnerable to such outbreaks among people who use intravenous drugs. The densest concentration of those counties is along the Appalachian Trail, with 28 of them in West Virginia — more than half of the state’s 55 counties.

“There is no way that doesn’t wind up as an H.I.V. outbreak in the state,” Ms. Young says. Yet unlike in places like New York — with its comprehensive sex education; efforts at queer- and trans-specific public health; embrace of public syringe exchanges; and what its health commissioner, Oxiris Barbot, describes as a “sex positive approach” — when it comes to confronting its H.I.V. epidemic, rural America is ill-prepared at best and antagonistic at worst.

[D]espite research showing that syringe programs are effective at limiting transmission of H.I.V. and encouraging people to enter drug treatment, two cities in West Virginia — Clarksburg and Charleston — have recently moved to close or limit their needle-exchange programs. Negative press, business worries and conservative approaches are among the reasons the programs have been reduced when they urgently need to be expanded (along with statewide testing and education about preventive H.I.V. medication).

While it’s true that people who are black, queer, transgender, homeless, incarcerated or poor, or who use injection drugs, are disproportionately affected by H.I.V. and AIDS, the misguided impression that members of these groups are the only ones affected has unfortunately contributed to the media’s choice to deprioritize coverage of H.I.V. and AIDS in recent years.

Meanwhile, the rural, heterosexual white Americans who have been the subject of countless national profiles because they’re imagined —  incorrectly — to represent all of President Trump’s supporters, are more at risk all the time. But while we’re bombarded by analyses of many aspects of their plight, we don’t hear about this crisis facing them.

[T]he new major terrain of the crisis right now is in rural America, and it can’t be ignored any longer.

The Failure of Christian Political Leadership

I will concede that there have been quite a few posts on religion and failures of religious leadership to even remotely reflect the gospel message of Christ.  As I have noted often, in the aggregate, I have come to view religion as among of the most toxic forces in society.  And then there is the hypocrisy, largely demonstrated by "religious conservatives" who seem most motivated by hatred of others and a desire to divide society into "us" versus "them" - those labeled as "other."  Be it Franklin Graham preach hate (and enriching himself) under the guise of serving "Jesus," the Catholic hierarchy turning a blind eye to - if not outright abetting - the sexual abuse of minors, or Paul Ryan pretending to care about the poor and unfortunate even as he seeks to gut the social safety net, far too many religious leaders either support the reprehensible or look the other way.  In yet another column in the Washington Post, Michael Gerson blasts the failure - I would call it moral bankruptcy - of leaders of Christian denominations, some of whom have thoroughly prostituted themselves to the amoral occupant of the White House.  Here are excerpts:

Three recent news items:
● At the Catholic Prayer Breakfast in Washington, House Speaker Paul D. Ryan said: “We see moral relativism becoming more and more pervasive in our culture. Identity politics and tribalism have grown on top of this.” Ryan went on to talk about Catholic social doctrine, with its emphasis on “solidarity” with the poor and weak, as “a perfect antidote to what ails our culture.”

● In the Oval Office, according to new reporting from The Post, President Trump boasted in February 2017 about how easy it is to appeal to audiences with an anti-immigrant message: “Acting as if he were at a rally, he recited a few made-up Hispanic names and described potential crimes they could have committed, such as rape and murder. Then, he said, the crowds would roar when the criminals were thrown out of the country.” In The Post’s account, “[Stephen] Miller and [Jared] Kushner laughed.”

● At the U.S. border, the brutal separation of confused, weeping children from parents who cross illegally is being implemented. Unaccompanied minors, too, are suffering. According to the Arizona Republic, “The Office of Refugee Resettlement reported at the end of 2017 that of the 7,000-plus children placed with sponsored individuals, the agency did not know where 1,475 of them were.” Some could be lost to abuse or trafficking.

What do these incidents add up to? A political, moral and religious failure of massive, discrediting proportions.

It is often difficult to apply theological doctrines to public policy. But if there is one area where the teaching of the Christian faith is utterly clear, it is in the requirement to care for the vulnerable stranger. According to the Hebrew scriptures: “When a foreigner resides among you in your land, do not mistreat them. The foreigner residing among you must be treated as your native-born.” In the New Testament, Jesus employs compassion for an abused, reviled foreigner (a Samaritan) as the test and definition of neighborly love.

The dehumanization of migrants and refugees has been one of the most consistent themes of [Trump] this president — including using the fact that some criminals enter the country illegally to fan a generalized hostility to Hispanic immigration. Can you imagine what would have happened if a White House staffer attending a policy meeting on family separation had said, “This is cruel. This is immoral. This is wrong”? They would have been quickly cleaning out their desk. The rejection of Christian teaching on this issue is pretty much a job requirement in the Trump administration.

And how did Ryan address the issue of Trump’s habit of dehumanization at the Catholic Prayer Breakfast? By avoidance, under a thick layer of hypocrisy. . . . . Ryan was effectively criticizing the whole theory of his speakership. . . . . Ryan can no longer speak of “moral relativism” as the defining threat of our time. . . .  In the name of survival, Ryan has ignored and enabled the transformation of the GOP into an anti-immigrant party. 

My tradition of evangelical Protestantism is, if anything, even worse. According to a recent Pew Research Center poll, white evangelical Protestants are the least likely group in America to affirm an American responsibility to accept refugees. Evangelicals insist on the centrality and inerrancy of scripture and condemn society for refusing to follow biblical norms — and yet, when it comes to verse after verse requiring care for the stranger, they don’t merely ignore this mandate; they oppose it.

This represents the failure of Christian political leadership — not only from the speaker but from most other elected religious conservatives, too. . . . it indicates the failure of the Christian church in the moral formation of its members, who remain largely untutored in the most important teachings of their own faith.

Ryan concluded his remarks by quoting Mother Teresa on God’s call to “be faithful,” not to “be successful.” But what if one is neither? Perhaps silence is the best option.

The Ugly Fruits of Conservative Religion: A Rising Number of Homeless Gay Teens

One of the very first post I wrote on this blog addressed what I see as a form of child abuse: LGBT youth being raised in conservative Christian homes (the same, of course, holds true for conservative Muslim and Jewish homes).  The enemies of LGBT rights and equality time and time again claim that gays make unfit parents when the truth is that it is they, the Christofascists and other religious fundamentalists who are unfit.  Sadly, even as gays are find increased societal acceptance, religious conservatives continue to disown their gay children and throw them out literally on the streets.  Indeed, some reports indicate that the number of homeless LGBT youth is growing.  For children under age 18, I believe that such parental behavior ought to result in criminal prosecution of the parents, but unfortunately this almost never happens.  A piece in Rolling Stone looks at the moral bankruptcy of religious conservatives and the toll it is taking on literally hundreds of thousands of LGBT youth.  Here are highlights:

[Jackie] she got a call from her older brother. "He said, 'Mom and Dad don't want to talk to you, but I'm supposed to tell you what's going to happen,'" Jackie recalls. "And he's like, 'All your cards are going to be shut off, and Mom and Dad want you to take the car and drop it off at this specific location. Your phone's going to last for this much longer. They don't want you coming to the house, and you're not to contact them. You're not going to get any money from them. Nothing. And if you don't return the car, they're going to report it stolen.'

Jackie's story may be distinctive in its particulars, but across America, it is hardly unique. Research done by San Francisco State University's Family Acceptance Project, which studies and works to prevent health and mental­health risks facing LGBT youth, empirically confirms what common sense would imply to be true: Highly religious parents are significantly more likely than their less-religious counterparts to reject their children for being gay – a finding that social-service workers believe goes a long way toward explaining why LGBT people make up roughly five percent of the youth population overall, but an estimated 40 percent of the homeless-youth population. The Center for American Progress has reported that there are between 320,000 and 400,000 homeless LGBT youths in the United States. Meanwhile, as societal advancements have made being gay less stigmatized and gay people more visible – and as the Internet now allows kids to reach beyond their circumscribed social groups for acceptance and support – the average coming-out age has dropped from post-college age in the 1990s to around 16 today, which means that more and more kids are coming out while they're still economically reliant on their families. The resulting flood of kids who end up on the street, kicked out by parents whose religious beliefs often make them feel compelled to cast out their own offspring (one study estimates that up to 40 percent of LGBT homeless youth leave home due to family rejection), has been called a "hidden epidemic." Tragically, every step forward for the gay-rights movement creates a false hope of acceptance for certain youth, and therefore a swelling of the homeless-youth population.

[N]ot only were more kids showing up, they were also disappearing. "Every couple of months one of our kids would get killed," Siciliano says. "And it would always be a gay kid." In 2002, he founded the Ali Forney Center, naming it after a homeless 22-year-old who'd been shot in the head on the street in Harlem, not far from where the organization's drop-in center currently resides. Siciliano had been close with Forney and felt that had he had a safe place to go, he might be alive today.

In one survey, approximately one in five LGBT youth were unable to secure short-term shelter, and 16 percent could not get assistance with longer-term housing – figures that were almost double those of their non-LGBT peers. However, it's clear that funding is also a problem.

Currently, Lewis tells me, "there are no legal federal protections in place to bar discrimination based on sexual orientation or gender identity in RHYA programs." At one residential placement facility in Michigan, LGBT teens were made to wear orange jumpsuits to "warn" other residents about their sexuality. 

Since 2002, when President George W. Bush issued an executive order that permitted faith-based organizations to receive federal support for social services, an increased amount of federal funding has gone to churches and religion­affiliated organizations where LGBT youth may not feel welcome.

In New York, a city with nearly 4,000 homeless youth, there are only around 350 spots in youth shelters, and less than a third of those spots are designated for LGBT kids, despite their disproportionate share of the homeless-youth population. (And considering that many homeless youth may not openly identify themselves as LGBT when seeking services, many providers believe that the estimate of 40 percent may be far too low.) Across the country, there are only 4,000 youth-shelter beds overall, while an estimate derived from the National Incidence Studies of Missing, Abducted, Runaway and Thrownaway Children put the number of homeless minors at 1.7 million. 

For LGBT kids who remain homeless, the stakes are clearly life and death. They are seven times more likely than their straight counterparts to be the victims of a crime, often a violent one. Studies have shown they are more than three times more likely to engage in survival sex – for which shelter is the payment more often than cash. They are more likely to lack access to medical care, more likely to attempt suicide, more likely to use hard drugs and more likely to be arrested for survival crimes. According to the Equity Project, leaving home because of family­ rejection is the single greatest predictor of involvement with the juvenile-justice system for LGBT youth.

In America, we lose six queer kids a day to the street. That's every four hours a queer kid dies, whether it be from freezing to death or getting the shit beat out of them or a drug overdose. This is our next real plague."

"LGBT­advocacy groups don't want to talk about religion," says Mitchell Gold, founder of Faith in America. "One, they don't want to come across as anti-religion. And two, they just aren't familiar with it. But the number-one hurdle to LGBT equality is religious­based bigotry. The face of the gay-rights movement shouldn't be what I call '40-year-old well-moisturized couples.' The face of the gay-rights movement should be a 15-year-old kid that's been thrown out of his house and taught that he's a sinner."

There's more that will make your blood boil.  As readers know, I am not afraid to talk about religion or hide the fact that I hold open contempt for "godly Christian" parents who disown their children.  Being gay is not a choice.  Adhering to hate-filled, bigoted religious beliefs based on what is being increasingly demonstrated to be pure myth and fiction, however, IS A CHOICE. Religious conservatives truly need to become societal outcasts and subject to child abuse prosecution for mistreatment of their LGBT children.   They are NOT nice or decent people. The rest of us need to fully open our eyes to this reality.

Homophobia: A Mark of Losers Nations and Loser States

I have noted before the growing homophobia that is sweeping Russia where anti-gay propaganda laws are under consideration in a number of many of Russia's major cities. Then, of course, we have the economic and social cesspools of sub-Sahara Africa where it seems as if nations are racing to see which one can enact the most anti-gay legislation. In contrast, most developed nations - the USA being a glaring exception - are increasingly gay accepting. Some countries in South America even deliver better nowadays on the promise of liberty and freedom than the USA. My activist friend Wayne Besen has a column in the Falls Church News-Press that the level of homophobia is increasingly a gauge for whether a nation is in decline or ascendancy. Sadly, employing this measure, the USA is in an accelerating state of decline because of the special privileges afforded Christianists and the unwillingness of elected officials to protect and deliver on constitutional rights of all citizens. The same holds true for states like Virginia and others in the South in particular that support bigotry rather than constitutional rights. Here are some highlights from Wayne's column:

I knew Russia was likely to embrace homophobia the moment I read that approximately 1.25 million Russians have emigrated from the nation in the past decade. Population experts say that the mass exodus is comparable in size to the migration following the Bolshevik Revolution. This one-time superpower is disintegrating into a superstitious country more concerned about angels than economics.

In this politically stagnating and spiritually stifling environment, it is predictable that the city of Saint Petersburg would consider a totalitarian bill imposing fines for the so-called promotion of gay "propaganda." If it were to pass, anyone who committed "public acts" promoting homosexuality, bisexuality or transgender identity to minors could pay up to 3,000 rubles while an organization could pay 10,000 to 50,000 rubles.

Such an outright assault on expression and speech are not the product of a free country and rightfully raised red flags within the U.S. State Department.

Without exception, loser nations are always the most homophobic. Leaders of such lands desperately look for scapegoats to distract the public from noticing their dismal failures. They also find the promotion of religious extremism useful, because it is more difficult to vilify leaders who present themselves as deified.

The LGBT community rarely thrives in backward places that promote ignorance over education and medieval views over modernity. As these intellectual swamps sink, sexual minorities make ideal targets because their members are often isolated and deeply closeted, vulnerable to persecution, and don't have the numbers to fight back.

Russia is not the only loser nation where leaders manipulate the public through virulent gay bashing. Brutal Zimbabwe dictator, Robert Mugabe, called homosexuality un-Christian and un-African last week, and then threatened to severely discipline anyone in a gay relationship.

Even in some advanced nations there is the threat of retrograde preachers who have no qualms about dragging their countries into the gutter for personal riches and political gain.

Homophobia is a mark of failing nations. Even in America, it is the emblem of poor, second-tier states. It is the signpost of inferior cities that perpetually fail to reach their potential and can't figure out why.

It is not that anti-gay sentiment on its own causes the collapse of such places. It is that homophobia virtually never stands alone. It can only flower in corrupt environments that lack basic freedom, devalue education, limit liberty, have huge income disparities, degrade women, discourage religious pluralism, mock intellectuals, and promote superstition at the expense of science.

As a general rule, places that are leaders in passing anti-gay laws are losers in virtually every other category that defines successful, civilized societies.

I believe that Wayne is pretty much on target. His analysis certainly holds true in the case of Virginia and regions of this state which are the most homophobic (homophobic, of course, being a relative term since the entire state is homophobic in terms of its anti-gay legal framework). The more conservative and homophobic they become, the more they spiral downward toward economic collapse. Don't believe me? The map below shows a county breakdown of unemployment. The lowest unemployment figures are for the most part clustered around cities with major universities and more liberal counties. The highest unemployment rates correlate closely with the most conservative and anti-gay areas of Virginia.

Wingnut Excuses for Adultery

I swear at times you could not make up some of the wackiness of the fruit loops Christianist set if you tried. Now Mark "I like to Cheat on My Wife" Sanford's "spiritual advisor" is blaming Sanford's apparent multiple cases of adultery on "the power of darkness." I guess this new "Satan made me do it" excuse will sweep like wildfire through the "family values" GOP as an explanation as to why they seem to have a more difficult time keeping their pants up that the supposedly godless liberals or all those heterosexual couples in Massachusetts site of the first gay marriages in the USA. The truth is that Sanford - like so many of his "family values" brethren (think multiple times divorced Newt Gingrich and thrice divorced Rush Limbaugh - is a hypocritical dirt bag who was fortunately exposed. Here are highlights from USA Today:

*

Each Sunday afternoon in May, Gov. Mark Sanford and his wife hosted five other couples at the executive mansion for a spiritual "boot camp." Topics discussed during the hour-and-a-half-long sessions included forgiveness and "not loving your wife as Christ loved the church." Group leader Warren "Cubby" Culbertson did not tell the other four couples what he and his wife, Susan, had known for months: The governor was having an affair with a woman in Argentina.

*

For nearly six months, Culbertson has been the first couple's spiritual counselor — and their secret keeper. The Sanfords "passed" the Culbertsons' course with flying colors. A week later, Jenny Sanford asked her husband to leave their home.

*

In an interview with The Associated Press this weekend at his Columbia office, just blocks from the State House, Culbertson said he believed his friend when he said that this was his only marital transgression. He thinks Sanford was simply caught off guard by "the power of darkness."

*

Culbertson helped found the Round Table, a Bible study that, according to a paper posted on the Web, offers men "a safe place to pose their questions, test their assumptions, and know that they will not be alone or stand out as a spiritual seeker." Sanford sought that spiritual refuge on at least a couple of occasions.

*

Some who watched Sanford's news conference felt he was insincere, playing to the Palmetto State's religious base to salvage his political future. Janine Driver, a Washington, D.C.-based body language and deception detection expert, said Sanford showed more emotion when apologizing to Culbertson and longtime political aide Tom Davis than he did when speaking of his wife and four sons. She also believes he lied when a reporter asked if this was the first time he had been unfaithful.

*

These folk like Sanford and Culbertson make me gag and for the life of me I do not understand why people fall for this manure. They might as well be selling snake oil.

Porn in the USA: Conservatives are Biggest Consumers

When I happened across this story on New Scientist it reminded me of my teenage years - among my friends who had the biggest problems with consuming too much alcohol, they always seemed to be the ones from families where drinking was forbidden. A case of the forbidden fruit being always more attractive than what is allowed in moderation. It seems that the same applies as well to online pornography. The states that are the most religiously and politically conservative are the ones where there is the highest per capita consumption on line porn (Utah, home of the Mormons has the highest per capita consumption). It parallels the fact that evangelicals talk the most about applying the Bible literally, yet they have the highest divorce rate of any religious denomination. Why does the word HYPOCRITE spring to mind? I'm not trying to be mean, but give me a break. Publicly these folks obsess about sex being bad, but apparently in private cannot get enough of it. Here are are some story highlights:

*

Those states that do consume the most porn tend to be more conservative and religious than states with lower levels of consumption, the study finds. "Some of the people who are most outraged turn out to be consumers of the very things they claimed to be outraged by," Edelman says.

*

The biggest consumer, Utah, averaged 5.47 adult content subscriptions per 1000 home broadband users; Montana bought the least with 1.92 per 1000. "The differences here are not so stark," Edelman says. Number 10 on the list was West Virginia at 2.94 subscriptions per 1000, while number 41, Michigan, averaged 2.32.

*

Residents of 27 states that passed laws banning gay marriages boasted 11% more porn subscribers than states that don't explicitly restrict gay marriage. . . . States where a majority of residents agreed with the statement "I have old-fashioned values about family and marriage," bought 3.6 more subscriptions per thousand people than states where a majority disagreed. A similar difference emerged for the statement "AIDS might be God's punishment for immoral sexual behaviour."

*
Eight of the top 10 pornography consuming states gave their electoral votes to John McCain in last year's presidential election – Florida and Hawaii were the exceptions. While six out of the lowest 10 favoured Barack Obama.

*

"One natural hypothesis is something like repression: if you're told you can't have this, then you want it more," Edelman says.