S.F. Supervisor Wiener Announces He’s Taking AIDS Preventive Drug

San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)

San Francisco Supervisor Scott Wiener (left) says he started taking a drug to prevent HIV infection earlier this year. (Lisa Aliferis/KQED)

San Francisco Supervisor Scott Wiener publicly announced Wednesday afternoon that he is taking Truvada, an FDA-approved drug that dramatically reduces the risk of HIV infection.

Wiener said he began taking the medication earlier this year. This preventive approach is also referred to as pre-exposure prophylaxis or PrEP.

“I am using PrEP as a personal health choice that I made in consultation with my physician,” he said in an interview at his office at City Hall. “My hope is that by disclosing my PrEP use publicly that I can help move the conversation forward and get more people thinking about PrEP as a possibility, and encouraging people to consult with their medical provider.”

Truvada combines two different drugs into a single pill that, when taken daily, can reduce the risk of HIV infection by more than 90 percent. It was approved by the FDA in 2012. Both the Centers for Disease Control and the World Health Organization recommend its use by people who are at high risk of HIV infection. Still, it is the subject of debate, especially within the gay community.

Wiener, 44, was first elected to the Board of Supervisors in 2011. He says he started coming out as a gay man in 1990, at what he called the height of the AIDS epidemic.

“Coming out in that environment was challenging and stressful,” he said. “Immediately associating sex with illness and death was very stressful and many, many people, I think, had that same experience.” He spoke of friends who have started using PrEP recently who “have told me that their general anxiety level around intimacy has gone down significantly.”

Wiener said that only a few people knew that he was taking PrEP. James Loduca, vice president of philanthropy for the San Francisco AIDS Foundation, called Wiener’s disclosure “incredibly courageous.”

“We need more people like Supervisor Wiener,” Loduca said. “In my own personal network, many of my HIV-negative gay male friends are on PrEP. none of them talk about it publicly, and that is a reflection of the enormous stigma and shame that we still have around sex, around a desire to have intimacy. … It’s an important watershed moment for our community that someone so visible steps forward and says ‘PrEP is helping me.’”

Wiener spoke openly of people availing themselves of all options to prevent acquiring the virus, including the use of condoms and being tested regularly. If someone becomes infected with HIV, identifying the infection sooner yields more immediate treatment, which has positive long-term health outcomes.

Wiener’s announcement comes on the eve of a rally to be held Thursday, coordinated by San Francisco Supervisor David Campos. Campos is calling for San Francisco to make PrEP available to San Franciscans regardless of income. New York Gov. Andrew Cuomo has made a similar proposal for his state.

Nationally, there have been 50,000 new HIV infections every year for the last 20 years. “PrEP is the first new tool in our fight to protect ourselves from HIV since the epidemic began,” Campos said in a release.

Wiener backs the effort. “In order for PrEP to be successful, we have to do three things,” he said. “We need to raise awareness about it, make sure people know about it. … We need to secondly remove the stigma around it, so people are able to talk about it, are able to consider it, and finally, we need to expand access.”

But that kind of community-wide campaign is exactly the wrong idea, some advocates say.

“To deploy (PrEP) as a community-wide preventive is a public health disaster in the making,” said Ged Kenslea, spokesman for AIDS Healthcare Foundation, a global advocacy group. He stressed the organization is not opposed to the use of PrEP on a case-by-case basis.

“The crucial problem is adherence to the medication,” he said. He also pointed out that condoms are not only effective against protecting against HIV infection, but also against other sexually transmitted diseases “for which PrEP does nothing.” Kenslea said that he’s worried that people “seem to be throwing condoms out the window.”

Dr. Robert Grant with the UCSF Gladstone Institute led the research that ultimately showed Truvada’s effectiveness as a preventive agent against HIV and has followed it since.

He said that there’s no link between PrEP and increasing high-risk sexual behavior. He also supports efforts to make PrEP available more widely and compared having a variety of tools to fight HIV with having a variety of methods of birth control available.

“Just like contraception,” he said. “We’re happy to have people using different methods. Same way with HIV. We have to have lots of different methods for people to use, so people can find one that’s attractive to them.”

Grant said that in his research “we have not seen anyone become infected who has taken PrEP daily or nearly daily.”

Wiener also published an essay in the Huffington Post Wednesday about his decision to use Truvada.

Put Down the Heating Pad: Physical Therapists Say It Doesn’t Help

Physical therapy is about being, well, physical, new guidelines say. (Getty Images)

Physical therapy is about being, well, physical, new guidelines say. (Getty Images)

By Nancy Shute, NPR

I have fond memories of listening to NPR while lounging at the physical therapist’s with a heating pad on my shoulder. Don’t do that, the nation’s physical therapists’ association says.

Heat therapy, electrical stimulation, ultrasound and other “passive physical agents” almost never help, according to a list released Monday by the Choosing Wisely campaign. Instead, they siphon time and money away from what you really want from a physical therapist — an exercise program that will restore strength and mobility.

Well, this is certainly going to make physical therapy less restful.

But seeing as I’ve been to several physical therapists over the years and they’ve all used this stuff, the fact that the American Physical Therapy Association put passive physical agents on top of their list of things not to do seems like big news. Continue reading

Covered California Launches 2015 Outreach Campaign

Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)

Covered California executive director Peter Lee, seen here at a November, 2013, press conference. (Max Whittaker/Getty Images)

Covered California, the state’s health insurance exchange, kicked off its marketing and outreach campaign Monday for the upcoming 2015 open enrollment period. Officials say they forecast enrolling 1.7 million people, about 500,000 more than are presently signed up.

Peter Lee, the agency’s executive director, acknowledged the work ahead. “It won’t be easy,” he said. “In many ways, it will be harder than last year.”

For starters, the next open enrollment runs three months compared to last year’s six month period when more than three million people signed up either for Covered California or to Medi-Cal, the state’s version of Medicaid. Continue reading

Autism Benefit Finally a Reality for Children on Medi-Cal

Jazzmon Wilson with her son Timothy, 6, who has autism. (Jeremy Raff/KQED)

Jazzmon Wilson with her son Timothy, 6, who has autism and has benefited greatly, Wilson says, from Applied Behavior Analysis therapy, now covered by Medi-Cal. (Jeremy Raff/KQED)

By David Gorn

California health officials Monday are launching a new benefit for thousands of children with autism who are covered by Medi-Cal, California’s low-income health program.

“He’s doing things other kids can do. And it’s those little moments, it makes you just so grateful.”

That makes California the first state in the nation to implement new federal standards on autism care.

The new benefit includes coverage of the clinical standard of care for autism treatment — Applied Behavior Analysis, also known as ABA therapy. That treatment has shown significant results for a cross-section of children with autism.

Of the 5 million children on Medi-Cal in California — that’s roughly half the state’s total children — there are an estimated 75,000  who likely have autism spectrum disorder. Of those children, experts expect about 12,000 children to access the new benefit, based on utilization figures from programs in other states. Continue reading

Remaining Uninsured Face Challenges in Cost and Simply Signing Up

Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)

Leaburn Alexander works two jobs and does not have health insurance. Here, he is on the start of his 3-hour commute home from the job he works as an overnight hotel janitor. (Lisa Morehouse/KQED)

By Lisa Morehouse

When the Affordable Care Act rolled out last fall, Californians enrolled in both Covered California and expanded Medi-Cal in high numbers. But there are still millions in the state without health insurance. Undocumented people don’t qualify for Obamacare benefits. Many others still find coverage too expensive, or face other obstacles in enrolling.

One of those people is Leaburn Alexander. I meet up with him at 6 a.m. as he is finishing his shift as the night janitor at a hotel near the San Francisco Airport. He clocks out just in time to catch the hotel’s shuttle back to SFO, where he will catch a bus.

“Right now I’m on the beginning of my commute,” he tells me. “After an eight hour shift, my commute is like 2 and a half hours.”

I accompany Alexander on his commute to East Palo Alto, about 20 miles south. It actually takes three hours, on the hotel shuttle plus three more buses. He does this commute 5 days a week. Continue reading

Field Poll Shows Support Slipping for Two Health Propositions

(David Paul Morris/Getty Images)

(David Paul Morris/Getty Images)

A new Field Poll shows voter support dropping for two propositions on the November ballot.

Prop. 45 would give the state insurance commissioner the authority to reject excessive rate hikes. Support has dropped from 69 percent early in the summer to 41 percent in the current poll. Twenty-six percent are opposed and 33 percent are undecided.

Prop. 46 would require drug testing of doctors and increase the cap on pain and suffering awards in medical negligence lawsuits from $250,000 to $1.1 million. Early this summer, support stood at 58 percent; today it is 34 percent, with 30 percent opposed and 29 percent undecided.

“This current poll is relatively big news on Prop. 46. I don’t think its chances of passage are all that great,” Field Poll director Mark DiCamillo told the San Francisco Chronicle. He added that it’s harder to predict what might happen with Prop. 45. Continue reading

Vaccine Opt-Out Rate Doubled in 7 Years; Look Up Your School Online

By Olivia Allen-Price and Lisa Aliferis

California law requires that children entering kindergarten be fully vaccinated against a range of diseases. But despite overwhelming evidence that vaccines are safe and effective, the rate of parents opting out of vaccines for their children has doubled since 2007.

To opt out, parents must file a personal belief exemption, or PBE, a signed statement that vaccines are against their personal beliefs. In the 2007-2008 school year, the statewide PBE rate was 1.56 percent. By 2013-2014, the most recent year statistics are available, the rate had jumped to 3.15 percent.

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PBE rates vary by county and by individual school. In the Bay Area, Marin has the highest PBE rate by far — 7.57 percent. (Marin was highest in the Bay Area last year too.) The PBE rate at private schools tends to be higher, overall, then that at public schools. In the 2013-2014 school year, only 85 percent of private school kindergarten students statewide were fully vaccinated when school started, compared to about 90 percent of public school students. Other students enter on “conditional” status, meaning the school is to follow up with these children to make sure they receive all their vaccines.
Continue reading

Government Funding Drops — and Scientists Give Up

Randen Patterson

Randen Patterson left a research career in physiology at U.C. Davis when funding got too tight. He now owns a grocery store in Guinda, outside Davis. (Max Whittaker/Prime for NPR)

By Richard Harris, NPR

Ian Glomski thought he was going to make a difference in the fight to protect people from deadly anthrax germs. He had done everything right — attended one top university, landed an assistant professorship at another.

“I shouldn’t be a grocer right now. I should be training students. I should be doing deeper research. And I can’t. I don’t have an outlet for it.” Former UC Davis professor

But Glomski ran head-on into an unpleasant reality: These days, the scramble for money to conduct research has become stultifying.

So, he’s giving up on science.

And he’s not alone. Federal funding for biomedical research has declined by more than 20 percent in the past decade. There are far more scientists competing for grants than there is money to support them. Continue reading

First Death Reported from the Napa Quake

The magnitude-6.0 earthquake struck Aug. 24. (Craig Miller/KQED)

The magnitude-6.0 earthquake struck Aug. 24. (Craig Miller/KQED)

A 65-year-old woman who suffered a head injury when a television struck her during last month’s earthquake in California’s wine country has died — the first death attributed to the magnitude-6.0 quake, sheriff’s officials said.

Laurie Anne Thompson was at her Napa home during the Aug. 24 earthquake when she was hit, according to the Napa County Sheriff’s Office. She did not go to the hospital until the next day when she felt dizzy and experienced a decline in mental function.

Sheriff’s officials said she died Friday at a hospital of an intracranial hemorrhage.

“Her condition continued to deteriorate over time and, unfortunately, she passed away,” Sheriff’s Capt. Doug Pike said. Continue reading

Covered California Income Verifications Lead to Canceled Coverage

Screenshot from CoveredCA.com, the website of Covered California.

Screenshot from CoveredCA.com, the website of Covered California.

By Judy Lin, Associated Press

Some Californians who purchased individual health coverage through the state’s insurance exchange are suddenly being dropped or transferred to Medi-Cal, the state Medicaid program for the poor that fewer doctors and providers accept.

Covered California, which is responsible for determining and directing Californians to an appropriate health plan, has no estimate of how many people are affected, saying only that the changes are occurring as incomes are checked to verify the policyholders can purchase insurance through the exchange.

Since the shifts often happen without warning, there’s confusion and anger among policyholders.

Glendale resident Andrea Beckum learned last month that she and her husband had been shunted to Medi-Cal only after getting a call from their insurance broker telling them their Anthem Blue Cross policy had been canceled. Continue reading