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Bill incentivizes companies to offer trans benefits by Matthew S. Bajko
C
ompanies that seek state contracts in California would be unable to do so if they do not offer their transgender employees the same benefits other employees receive under legislation pending in Jane Philomen Cleland the Statehouse. State Senator The bill would priMark Leno marily impact those businesses in other states that do not require companies to offer transgender health care benefits. Companies based in California have been required to provide such coverage since 2006, with eight other states and the District of Columbia following suit. Gay state Senator Mark Leno (D-San Francisco) introduced the bill, SB 703, last Friday a day ahead of the deadline for lawmakers to submit legislation for this session. The legislation, which Leno’s office will officially announce Thursday, is co-sponsored by Equality California, the National Center for Lesbian Rights, and the Transgender Law Center. “Given that health coverage for transgender people is already state law in California, why would we want taxpayer dollars from our state going to contractors that don’t provide the same benefits?” asked Leno in an interview with the Bay Area Reporter. The legislation, added Leno, levels the playing field in state contracting between in-state and out-of-state companies. “If I am an in-state contractor and bidding on government jobs, I could be potentially under bid by out-of-state contractors in a state that doesn’t require, as ours does, health coverage for transgender people,” said Leno. SB 703 is modeled after legislation passed in 2003 that prohibited state agencies from doing business with companies that did not offer the same benefits to employees with domestic partners as those received by employees with spouses. Since then state leaders have enacted several bills that require health care insurers in California not to discriminate against transgender policyholders. More than 25 percent of Fortune 500 companies now offer equal health care benefits to transgender employees, and last year, the federal Medicare system removed its discriminatory transgender exclusion. “The cost is immaterial for transgenderrelated healthcare benefits,” noted Sasha Buchert, a TLC staff attorney. Leno’s bill would apply to state contracts of $100,000 or more. It would also require the Department of General Services to create an online database listing all contracts subject to the provision, and to establish a method for See page 6 >>
Vol. 45 • No. 10 • March 5-11, 2015
Castro rally for black LGBTs met with anger at bar by Khaled Sayed
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rally in the Castro to affirm and celebrate black LGBTQs briefly turned ugly when some of the demonstrators went to a bar and said they were met with hostility. Organizers with Queer #BlackLivesMatter held the February 28 rally to mark the end of Black History Month and call attention to violence against trans women of color. One of those women, Taja DeJesus, was stabbed to death in San Francisco’s Bayview neighborhood last month. See page 6 >>
San Francisco Police Officer C. Stokes, right, takes a report from Danielle Castro, seated center, who said she was battered by an employee of Toad Hall as he was trying to close the door to the bar.
Rick Gerharter
HIV treatment, cure discussed at CROI New tenofovir in the pipeline
by Liz Highleyman
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trio of experimental antiretroviral drugs and research toward a cure for HIV were among the more than 1,000 presentations at the recent Conference on Retroviruses and Opportunistic Infections in Seattle. With current HIV treatment being highly effective and easy to use, the pipeline for new antiretrovirals has slowed to a trickle. Liz Highleyman But there is still room for new drugs that are Researchers David Wohl, left, and Max Lataillade better tolerated and attack the virus by novel presented the tenofovir and HIV maturation mechanisms.
ART old and new
inhibitor studies at the recent Conference on Retroviruses and Opportunistic Infections.
David Cooper from the University of New South Wales in Australia kicked off the confab with a rundown of the history of antiretroviral therapy (ART), following a tribute to AIDS researcher Joep Lange. Lange and several colleagues were killed last July enroute to the International AIDS Conference in Melbourne when Malaysian Airlines flight MH17 was shot down by a missile near the Russia-Ukraine border. Cooper discussed the ongoing controversy about whether to start treatment immediately after HIV diagnosis – an approach adopted by the San Francisco Department of Public Health and UCSF in early 2010, and now part of national treatment guidelines – or to wait until immune function declines. Starting treatment early reduces immune activation and inflammation, leads to lower viral
reservoirs in resting T-cells, and viral suppression nearly eliminates the risk of HIV transmission. But antiretroviral drugs can cause longterm toxicities and so far there is little evidence from randomized trials showing that starting treatment with a CD4 T-cell count over 500 offers a survival advantage. Currently 13.6 million people are receiving antiretroviral therapy worldwide – a “remarkable achievement in scaling up” – but there are still 28.6 million more who need treatment. “It’s hard to see how current flat levels of funding can allow for a doubling of people on ART,” Cooper said. “We simply need to tell civil society that these funds cannot be flat-lined ... that is unacceptable and we need to finish the job.”
Researchers presented results from a pair of studies looking at Gilead’s tenofovir alafenamide or TAF, a new version of the widely used tenofovir disoproxil fumarate or TDF. A component of several combination pills including Truvada – used for both HIV treatment and pre-exposure prophylaxis, or PrEP – TDF is generally safe and effective, but it can cause kidney and bone problems in some people. TAF reaches higher levels in HIV-infected cells but lower levels in the blood, meaning less drug exposure for the kidneys, bones, and other organs. David Wohl from the University of North Carolina reported that a TAF coformulation works as well as the current TDF coformulation sold as Stribild. In two studies that together enrolled more than 1,700 people starting HIV treatment for the first time, 92 percent of participants in the TAF group and 90 percent in the TDF group achieved undetectable viral load by 48 weeks. While the overall safety profiles of the two drugs were similar, Paul Sax from Brigham and Women’s Hospital in Boston reported that TAF has less detrimental effects on the kidneys and bones than TDF. People taking TAF had fewer kidney-related side effects and DEXA scans showed less bone loss in the spine and hips. “Efficacy was very comparable and clearly TAF held its own against TDF,” Wohl said at a CROI See page 8 >>
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