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Matthew Limpede takes a pill that gives him protection, peace of mind, and a reassuring sense of community.

That pill is the drug Truvada, more commonly referred to as "PrEP" (Pre-exposure Prophylaxis). And it's been a game-changer in the fight against HIV/AIDS.

"I think for the whole [gay] community and for me personally, [PrEP has] lifted us up to a place of being more responsible for our own health," Limpede explains.


If taken as directed, PrEP is 99% effective in stopping the transmission of HIV. It's mostly used by HIV-negative men and women who are more at risk of exposure to the virus.

Photo courtesy of Matthew Limpede.

From Limpede's own experiences, the drug isn't just about personal protection, either — it has encouraged more gay and bisexual men to have important conversations about staying safe with their sexual partners, building a sense of openness and honesty within the LGBTQ community. Those conversations have helped destigmatize those who are HIV-positive, too, he says — people who can live long and healthy lives while being sexually active.

The only way Limpede was able to get on PrEP was because of an insurance plan provided through the Affordable Care Act in 2014.

And he's definitely not the only one.

Jim Pickett, director of prevention advocacy and gay men's health at the AIDS Foundation of Chicago, says about 110,000 people across the U.S. started using PrEP between 2012 and February 2017. The ACA played a big role in making that happen.

"PrEP is quite a robust intervention," he says. "It's not just a niche thing for gay men."

Photo illustration by Justin Sullivan/Getty Images.

Making PrEP more accessible has become an increasingly important component of a broader strategy to prevent HIV among groups most vulnerable to the virus, such as transgender women, gay men — particularly gay men of color — and cisgender (non-transgender) black women, according to Pickett.

While PrEP accessibility has grown significantly in the past few years, it's just the tip of the iceberg, Pickett says. About a million more people living at high risk of HIV exposure are good candidates to go on the drug if we can just keep expanding efforts where they're needed most.

Under the current Congress and administration, however, that's shaping up to be quite the tough task.

If the Affordable Care Act is repealed, access to PrEP would take a blow, causing a major setback in our fight against HIV/AIDS.

Image via iStock.

Without health insurance, the price tag for PrEP is about $1,500 a month. With insurance, most people pay between $0 and $500.

Without significant help from an insurer, most Americans can't afford PrEP. Through the ACA's Medicaid expansion, which mostly helped low-income folks — notably, the same groups most affected by HIV/AIDS — PrEP was made accessible in 31 states plus Washington, D.C. Other patients, like Limpede, found the drug was available for free through their ACA plans.

This progress would be reversed under the American Health Care Act, the GOP's plan to "repeal and replace" the Affordable Care Act (aka Obamacare). In the new proposal — one that would cause an estimated 24 million Americans to lose their health care coverage over the next decade — the ACA's Medicaid expansion would phase out. As a result, thousands of people — again, mostly the at-risk groups who desperately need it — would lose access to PrEP.

Photo by Chip Somodevilla/Getty Images.

New HIV diagnoses fell 19% overall from 2005 to 2014, according to the CDC (although progress has been uneven depending on demographics, with some groups seeing increases). With repealing the ACA, we risk reversing this long-term trend.

"If Trumpcare were to be enacted as written, it would be a devastating blow to all of our HIV efforts, both care and prevention," Pickett says. "It would be absolutely devastating."

"If less people are on PrEP, we'll have more HIV infections," Pickett emphasizes. "HIV is forever — that's a cost forever — and that's an increased burden on a system that's overburdened."

Although living a long and healthy life while being HIV-positive is possible, that's only the case for people with access to ongoing health care and treatments that don't come cheap or easy.

For people like Limpede, who has even contemplated moving from Texas to Massachusetts if it means keeping his health care and PrEP access intact, tossing aside life-changing provisions isn't just politics as usual.

It's deeply personal.

"Repealing something like this — that's going to hurt minorities, that's going to hurt people who are low on the socioeconomic scale. It feels very pointed and purposeful," he says. "That's definitely a concern."

Image via iStock.

The HIV/AIDS advocacy community is getting ready for a battle because this is a fight they can't afford to lose.

"The community's main focus now is making sure that Trumpcare does not see the light of day and stopping these harmful provisions in the bill from happening," Limpede says. "We're fighting tooth and nail."

Joy

Nurse turns inappropriate things men say in the delivery room into ‘inspirational’ art

"Can you move to the birthing ball so I can sleep in the bed?"

Holly the delivery nurse.

After working six years as a labor and delivery nurse Holly, 30, has heard a lot of inappropriate remarks made by men while their partners are in labor. “Sometimes the moms think it’s funny—and if they think it’s funny, then I’ll laugh with them,” Holly told TODAY Parents. “But if they get upset, I’ll try to be the buffer. I’ll change the subject.”

Some of the comments are so wrong that she did something creative with them by turning them into “inspirational” quotes and setting them to “A Thousand Miles” by Vanessa Carlton on TikTok.

“Some partners are hard to live up to!” she jokingly captioned the video.

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All images provided by Adewole Adamson

It begins with more inclusive conversations at a patient level

True

Adewole Adamson, MD, of the University of Texas, Austin, aims to create more equity in health care by gathering data from more diverse populations by using artificial intelligence (AI), a type of machine learning. Dr. Adamson’s work is funded by the American Cancer Society (ACS), an organization committed to advancing health equity through research priorities, programs and services for groups who have been marginalized.

Melanoma became a particular focus for Dr. Adamson after meeting Avery Smith, who lost his wife—a Black woman—to the deadly disease.

melanoma,  melanoma for dark skin Avery Smith (left) and Adamson (sidenote)

This personal encounter, coupled with multiple conversations with Black dermatology patients, drove Dr. Adamson to a concerning discovery: as advanced as AI is at detecting possible skin cancers, it is heavily biased.

To understand this bias, it helps to first know how AI works in the early detection of skin cancer, which Dr. Adamson explains in his paper for the New England Journal of Medicine (paywall). The process uses computers that rely on sets of accumulated data to learn what healthy or unhealthy skin looks like and then create an algorithm to predict diagnoses based on those data sets.

This process, known as supervised learning, could lead to huge benefits in preventive care.

After all, early detection is key to better outcomes. The problem is that the data sets don’t include enough information about darker skin tones. As Adamson put it, “everything is viewed through a ‘white lens.’”

“If you don’t teach the algorithm with a diverse set of images, then that algorithm won’t work out in the public that is diverse,” writes Adamson in a study he co-wrote with Smith (according to a story in The Atlantic). “So there’s risk, then, for people with skin of color to fall through the cracks.”

Tragically, Smith’s wife was diagnosed with melanoma too late and paid the ultimate price for it. And she was not an anomaly—though the disease is more common for White patients, Black cancer patients are far more likely to be diagnosed at later stages, causing a notable disparity in survival rates between non-Hispanics whites (90%) and non-Hispanic blacks (66%).

As a computer scientist, Smith suspected this racial bias and reached out to Adamson, hoping a Black dermatologist would have more diverse data sets. Though Adamson didn’t have what Smith was initially looking for, this realization ignited a personal mission to investigate and reduce disparities.

Now, Adamson uses the knowledge gained through his years of research to help advance the fight for health equity. To him, that means not only gaining a wider array of data sets, but also having more conversations with patients to understand how socioeconomic status impacts the level and efficiency of care.

“At the end of the day, what matters most is how we help patients at the patient level,” Adamson told Upworthy. “And how can you do that without knowing exactly what barriers they face?”

american cancer society, skin cacner treatment"What matters most is how we help patients at the patient level."https://www.kellydavidsonstudio.com/

The American Cancer Society believes everyone deserves a fair and just opportunity to prevent, find, treat, and survive cancer—regardless of how much money they make, the color of their skin, their sexual orientation, gender identity, their disability status, or where they live. Inclusive tools and resources on the Health Equity section of their website can be found here. For more information about skin cancer, visit cancer.org/skincancer.

The mesmerizing lost art of darning knit fabric.

For most of human history, people had to make their own clothing by hand, and sewing skills were subsequently passed down from generation to generation. Because clothing was so time-consuming and labor-intensive to make, people also had to know how to repair clothing items that got torn or damaged in some way.

The invention of sewing and knitting machines changed the way we acquire clothing, and the skills people used to possess have largely gone by the wayside. If we get a hole in a sock nowadays, we toss it and replace it. Most of us have no idea how to darn a sock or fix a hole in any knit fabric. It's far easier for us to replace than to repair.

But there are still some among us who do have the skills to repair clothing in a way that makes it look like the rip, tear or hole never happened, and to watch them do it is mesmerizing.

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Pop Culture

Artist uses AI to create ultra realistic portraits of celebrities who left us too soon

What would certain icons look like if nothing had happened to them?

Mercury would be 76 today.

Some icons have truly left this world too early. It’s a tragedy when anyone doesn’t make it to see old age, but when it happens to a well-known public figure, it’s like a bit of their art and legacy dies with them. What might Freddie Mercury have created if he were granted the gift of long life? Bruce Lee? Princess Diana?

Their futures might be mere musings of our imagination, but thanks to a lot of creativity (and a little tech) we can now get a glimpse into what these celebrities might have looked like when they were older.

Alper Yesiltas, an Istanbul-based lawyer and photographer, created a photography series titled “As If Nothing Happened,” which features eerily realistic portraits of long gone celebrities in their golden years. To make the images as real looking as possible, Yesiltas incorporated various photo editing programs such as Adobe Lightroom and VSCO, as well as the AI photo-enhancing software Remini.

“The hardest part of the creative process for me is making the image feel ‘real’ to me,” Yesiltas wrote about his passion project. “The moment I like the most is when I think the image in front of me looks as if it was taken by a photographer.”

Yesiltas’ meticulousness paid off, because the results are uncanny.

Along with each photo, Yesiltas writes a bittersweet message “wishing” how things might have gone differently … as if nothing happened.
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