The Tennessee Equality Project rescinds our endorsement of Sen. Steven Dickerson in the Tennessee Senate District 20 race.
Although he has an exemplary record on LGBTQ rights in the Legislature, elected officials are called to speak out against racism in politics.
We have seen the disgusting, racist ad targeting Mayor Heidi Campbell and Gideon's Army that was created by a political action committee. We call for it to be taken down and we call on Sen. Steve Dickerson's campaign to denounce it and call for its removal. Even those who are not responsible for creating a campaign ad must act responsibly when they become aware of it because racism is a deadly force in our state.
We are considering the future of our endorsement in the Senate District 20 race.
The following information was written by and is provided in partnership with the Tennessee Department of Health:
October is Health Literacy Month, and it could not come at a better time. We have been bombarded with health information because of the pandemic, and wading through it all can be difficult. Health literacy is the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions (source).
Most of us experience greater health literacy in some instances and less in others. Those of us living with a chronic health condition find ourselves becoming expert in that condition and the resources around it. On the flip side, some parts of our health are less familiar to us. Sexual health usually falls on the less familiar side.
Sexually transmitted infections (STIs) are a topic where health literacy is often low. While one in two sexually active people will get an STI by their 25th birthday, the common experience of having STIs has not been enough to build expertise and comfort with this facet of our health.
There are as many reasons to change this as there are different types of STIs. All STIs are treatable, and most infections can be cured with oral or injectable antibiotics. For infections like HIV and genital herpes, early and consistent treatment can make a huge impact on how the disease affects a person’s life. Most STIs infect us without symptoms, so routine testing is the only way we have to know when treatment is needed.
Nationally and in Tennessee, rates for almost every STI are rising. But not all STI testing is created equal, and research demonstrates that requesting the right type of STI testing is increasingly important.
According to the Centers for Disease Control, 15–24 year olds make up a fourth of the nation’s population, but account for half of all new STIs (source). STI rates in Tennessee are also on the rise. From 2018 to 2019 all STI rates increased: Chlamydia by 8%, Gonorrhea by 9%, Syphilis (all stages) by 29% (source: Patient Reporting Investigation Surveillance Manager (PRISM), 2018–2019). Tennessee surpassed U.S. rates for both gonorrhea and chlamydia in 2018-2019 (source).
Even with these rising STI rates, the numbers are still under-estimates because when people present to get STI testing, they are often not getting the most complete testing available. Testing for STIs like Gonorrhea and Chlamydia is recommended at all sites of exposure, including the throat and rectum, and oral and anal testing is referred to as extragenital testing. Those presenting for STI testing usually receive standard testing, which is done by collecting a urine and/or vaginal swab and for some STIs a blood sample; but standard testing only identifies penile and vaginal infections in some STIs, and does not identify extragenital infections. Standard testing is often focused on the least invasive and most comfortable option for the patient, and is what is routinely offered in health department clinics.
When it comes to STIs, a little bit of additional discomfort during testing is worth it. Nationally, traditional urine testing for gonorrhea and chlamydia miss 70%–88% of infections that are found using extragenital testing with men who have sex with other men (source). In 2019, a Tennessee Department of Health study identified that standard testing alone would have missed up to 46% of infections in males, and 18% of infections in females (Source: Patient Tracking Billing Management Information System [PTBMIS], 2019).
STI tests now include a lot of new options, and one key characteristic of STI screening that can significantly impact its accuracy is the type of sample used to run the test. Unless you specifically request something different as the patient, you are likely to be provided with standard testing for STIs.
In 2019, a Tennessee Department of Health study found that when extragenital testing was offered to all patients, testing increased significantly. Among males, rates of rectal testing increased by 200%, and oral testing increased by 78%; among females, oral testing increased 122%, and rectal testing increased 316% compared to 2018 testing data (Source: PTBMIS,2019). This suggests that patients and health care providers are not always talking about oral and anal sex. If health care providers use patient reporting alone, oral and rectal testing may not be completed or offered, even if warranted. This is why it is so important to not only talk to your health care provider about all of your sexual practices, but also to request extragenital testing.
Extragenital testing is not new, but health literacy and personal advocacy are required to get access to it. Healthy literacy includes knowing that this type of testing is more accurate and where you can go to get it. In Tennessee, local health departments that provide STI testing have oral and rectal testing available. Personal advocacy involves asking for the version of the test during the appointment that fits your needs and answering the detailed questions about sex asked by a medical provider that will lead to knowledgeable, personalized care. Medical providers often assume that patients will be more comfortable giving a urine sample than they will be using an anal swab, so personal advocacy includes speaking up to let your provider know that you want to get more comfortable taking oral and rectal tests.
Annual testing is recommended for all adults for all STIs, so every year you have a chance to use your increased health literacy and personal advocacy skills to get more effective testing. Asking for STI testing that includes oral and rectal swabs will not increase the cost you are asked to pay, and health departments all over Tennessee offer STI testing at little to no cost. HIV testing on its own is free, and the cost range for full STI testing is usually between $10–$20 in metro areas and is either free or calculated using a sliding scale based on income at regional Health Departments. When making an appointment, the clinic can provide information on cost. You will not be turned away due to an inability to pay the day of services. Many clinics have same day or next day appointments and some clinics allow for same-day walk-ins.
Here are some helpful steps to take as you get ready to get STI testing:
- Identify your testing location and learn more about STI testing there. Click here for a list of health departments in Tennessee to quickly find one close to you. Once you’ve identified the place, go on their website or call to learn more about their scheduling procedures, what forms of identification you need to bring, and what your STI testing (and potential treatment) will cost.
- If you are coming to a health department clinic after being tested at another location, bring your information with you. Bring any lab results and information from your last clinic appointment with you to your health department visit to save time and ensure you are getting the correct tests and treatment options.
- Be ready to answer questions about your sexual history. Be prepared for the questions they will ask you, and bring questions of your own. Write down 2 – 4 questions you have so that when you are face-to-face with your provider, you don’t forget what to ask.
- Write down any requests that are important to you. This includes requesting extragenital testing for STIs. It can also include requesting a walkthrough of the exam before you start.
- Learn more about STIs before you go. Doing your own research can both increase your knowledge and help you feel confident and comfortable during the process. The Centers for Disease Control and Prevention’s STI resource page is a great place to start.
- Choose a change to make in the next year. STI testing is annual, and it can be a great time to make a new resolution to improve your sexual health. Learn more about how to get free condoms, start on Pre-Exposure Prophylaxis (PrEP), and other ways you can improve your health on Tennessee Department of Health’s HIV Prevention page.
STIs are common, but STI testing is widely available in Tennessee. Start planning today, and don’t let discomfort or a lack of information stop you from getting the best testing and care possible.
Tennessee Equality Project
State and Local Endorsements
Tennessee Equality Project lobbies the Tennessee General Assembly and local governments around the state on behalf of the LGBTQ community. We are pleased to endorse a strong group of candidates for state and local government this year, including a number of LGBTQ candidates who can significantly change the conversation about our issues in Tennessee. The Slate of Hate, which is a set of vicious anti-LGBTQ bills, looms as a threat when the Legislature reconvenes in January. On the other hand, we have important opportunities to advance equality in many of our cities. The candidates we have endorsed can play a vital role in fighting discrimination and making life better for LGBTQ Tennesseans.
TENNESSEE GENERAL ASSEMBLY ENDORSEMENTS
TN Senate District 6-Knox County
TN Senate District 10-Bradley and Hamilton Counties
TN Senate District 14-Bedford, Lincoln, Marshall, Moore, and Rutherford Counties
TN Senate District 22-Houston, Montgomery, and Stewart Counties
TN House District 4-Unicoi and Carter Counties
TN House District 6-Washington County
TN House District 13-Knox County
Rep. Gloria Johnson
TN House District 18-Knox County
Eddie Mannis-LGBTQ candidate
TN House District 25-Cumberland, Putnam, and Van Buren Counties
TN House District 37-Rutherford County
TN House District 38-Clay, Fentress, Macon, Pickett, and Scott Counties
TN House District 40-DeKalb, Smith, Sumner, and Trousdale Counties
TN House District 48-Rutherford County
TN House District 49-Rutherford County
Brandon Thomas-LGBTQ candidate
TN House District 56-Davidson County
TN House District 63-Williamson County
Our endorsement goes to Elizabeth Madeira for her strong outreach to the LGBTQ community. We also wish to commend candidate Brad Fiscus for his clear expressions of support for our community.
TN House District 82-Crockett, Haywood, and Lauderdale Counties
Andrea Bond Johnson
TN House District 83-Shelby County
TN House District 89-Knox County
Keri Keeling (Write-in candidate)
TN House District 90-Shelby County
Torrey Harris-LGBTQ candidate
TN House District 96-Shelby County
TN House District 97-Shelby County
CITY GOVERNMENT ENDORSEMENTS
City Council Ward 4
Margaret Thompson-LGBTQ candidate
City Council Ward 5
City Council Ward 9
City Council Ward 11
Ashlee Evans-LGBTQ candidate
City Council Ward 12
Our endorsement goes to Joe Shakeenab for his demonstrated willingness to take action to address discrimination. We are also grateful to candidate Trisha Butler for her expressions of support for the LGBTQ community.
Kyle Beagle-LGBTQ candidate
Jeffrey Clark-LGBTQ candidate
Board of Aldermen
Lloyd Dunn-LGBTQ candidate
The Tennessee Equality Project surveyed candidates in these cities that are holding November 3 elections. All candidates for the city legislative body were surveyed. If you are a candidate and we didn't survey in your city and you would like us to do so, be in touch at firstname.lastname@example.org and we will consider your request.
Below are the responses for those candidates who completed surveys by the September 28 deadline:
Voters cast their ballots for alderman by district and may select one candidate in their district.
*Alderman Position 6
Voters cast their ballots for city council according to the ward in which they live. There are multiple candidates per ward in most races, but voters may only select one.
There are eight candidates for city commission; voters may select up to three.
There are four candidates for city council; voters may select up to two.
There are eight candidates for alderman; voters may select up to four.
The following state legislative candidates (TN Senate and TN House) turned in surveys to Tennessee Equality Project by the September 17 deadline. TEP did not survey in all legislative races. For example, there is only one candidate in many races where an incumbent is seeking reelection. In some races in which we sent out surveys, no candidate responded.
Candidates are listed within their district in the order in which they responded to the survey.
District 2-Blount and Sevier Counties
District 6-Knox County
District 10--Bradley and Hamilton Counties
District 14-Bedford, Lincoln, Marshall, Moore, and Rutherford Counties
District 20-Davidson County
District 22-Houston, Montgomery, and Stewart Counties
STATE HOUSE OF REPRESENTATIVES
District 4-Unicoi and Carter Counties
District 6-Washington County
District 13-Knox County
District 18-Knox County
District 25-Cumberland, Putnam, and Van Buren Counties
Robyn Deck-Democrat (received after deadline)
District 37-Rutherford County
District 38--Clay, Fentress, Macon, Pickett, and Scott Counties
District 40-DeKalb, Smith, Sumner, and Trousdale Counties
District 48-Rutherford County
District 49-Rutherford County
District 56-Davidson County
District 63-Williamson County
District 82-Crockett, Haywood, and Lauderdale Counties
District 83-Shelby County
District 89-Knox County
District 90-Shelby County
District 96-Shelby County
District 97-Shelby County
The following information is written by and provided in partnership with the Tennessee Department of Health:
2020 has been a difficult year for all of us. This Spring and Summer have made us all think more about our health, and how important it is that we take care of ourselves today to prepare for the problem that could be just over the horizon.
This year has also put into sharp focus all the reasons we have for not being proactive about our health. Health care is expensive and, for many of us, challenging to access. Health information is hard to understand and is changing every day. The evolution around HIV is a perfect example of this. HIV treatment gets easier to access for Tennesseans every year, and in the last decade has gone from a process which a person might delay to one where getting into treatment as soon as possible changes how a person lives with the disease. On top of that, HIV prevention tools now include PrEP, a daily pill.
The realities around prevention and treatment for hepatitis C have gone through a similar evolution. The term hepatitis refers to inflammation of the liver, and can be caused by many different things. These causes include fatty liver disease, over-consumption of alcohol, exposure to toxins and chemicals, some drugs and medications, and infections. In Tennessee, one of the main causes of hepatitis is the hepatitis C virus.
Hepatitis C virus is ten times more infectious than HIV, and one in four people with HIV will experience hepatitis C co-infection. As the use of injection drugs continues to rise statewide, so too does hepatitis C; approximately 53% of people who inject drugs have hepatitis C (source).
LGBTQ people are more likely to misuse substances, including both drugs and alcohol, than others. Discrimination and stigma can contribute to over-dependence on alcohol and drugs for LGBTQ people (source). LGB youth are 25% more likely to drink alcohol, twice as likely to use ecstasy and cocaine, and four times as likely to use heroin and meth (source). LGBTQ people are also less likely to have health insurance than others, particularly youth, seniors, and transgender persons, putting significant barriers between them and routine medical care (source, source, source). These realities mean that LGBTQ people are more likely than others to come into contact with HIV and hepatitis C, while also having unique barriers to health care.
In Tennessee, access to hepatitis C screening and treatment has increased dramatically in the last few years. This is huge for LGBTQ people who are at elevated risk for hepatitis C, because it can now be cured in most people while the consequences of lack of treatment compound significantly over time. Over 90% of people with hepatitis C can be cured with 8-12 weeks of oral medication (source). If left untreated, complications include chronic hepatitis C infection (75-85 out of every 100 people), chronic liver disease (60-70 out of a 100), cirrhosis (5-20 out of a 100), and death (1-5 out of 100) (source). Cirrhosis and liver cancer cause about 1 in 5 percent of hepatitis C-related deaths, as treatment options are limited for these conditions (source).
Hepatitis C is a health concern where knowledge about screening and treatment is critical, and can mean the difference between three months of treatment and years of chronic health issues. Hepatitis C screening is a two-step process that starts with an antibody test (which will always be positive for anyone who has ever been exposed to hepatitis C) and an RNA confirmatory test (which can tell you if you currently have hepatitis C). Antibodies to hepatitis C are not protective, and you can be re-infected even if you have successfully completed past hepatitis C treatment.
If you think you might have hepatitis C, your local health department can provide you with testing and treatment options. Here is a list of health departments in Tennessee that you can use to find the location most convenient for you.
If you have a positive hepatitis C test, or if you have had a positive test in the past but need support finding free or low cost treatment, Tennessee has Viral Hepatitis Case Navigators who provide resources to patients seeking hepatitis C treatment. To get started, contact your local health department and ask to be connected to a Viral Hepatitis Case Navigator.
If you want to get involved in the statewide effort to better coordinate work around HIV, sexually transmitted infections, hepatitis C, and substance misuse, click here to learn more about the End the Syndemic Tennessee initiative.
On July 3 Tennessee Governor Bill Lee granted county mayors the authority to issue mask/face covering mandates. Here is the status of mask mandates in Tennessee counties.
Bradley County: No mask mandate for now.
Cheatham County: "Hard no," according to a July 6 WSMV report.
Davidson/Nashville: Mask mandate is in place.
Dickson County: "Hard no," according to a July 6 WSMV report.
Franklin County: The Mayor says NO in this video.
Greene County: Mask mandate announced on July 13 to begin on July 15.
Hamblen County: Mask mandate issued on August 1.
Henry County: Mask mandate in place.
Jefferson County: Mayor announced no mask mandate on July 8.
Knox County: Mask mandate in place, but the County Mayor voted against it and the Sheriff has not indicated he will enforce it. This Facebook group discusses which Knoxville-area businesses are following the mask mandate.
Loudon County: County Mayor says no mask mandate at this time, according to WATE.
Madison County: Mask mandate is in place, but there has been a protest.
Montgomery County: Mask mandate announced on July 14.
Putnam County: No mask mandate announced on July 7.
Robertson County: Mask mandate announced on July 7.
Rutherford County: Mask mandate announced on July 20.
Sevier County: Mask mandate announced on July 7.
Shelby County: Mask mandate in place.
Sumner County: Sumner County's mandate was issued on July 6. Read the statement from Mayor Holt here. Thanks to everyone who contacted the County Mayor.
Sullivan County: Mask mandate announced on July 10.
Washington County: Mask mandate announced on July 13 to begin July 14.
Williamson County: Mask mandate in place as of July 6. Thanks to everyone who contacted the County Mayor.
Wilson County: Mask mandate announced on July 17.
*Send any updates to email@example.com .
The following information is provided through a partnership with the Tennessee Department of Health:
June is a month of great importance for people living with HIV. June 5th was HIV Long Term Survivors’ Day, a celebration of and a day of awareness for people who have been living with HIV for 20 or more years. In Tennessee, 4,126 people have been living with HIV for at least 20 years, and 252 people have lived with HIV for 30 years or more.
The theme of HIV Long Term Survivors’ Day this year was “Not Our First Pandemic,” connecting the early years of the HIV epidemic to our current fight with COVID-19. Tennesseans in this group struggle with challenges managing their HIV including isolation, poverty, increased stigma amongst their age peers, and AIDS Survivor Syndrome.
People who have lived with HIV for multiple decades have watched the world go from ignorance to knowledge about how a virus works, spreads, and is successfully treated. The present progression of COVID-19 in the United States and globally mirrors some of those same community and public health steps. 2020 will be the first year in more than a decade when National HIV Testing Day (June 27) does not result in large, in-person community gatherings and testing events. In many states, in-person Pride celebrations and parades have been cancelled or brought online.
For those who have lived with HIV for decades, COVID-19 might have interrupted their medical appointments, mental health care, and health-promoting social interaction. Additionally, fear that their long-term immunocompromising condition might make them more susceptible to COVID-19 means there is a new cause for anxiety and distress. Currently, the U.S. Department of Health and Human Services maintains that HIV alone is not one of the chronic conditions that puts people at increased risk for a life-threatening COVID-19 infection.
According to the CDC, people living with HIV trying to protect themselves from COVID-19 should be doing the same things recommended for all other Americans: maintaining daily healthy practices (including rigorous hand-washing and wearing a face mask when interacting outside the home) and reducing in-person social contact as much as possible. Maintaining their HIV treatment regimen during this time and continuing activities that reduce stress are vitally important. While many medical services are unavailable during COVID-19 community mitigation, HIV treatment and mental health care are essential services. Click here for a list of HIV medical providers in Tennessee that are designated as Ryan White Part B Centers of Excellence. Click here for more information about maintaining mental, social, and behavioral health during COVID-19 community mitigation.
Day-to-day, we all have people and habits we turn to for emotional support and to curb rising stress. COVID-19 makes it harder to find opportunities to socialize, communicate with family, and keep up with healthy habits. For those struggling with substance abuse, this stress could contribute to desires to turn to unhealthy coping behaviors. Click here for a list of harm reduction programs providing services related to substance use and abuse near you. COVID-19 has interrupted our regular plans with friends and social interaction in public settings. There are supportive social groups all over Tennessee that are meeting or hosting activities online during the pandemic. Don’t let fear or discomfort with video conferencing get in the way of your ability to enjoy these new opportunities to connect with your peers. Click the links for more information about how to navigate Zoom, Go-To Meeting, Webex, and Google Hangouts/Google Meet.
For people living with HIV who are at home, the activities we have grown accustomed to seeing in June are still happening, just in different forms. Globally, Pride organizations are coming together to create an online, international Pride event on June 27. For those who would normally refer their friends and family members not living with HIV to free testing at this time of year, many of the organizations on this list are now offering no-contact telehealth HIV testing.
This summer is both radically different from what we all expected, and eerily familiar for our HIV Long Term Survivors. No matter how different (or familiar) things look, we do have the tools we need to take care of ourselves and each other.
Rep. Ragan's HB2576, which says that it is child abuse to offer gender-affirming health care to transgender youth, could be coming to the House floor soon. On June 11, it was deferred to the final calendar of the House Calendar & Rules Committee. It got slowed down a bit, but could pick up speed next week. Take action today!
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