A New Hub at the Intersection of ‘Multiple Vulnerabilities’  

UCLA Luskin’s newest research initiative is deeply rooted in the community, with the aim of improving the well-being of its most vulnerable members. 

Launched in late 2019, the Hub for Health Intervention, Policy and Practice (HHIPP) connects scholars, policymakers and advocates for those battling poverty, racism, homophobia and discrimination of all kinds.

“We really see HHIPP as in service to Los Angeles’ diverse communities, especially those at the intersection of multiple vulnerabilities,” said Social Welfare Professor Ian Holloway, director of the initiative.

In his long career in research, Holloway has focused on health policy through a social justice lens, working closely with Social Welfare faculty colleague Ayako Miyashita Ochoa.

“When we looked across all of our projects, one of the unifying themes was that we always started with our community partnerships,” Holloway said. “We centered the needs and priorities of the communities that we’re engaged with: lots of diverse LGBTQ+ communities, BIPOC communities, communities of people who use different substances or who are street-connected.”

This has led to innovative and collaborative projects including one using machine learning algorithms to provide personalized information about HIV prevention to gay and bisexual young men. A team led by Miyashita Ochoa is working with people involved in L.A. County’s sex trade to measure the impact of a new state law that prohibits law enforcement from using condoms as evidence of sex work.

HHIPP is also tracking the trajectory of cannabis use among LGBTQ young people in the state. This includes efforts to understand high rates of tobacco use among gender-non-conforming youth, including the role of targeted marketing campaigns.

“And so the idea for HHIPP was really to unify all of these streams of research under one hub,” Holloway said.

HHIPP is committed to making its research widely accessible to the public. To share early findings from the hub’s tobacco-related research, Holloway hosted a webinar tied to LGBTQ Health Week and Transgender Day of Visibility.

During the COVID-19 pandemic, when the School’s signature Luskin Summit went virtual, HHIPP used the platform to share information on the coronavirus’ impact on the opioid crisis and the role of telemedicine in protecting sexual health.

Even though the pandemic lockdown struck HHIPP just as it was getting off the ground, Holloway noted that the COVID era also brought new opportunities, including development of a proposal to create community-based tools for vaccine promotion and delivery.

“We certainly have seized the moment in terms of trying to understand the impact of COVID on the communities that we’re serving,” he said.

HHIPP’s work has been funded by a variety of organizations, including the National Institutes of Health, the California HIV/AIDS Research Program and the California Bureau of Cannabis Control. The initiative established a cross-cutting advisory board and continues to launch partnerships with community groups across Southern California.

Looking down the road, Holloway envisions a brick-and-mortar field site where HHIPP can truly serve the community. Local residents could come to the site for social services or health and mental health support. Scholars could co-create research alongside community members, and Social Welfare, Urban Planning and Public Policy students could develop their skills in real time and alongside policymakers.

“Bridging worlds together and locating power in community would be very aligned with our ethos at HHIPP,” Holloway said. “I think that that is one strategy that moves us closer to achieving our vision.”

Miyashita Ochoa on History of Discriminatory Blood Donation Ban

Adjunct Assistant Professor of Social Welfare Ayako Miyashita Ochoa wrote an article in the Regulatory Review about the inconsistencies between current blood donation deferral policies and modern scientific knowledge. At the height of the HIV epidemic, the FDA implemented a blood donation deferral for all men who have had sex with men in the last year. Miyashita Ochoa explained that, “at the time, exercising extreme caution was the wisest course of action” since scientists didn’t know how the virus was transmitted. However, the policy continued for decades, even as scientists learned more about HIV transmission and improved blood screening techniques. In April 2020, the FDA decreased the deferral period from 12 months to three months. While this was a step in the right direction, “it does not reflect the latest science,” Miyashita Ochoa said. She called on the United States to address HIV and gay-related stigma. “The FDA’s policies must harness truths based on science rather than fear.”


Miyashita Ochoa on Outdated Blood Ban for Gay Men

Adjunct Assistant Professor of Social Welfare Ayako Miyashita Ochoa spoke to North Carolina Health News about policies that continue to bar some gay men from donating blood. Miyashita Ochoa explained that at the beginning of the AIDS epidemic, there was no test for HIV or AIDS, and scientists weren’t sure how it was transmitted. “The policy itself was a reflection of that,” she said. “It also obviously targeted specifically the populations that were hardest hit by HIV and AIDS.” Over time, the policies endured despite advances in science. Miyashita Ochoa pointed out that a lot has changed since the 1980s, including what we know about HIV transmission and the efficacy of prevention measures. To combat a shortage in the blood supply caused by the COVID-19 pandemic, the FDA relaxed restrictions in 2020 to include men who have not had sex with men for three months. Advocates, however, argue for an end to all bans of gay and bisexual men.


Blood Donation Ban Fueled by Fear, Not Science, Miyashita Ochoa Says

Adjunct Assistant Professor of Social Welfare Ayako Miyashita Ochoa was featured in a Men’s Health article discussing the impact of the longstanding ban on blood donations from gay men. The country’s blood supply is running dangerously low, partly due to the cancellation of many blood drives during the pandemic. Gay and bisexual men, often referred to as men who have sex with men (MSM), are not allowed to give blood if they have had sex with another man in the past three months. A 2014 report by the Williams Institute at UCLA found that allowing MSM equal access to donating blood could increase the total annual blood supply by 2% to 4%, which would help save the lives of more than a million people. Miyashita Ochoa expressed frustration that the ban still has not been lifted. “It is my opinion that we continue to have a real problem with laws and regulations based on fear rather than science,” she said.


Examining the Science Behind Decriminalizing Sex Work

Governments have cited protection of public health as a rationale for outlawing sex work, yet evidence shows that decriminalizing the trade increases health and safety and reduces the risk of disease, according to a new policy brief from researchers at UCLA. Released on International Sex Worker Rights Day, the brief reviews global data showing that the public health justification for criminalization and regulation of sex work is not supported by science. “There is scant evidence that criminalizing the sex trade has any positive effects on public health and the health of sex workers,” the brief states. Instead, it cites empirical studies linking criminalization to a rise in sexually transmitted infection and HIV transmission, as well as an increased risk of violence against sex workers. The authors draw a distinction between sex work, which is consensual, and sex trafficking, which is based on force, fraud or coercion or involves the participation of minors. The policy brief calls for further study on how laws and policies related to the sex trade can improve public health. While decriminalization may not fully eliminate the stigma and victimization of sex workers, the authors argue that “by removing criminal liability from the picture, approaches that seek to integrate sex workers into society can advance both human rights and labor rights of communities made vulnerable by multiple systems of oppression.” The policy brief was issued by researchers from UCLA’s Center for HIV Identification, Prevention and Treatment Services, Southern California HIV/AIDS Policy Research Center and Global Lab for Research in Action in partnership with the Sex Workers Outreach Project — Los Angeles.


 

Luskin Summit Looks at Sexual Health in the COVID-19 Era

The sixth Luskin Summit webinar, “Sexual Health: Hooking Up With Home-Based Testing and Telemedicine,” featured a panel of experts in health care, medicine, research and policy. Moderator Ayako Miyashita Ochoa, adjunct assistant professor of social welfare, explained that while the COVID-19 pandemic has presented new challenges for health care delivery, it has also served as an opportunity to integrate remote practices into sexual health care services. Associate Professor of Social Welfare Ian Holloway highlighted the resilience of sexual health care providers in their ability to pivot to remote care during the pandemic. “Telehealth is here to stay,” he said. Leah Millheiser, senior vice president of medical affairs for the telemedicine company Hims & Hers, noted that many patients who avoided physician offices out of fear of judgment or embarrassment are now taking advantage of telehealth services. Sonali Kulkarni, medical director of the Division of HIV/STD Programs for the Los Angeles County Department of Public Health, said that testing is an essential part of the strategy to address rising rates of sexually transmitted diseases. According to Holloway, physical distancing measures in place around the world have had a significant impact on the mental health of gay and bisexual men. Alex Garner of the Gay Sexuality and Social Policy Initiative at UCLA Luskin has been working on ways to promote and provide public health information on gay social networking apps while still respecting them as unique, cultivated spaces for men to connect with one another and to mitigate experiences of loneliness and isolation during the pandemic. — Zoe Day


Miyashita Ochoa on HIV Criminalization Laws

A Body Pro article about the human rights and public health implications of laws targeting HIV-positive and LGBTQ populations cited Ayako Miyashita Ochoa, adjunct assistant professor of social welfare. In California, people living with HIV can be prosecuted for specific offenses, Miyashita Ochoa explained. These laws are most likely to be enforced in marginalized communities, she said, noting that sex workers account for 95% of HIV-related prosecutions in the state. In addition, Miyashita Ochoa, who is also associate director of the UCLA California HIV/AIDS Policy Research Center, interviewed filmmaker and activist Marco Castro-Bojorquez about the role of HIV criminalization data in shifting the policy landscape. Human rights advocates are working to modify or repeal laws that single out people living with HIV while continuing to criminalize the behavior of people who intend to harm or infect others.


Taking the Border Crisis to Heart Team from UCLA Luskin Social Welfare counsels mothers and children seeking asylum in the United States

Team from UCLA Luskin Social Welfare travels to immigrant detention center in Texas to counsel mothers and children seeking asylum in the U.S.