In the Weeds of Legalized Pot Recreational cannabis raises pressing questions for California officials, citizens and UCLA faculty experts seeking to devise common-sense policies

By Mary Braswell

When Californians voted in 2016 to bring the cannabis industry out of the shadows, the aim was to create an environment where marijuana was safe, controlled and taxed. This has not been a simple undertaking.

Legalization of recreational pot has raised pressing questions from public health officials, local law enforcement, state regulators, city planners and citizens hungry for common-sense policies — not to mention the growers, retailers and users who drive California’s multibillion-dollar weed industry.

What will the city-by-city patchwork of laws look like? How can marijuana cultivators safely introduce pesticides into a neighborhood? When will communities see the benefits of tax revenues? How will lifting the stigma on pot use affect adolescents?

The need for facts, evidence and clear thinking has never been greater. Fortunately, UCLA Luskin researchers and policy experts are on the case, among them Public Policy lecturer Brad Rowe MPP ’13.

‘A REALLY TRICKY BUSINESS’

Proposition 64, the ballot measure that legalized recreational pot, gave each of California’s 482 cities and 58 counties the authority to license cultivation, manufacturing and sales. So far, most have declined to do so.

The more than 160 cities and unincorporated areas that decided to move forward face a labyrinth of policy questions, said Rowe, who launched his own research firm, Rowe Policy + Media, in 2017. He also serves on the faculty of UCLA’s Cannabis Research Initiative, teaches a Public Policy class on drugs and crime, and advises municipalities that are venturing into the marijuana fray.

“Cannabis is a really tricky business, and it’s one that is probably going to have more volatility than most of the other licensing areas,” Rowe said.

In many cases, he said, communities have overestimated the financial gains and underestimated the complications.

“Expectations have been set so high for tax revenues. Common claims from city representatives are, ‘We’re going to build libraries and parks and football programs for the kids,’ ” Rowe said. “The truth is that you’ve got to get your system up and running, and realistically expect that that store that you just licensed may only generate tens of thousands rather than hundreds of thousands in tax revenue for you this year. … It’s hard to pay for your new inspector and the new police officer you just hired, and your financial department has to figure out how to handle the cash.”

Cannabis commerce requires cities to create systems for licensing, taxation, financial compliance and the delicate matter of handling deposits from a largely cash business, Rowe said. They must keep up with evolving regulations from the state’s Bureau of Cannabis Control and shifting signals from the federal government, which strictly prohibits pot.

They will have to consider whether growing outdoors will create a nuisance and how to safeguard first responders against new threats. Firefighters arriving at a site that uses pesticides or volatile solvents for terpene extraction “shouldn’t be inhaling that stuff,” Rowe said.

Some of the policy debates veer toward the high end. Sonoma, he said, is considering whether to permit tastings of cannabis products, just as it does for viognier and pinot noir. “So then we’re getting into on-site consumption, event permits, more cannabis cops,” Rowe said.

On the whole, he said, “it can be a big hairy hassle for the cities, and that’s one of the reasons a lot of them have said we’re going to kick the can down the road and see how these other cities do.”

SEEKING JUSTICE, EQUITY AND FACTS

Rowe’s work with the UCLA Cannabis Research Initiative focuses on criminal and juvenile justice as drug offenses are reclassified.

“Are we even moving away from the war on drugs? That is the intent but in practice it’s a trickier thing, so we’re looking at equity considerations,” he said.

The health and well-being of young people must be a top policy priority, he argues.

“The one thing I am super concerned about is cannabis use disorder among adolescents,” Rowe said, citing brain research as well as recent studies measuring the toll that compulsive pot consumption takes on test scores and analytical skills.

“We just don’t know enough about the plant,” he said. “We don’t know enough about its addictive properties; we don’t really know what will happen as it becomes de-stigmatized and easily available.”

Legalization has led to new funding for research aimed at answering these questions. Proposition 64 earmarks $10 million a year for public universities to evaluate the impact of the law and make recommendations to the state.

Rowe has visited cities up and down the state as a consultant with MuniServices, which helps local governments manage their affairs. He has hosted forums for potential pot licensees, family and faith-based groups, and other stakeholders and says, “There have been some really heartfelt, interesting conversations. Some are opposed and some just want this to be done with caution.”

Many simply want reliable information, he said.

“There’s a lot of room for reasonable conversation; there’s a lot of room for public policy people to come into this area,” Rowe said. “It’s only going to get bigger. It’s going to be a very big industry.”

Social Welfare Ph.D. Faculty Ranked Among Top Three in Scholarly Productivity

Social Welfare Chair Laura Abrams, right.

UCLA Luskin’s Social Welfare doctoral program is one of the top three most productive in the nation, according to a newly published study measuring the impact of faculty research. “The search for meaningful metrics of program excellence has been a longstanding effort by social work schools and colleges,” the researchers said. To understand variations in faculty productivity, they built upon previous work analyzing scholarly citations by considering the impact of a program’s funding sources, regional location, year of establishment and faculty demographics. “Researchers are not expected to build knowledge in a vacuum,” the study said. “Rather, it is a professional expectation that researchers also demonstrate the ability to disseminate knowledge widely despite the narrowness of their specialty area.” The analysis found that the three most productive social work doctoral faculties were based at public universities in the West: the University of Washington, UC Berkeley and UCLA Luskin. “One surprising finding was that there were significant differences among programs with the same size but located in different parts of the country,” the researchers said. “Why Western and Midwestern programs outperform their Northeastern and Southeastern counterparts is unclear.”  The research, published in the journal Scientometrics, was based on empirical data from the entire population of doctoral tenure-track social work faculty at 76 research-oriented universities.

 

How Safer Drug Consumption Programs Can Help HIV Prevention Southern California HIV/AIDS Policy Research Center releases policy brief showing the impact of safer drug consumption sites

Ian Holloway

A policy brief published by the Southern California HIV/AIDS Policy Research Center confirms that safer drug consumption sites can reduce the risk and incidence of HIV and Hepatitis C infection.

The Southern California HIV/AIDS Policy Research Center is a partnership between the UCLA Luskin School of Public Affairs, APLA Health and the Los Angeles LGBT Center. Ian Holloway, assistant professor of Social Welfare at UCLA Luskin, is the center’s principal investigator.

Proposed legislation in California Assembly Bill 186 seeks to implement safer drug consumption sites in locations throughout California. These sites provide supervision by trained personnel, offer safe and sterilized equipment, and link people to medical care and substance use treatment.

Given that the risk factors presented by the opioid epidemic and increased intravenous drug use overlap substantially with risk factors associated with higher rates of HIV transmission, the policy brief clarifies the state of research pertaining to both epidemics. It identifies Californians that are impacted by and at greater risk of both intravenous drug use and HIV infection, and reviews research evidence for how safer drug consumption sites may be a key HIV prevention tool.

“Evidence shows that the HIV and opioid epidemics dangerously intersect,” said lead author Robert Gamboa, a Master of Public Policy (MPP) student at the UCLA Luskin School of Public Affairs. “Because of this relationship, the evolving frontier of HIV prevention must consider implementing safer drug consumption sites as an effective strategy. This intervention has the potential to prevent the further spread of HIV and other blood borne diseases while also saving lives from opioid overdose.”

Key findings of the report:

  • In 2015, California saw more than 4,700 new cases of HIV, was third in the nation for HIV transmissions via injection drug use and first in the national among men who have sex with men who inject drugs.
  • Other key groups impacted by both epidemics include women, people of color, those who are homeless and youth. Research has found that people who inject drugs from these subgroups are 4-29 times more likely to have an HIV-positive diagnosis.
  • Safer drug consumption sites offer supervision by trained personnel, safe and sterilized equipment, and link people to medical care and substance use treatment thereby reducing risk of HIV and Hepatitis C infection.
  • Safer drug consumption sites can help to facilitate continuity of care for both addiction and HIV among people living with HIV who use drugs.
  • In California, researchers have estimated that a single safe injection site in San Francisco could prevent 3.3 new HIV transmissions per year and would save the State of California roughly $3.5 million per year in expenses related to health care, emergency services and crime.

San Francisco recently joined Seattle and Philadelphia in implementing safer drug consumption sites in their jurisdiction. Prior research has provided evidence for leveraging safer drug consumption sites as an effective HIV prevention strategy.

Should state legislation clear the way for California to implement the strategy statewide, research supports the inclusion of broad HIV prevention and treatment services at local sites. To access the full report, visit www.chprc.org.

 

Dispensing Knowledge in Real Time UCLA Luskin Social Welfare students present the results of their rapid response research projects

By Stan Paul

Research, by design, is focused, systematic, methodical. It takes time.

But when information moves at the speed of social media, and false, distracting and potentially harmful information can be spread worldwide via tapping a screen in the middle of the night, there is a pressing need for responsible research that can be produced in real time.

A dozen social welfare graduate students at the UCLA Luskin School of Public Affairs reacted to this challenge by taking on projects — above and beyond their required studies — to match their data-gathering and synthesizing skills with the ability to make useful information available quickly to communities that may need it.

The social welfare master’s and doctoral students researched topics such as hate speech and immigration.

“You are going to enter your profession, a profession built around the question of human caring, at a time where human caring is not held in particularly high esteem,” UCLA Luskin Dean Gary Segura said in introducing “Rapid Response Research in the Trump Era,” a June 1, 2017, gathering at the Luskin School to review student projects.

Segura, whose research has centered on representation and empowerment, said: “You know the challenges that all of us face … across all racial and ethnic, socioeconomic subpopulations in the United States: access to affordable health care, dealing realistically and honestly with challenges that individuals and families face, providing quality education and job opportunities for people. The list is unbelievably long.

“The first piece of advice I’m going to give you for resistance is to call things by their name,” Segura said. “We must begin our resistance by calling things what they are: Racism is racism, sexism is sexism, anti-Semitism and Islamophobia are what they are.” He urged students not to pass these things off as merely rants not worthy of comment or notice.

Laura Abrams, the incoming chair of UCLA Luskin Social Welfare, said that a list of potential research ideas was presented to social welfare students early in the academic year, and a number of groups responded. The criteria for the projects included working with real-time data from social media platforms such as Twitter.

Abrams said the research topics “were going to be more immediately applicable to what communities might need in order to resist and they had to be social justice oriented.” Social welfare faculty such as assistant professors Ian Holloway and Laura Wray-Lake served as advisers for the students.

One project examined Twitter data based on the motivations of those who participated in the Women’s March, and how that motivation connects — or doesn’t — with broader issues of racial justice.

One immigration issue tackled by the students was part of a nationwide project asking how young people have been affected by the policies and rhetoric of the Trump administration. That project relied on responses from Latino high school students. The information gathered is intended to inform educators and others working with adolescents.

First-year MSW student Alexandra Rhodes said she studied anti-LGBT hate speech and the incidence of particular words used on Twitter.

“I was interested in seeing if anti-LGBT hate speech on Twitter increased after Donald Trump’s election,” said Rhodes, who gathered information from more than 40,000 users who had tweeted anti-LGBT search terms. From that group, just over 10,000 users were randomly selected for comparison of the number of such tweets before and after the election.

“I was most interested in how Donald Trump’s election was affecting the LGBT population given his seemingly anti-LGBT rhetoric and policies,” said Rhodes, who is primarily interested in working with the LGBT population and is considering pursing a Ph.D. in social welfare.

“It is very important to me to do ethical and essential research in my community and build evidence to support how we have been affected by various social changes and policies,” Rhodes said. “For now, I’m focusing on getting involved with research in whatever way I can as an MSW student. It is important to do research and look at the data and respond to what is happening right now.”

Abrams said she hopes that this becomes a tradition that can continue to be built into the curriculum in a meaningful way.

“As a Social Welfare Department, the rapid response research projects are a prime example of what we can accomplish when we have an idea, put our heads together, and work hard as team,” Abrams said. “I am proud of the students for carrying out their projects in such a timely and rigorous manner.”

More Than 45,000 Californians Living With HIV Would Be Impacted by Medicaid Cuts in Senate Health Plan According to a fact sheet from the California HIV/AIDS Policy Research Centers, the cuts would be felt by patients covered by Medi-Cal

Tens of thousands of Californians living with HIV would be impacted by Medicaid cuts under the Better Care Reconciliation Act (BCRA), according to a fact sheet released by the California HIV/AIDS Policy Research Centers in collaboration with the UCLA Luskin School of Public Affairs.

The fact sheet highlights new data from the California Department of Public Health, Office of AIDS, which indicates that 45,033 people living with HIV received health coverage through Medi-Cal in 2014. These data also indicate that approximately 11,500 people living with HIV enrolled in Medi-Cal because of the Affordable Care Act (ACA). Medi-Cal, California’s Medicaid program, covers the cost of medications that help low-income people living with HIV achieve viral suppression, which both improves their health and prevents new infections.

Last week, the U.S. Senate released the BCRA, which would make dramatic cuts to Medicaid. A similar bill passed by the U.S. House of Representatives, the American Health Care Act (AHCA), would have cut Medicaid nationwide by $834 billion over 10 years.

The BCRA would radically restructure the Medicaid program by converting it to a per capita cap or block grant and effectively end the ACA’s Medicaid expansion. Together, these changes would result in a massive fiscal shift from the federal government to the states and add billions in additional costs to the state of California.

“People living with HIV have complex health-care needs that require high-quality, consistent and affordable health care,” said Ian Holloway, director of the Southern California HIV/AIDS Policy Research Center and an assistant professor in the Department of Social Welfare at the UCLA Luskin School of Public Affairs.

The CHPRC fact sheet emphasizes that limits on Medicaid financing and coverage would have a detrimental impact on California’s efforts to provide care and treatment for people living with HIV and to reduce new HIV infections.

“It is important for policymakers to understand the threats the BCRA poses to people living with HIV and other vulnerable communities in California,” Holloway said.

 

Despite Ongoing Meningitis Outbreak, Vaccination Among Gay Men Remains Low Limited 2-dose completion among HIV-positive men puts them at particular risk, new study shows

Despite a yearlong outbreak of invasive meningococcal disease in Southern California primarily affecting gay and bisexual men, less than 27 percent of men who have sex with men (MSM) in Los Angeles County have been vaccinated for meningitis.

The findings released Thursday, March 30, 2017, by the California HIV/AIDS Policy Research Centers in collaboration with the UCLA Luskin School of Public Affairs, the Los Angeles LGBT Center and APLA Health call for more education about the disease and more places offering immunization throughout Southern California at venues where gay and bisexual men socialize.

More than 500 men were interviewed about their knowledge of the meningitis outbreak by UCLA Luskin’s Ian Holloway, an assistant professor in the Department of Social Welfare, and teams of researchers who visited venues throughout Los Angeles County. Most of the canvassers were current UCLA students or recent graduates.

“Our rapid-response research suggests that coordinated efforts to standardize data collection about sexual practices in conjunction with immunization will enable better tracking of meningitis vaccination among gay and bisexual men,” said Holloway, who is also the director of the Southern California HIV/AIDS Policy Research Center.

Meningococcal disease is often characterized with sudden onset of high fever, headache, nausea, vomiting, rash, stiff neck and confusion, which can lead to rapid septic shock and death if not treated quickly. Vaccination is highly effective and can prevent the disease. The current outbreak in Southern California is the second in the area in recent history. A 2014 meningitis outbreak led to the deaths of three gay men in their 20s.

Despite the outbreak and vaccination recommendations from the California Department of Public Health, the majority of respondents interviewed by the UCLA team were not protected against meningitis.

Holloway noted that HIV-positive people are at particular risk for developing serious health issues if infected with meningitis and are recommended to receive a two-dose primary series of meningitis vaccination. Few HIV-positive men surveyed by Holloway’s team had received two doses of the vaccination.

“Primary care doctors who treat gay and bisexual men and HIV-positive people should talk to their patients about the ongoing outbreak and make sure they receive the full recommended dosing,” said Phil Curtis, director of government affairs at APLA Health.

The study praises the efforts of the Los Angeles County Department of Public Health Immunization Program, which distributed free vaccines, and of participating community-based organizations such as AIDS Healthcare Foundation and the LA LGBT Center, but researchers concluded that more needs to be done.

In addition to Holloway, study authors include Elizabeth Wu and Jennifer Gildner from the Southern California HIV/AIDS Policy Research Center, and Vincent Fenimore and Paula Frew from Emory University.

Learn more about Ian Holloway and the meningitis study in this video:

Taking the Fight for LGBT Health Equity to the Streets Late-night canvassing to assess a meningitis outbreak exemplifies the dedication that has earned UCLA Luskin Social Welfare professor Ian Holloway national recognition for his groundbreaking research

By Les Dunseith

It’s the Tuesday night before Christmas as UCLA Luskin professor Ian W. Holloway tucks his 2-year-old daughter Sofía into bed and prepares to leave his home on a tree-lined street of bungalow-style houses in the Larchmont neighborhood of Los Angeles.

It’s time for Holloway, an assistant professor in the Department of Social Welfare, to get back to work.

Along with three UCLA student researchers, Holloway will spend the next several hours in West Hollywood doing legwork for his latest research project. Their task will be to find and interview gay and bisexual men outside popular nightspots and discover how much they know about an ongoing meningitis outbreak and the steps that health officials have taken to battle it.

This type of time-consuming, on-the-ground research is par for the course for Holloway, who serves as the director of the UCLA Luskin-based Southern California HIV/AIDS Policy Research Center and is currently juggling four major research efforts related to his expertise in health disparities among sexual and gender minority populations. Holloway’s dedication and his innovative methods recently led the Society of Social Work Research (SSWR) to select him for its Deborah K. Padgett Early Career Achievement Award, presented in January 2017 during the organization’s national conference in New Orleans.

“This is our primary professional society,” Holloway says about the honor, which recognizes social work research completed during the recipient’s first decade after earning a doctoral degree. “They give just one a year at the society’s big professional meeting.”

UCLA Luskin students Jorge Rojas and Christine Munoz listen as Ian Holloway outlines the agenda as another night of research gets underway. Photo by Les Dunseith

On this night, however, the meningitis study takes precedence. Outside the Urth Caffé, Holloway helps the student researchers establish a “line” — in this case basically a crevice in the sidewalk — at the corner of Melrose Avenue and Westmount Drive. One or more of the students then approaches any man who crosses that line, asking them to participate in the research effort by spending 20 minutes answering survey questions using an iPad.

In the first half-hour, however, only one man who meets the study’s criteria has been successfully interviewed. Holloway and his research team are trying to complete about 500 interviews for the project by February, and foot traffic is just too light to continue at the site. So they move on to the next venue that has been randomly preselected for this night’s canvassing effort — the Motherlode, a tavern with removable walls that proudly shows off its dive-bar atmosphere to passersby along Santa Monica Boulevard.

The thought of an academic research project centered around bar hopping in West Hollywood until 2 a.m. may seem incongruous, but it’s a proven research approach that works particularly well when the target audience is gay and bisexual men in Los Angeles County, including those who are HIV positive. During a meningitis outbreak that has led to two deaths in Southern California since it was first reported last spring, the researchers need to go where those who are most at risk can reliably be found.

UCLA Luskin student researchers Ryan Dougherty and Christine Munoz use digital devices to establish a survey zone. Photo by Les Dunseith

“We use a strategy called venue-based sampling,” Holloway explains. “It’s a systematic sampling strategy that is one of the best ways we know for how to approximate generalizability among gay and bisexual men.”

Holloway’s meningitis study is funded as part of a four-year, $4-million grant from the California HIV/AIDS Research Program to produce “what we call rapid response research,” he says. The idea is to complete research within months, not years, related to timely policy issues that impact people living with HIV or AIDS in California.

As noted on its website, CHPRC.org, the center works closely with community partners from AIDS Project Los Angeles Health and the Los Angeles LGBT Center to tailor research efforts to match urgent needs within the LGBTQ communities.

“We get community input, synthesize that and then set an agenda for policy research,” Holloway explains.

He took over the center’s leadership last April from Arleen Leibowitz, professor emeritus of public policy at UCLA Luskin, and feels fortunate to conduct research efforts that directly arise from community interaction.

“Models of funding like this aren’t widely available, so we are lucky to have a center here at UCLA, and we are lucky to have had it for seven years,” he says. “We want to continue to do this work and be able to conduct research that is driven by the community and that directly benefit the community.”

The meningitis study resulted from a meeting in October at which about 40-50 advocates, health workers and social service providers from across Southern California came to Los Angeles to talk about the needs of people in the local LGBTQ communities.

“These are people who are working with HIV-positive clients, who are doing prevention work,” Holloway says of the attendees. The meeting gave them an opportunity to think about and debate the issues most affecting their communities. The researchers primarily were there to listen and help structure projects that could be completed in a rapid response timeframe to produce data that would actually benefit those communities.

“It is … very much aligned with the mission of Luskin and the mission of the Department of Social Welfare,” Holloway notes.

Ian Holloway discusses where to relocate with his survey team when one of their preselected research sites proves unworkable. Photo by Les Dunseith

Back in West Hollywood, the Motherlode proves unworkable as a survey venue on this night. A private party is booked at the site, but it won’t start for a couple of hours and the survey team can’t afford to simply bide time waiting.

Holloway, ever cheerful no matter the hurdle he faces, quickly gathers his team to discuss their options. Proceed to the next pre-selected venue? Or go just around the corner to the “emergency backup” site, the Abbey, a 25-year-old West Hollywood landmark that has been voted the best gay bar in the world.

Within minutes, the team is in place outside the Abbey, and all three student researchers are actively engaged in recruiting potential survey respondents.

To gather enough surveys to produce statistically valid results by their deadline, Holloway has put together a rotating team of about 10 UCLA student workers, assisted occasionally by a couple of alumni who help out during staffing shortfalls. The majority are current Luskin master of social welfare students, but two are in a Ph.D. program.

“There’s lots of exciting work going on,” Holloway says with a broad smile. “And we have a fantastic team at UCLA supporting it.”

The data being gathered now will be analyzed by March to inform a research brief that should help California produce better outreach and better programs centered around meningitis vaccination for this population. The student workers collecting the information were carefully screened during a selection process led by Holloway’s research manager, Elizabeth Wu.

“We are looking for people who are obviously outgoing and who understand the importance of collecting good quality data,” says Holloway, whose own affable manner permeates the research effort. The canvassers, who refer to Holloway mostly by his first name, also need to be comfortable staying out to the wee hours to chat with strangers they encounter outside bars and clubs.

The iPad-based surveys are completed by the researchers based on respondents’ answers. Photo by Les Dunseith

For researcher Christine Munoz, a first-year MSW student who got her undergraduate degree at UC Riverside, the learning process was frenetic at first, but also rewarding.

“It is very new to me because I wasn’t really involved in the LGBTQ community previously,” she says during a break during the canvassing effort. “I am learning so much from this community. So, it’s broadening my skills, my social work skills. Now I can work with clients who are from the LGBT community. I am learning so much as a future social worker.”

The survey teams have been on the job since November, gathering data that Holloway says will either confirm or refute the notions that helped form the basis of the survey hypothesis.

For example, there is a feeling that the distribution of meningitis vaccine to the targeted community “is pretty haphazard,” Holloway says. “There isn’t always a good refrigeration system for the vaccine at community clinics; health workers aren’t always tracking how many doses have been given.”

Without a systematic infrastructure in place to promote the wellbeing of these men, health officials often find themselves in a defensive posture when dealing with outbreaks of vaccine-preventable illnesses among HIV-positive men or men at high risk for HIV. “It shouldn’t take an outbreak for us to realize this is a priority community,” Holloway says.

His passion to understand and promote better health options for LGBTQ communities is an outgrowth of Holloway’s life experience. He was raised in Northern California during the early years of the HIV crisis in America. His parents’ generation saw an entire community of gay men decimated, almost wiped out by AIDS.

“Growing up and knowing that I was gay, and hearing and seeing what happened close by in San Francisco, I think it was pretty impactful for my young life,” Holloway recalls. “When I decided that I wanted to go back to school for social work, I was pretty clear that this was the community that I wanted to work with, and this was the issue that I wanted to work around.”

Professor Ian W. Holloway has been selected by the Society for Social Work Research as its 2017 Early Career Achievement Award winner. Photo by George Foulsham

That dedication is evident in the meningitis study as well as three other research projects that Holloway is currently shepherding:

  • A two-year study supported by a $1.89-million grant from the U.S. Department of Defense is looking at the experiences of of lesbian, gay, bisexual and transgender active-duty service members since the 2010 repeal of “don’t ask, don’t tell,” the law barring homosexuals from openly serving in the military.
  • A study funded by the NIH through a small research grant mechanism uses predictive technologies to understand how gay and bisexual men use geo-social networking apps and other kinds of social media to find substance use partners and sexual partners. This collaborative effort with UCLA’s departments of engineering and computer science is using predictive algorithms and social media data to try to understand how social media behavior predicts health behavior.
  • And he is involved in the development of a social networking app for HIV-positive black men in L.A. County in the 18-29 age range through a grant from California HIV/AIDS Research Program. It will be a virtual community space where these men can connect with those with similar experiences, focusing not just on health and medication adherence but on housing, job assistance, social services and/or legal needs.

Despite his prolific research output, Holloway doesn’t neglect his classroom responsibilities. If fact, he finds that his research interests often dovetail nicely with teaching opportunities.

“I teach a class on diversity, oppression and social functioning. Each year when we talk about community responses to oppression, I show the ‘Silence = Death’ banner that Act Up used as a call to action in the early days of HIV when nobody was talking about it and the entire community was being wiped out,” he explains. “Each year I show that banner from the early days of the AIDS epidemic, and each year fewer and fewer students recognize it.”

UCLA students working as canvassers approach any men who cross into their survey area. Photo by Les Dunseith

Out on the streets of West Hollywood, student researchers such as Ryan Dougherty are learning first-hand how much knowledge exists among today’s gay and bisexual men about the serious health issues that still impact many of them.

Dougherty joined the survey team as a result of taking Holloway’s research methods class, where he learned “about the process of research, everything from the theoretical foundations of collecting data to the ethics of research. And Ian extended an opportunity for students to get involved and see what that process looks like on the ground.”

As a student in the social welfare Ph.D. program at UCLA Luskin, Dougherty may follow in Holloway’s footsteps someday, pursuing research of his own that will benefit marginalized populations and ameliorate health disparities.

“To be able to do this kind of work, and to work alongside Ian, has helped me to gain more theoretical perspectives and learn about different types of research methods,” Dougherty says. “You can spend all day in the classroom learning about research, but to actually do it and overcome the logistical barriers that come with implementing a really good research project, is a really good learning experience to have.”

At the Abbey, those logistical barriers are in full force as Dougherty attempts to stop men who cross his survey line outside the venue’s patio-style entrance. Some ignore him. A few politely wave him off. One is willing to take the survey but doesn’t qualify because he is not a resident of L.A. County.

Soon, however, a young man in a white hooded sweatshirt approaches. Dougherty catches his attention. The newcomer meets the research criteria. And he is willing to take the survey.

Nearby, Ian Holloway nods his approval. And the research interview begins.

Ryan Dougherty, a Luskin Ph.D. student, conducts a survey interview. Photo by Les Dunseith

New Report Examines Covered California’s Impact on HIV Pre-Exposure Prophylaxis Southern California HIV Policy Research Center releases policy brief to help individuals examine health plan options for PrEP under Covered California

The Southern California HIV/AIDS Policy Research Center has released a new report that will help consumers better understand the cost of accessing pre-exposure prophylaxis (PrEP) through Covered California health plans. Open enrollment for Covered California, the state’s health insurance marketplace, begins this week.

The Southern California HIV/AIDS Policy Research Center is a partnership between the UCLA Luskin School of Public Affairs, APLA Health and the Los Angeles LGBT Center. Ian Holloway, assistant professor of Social Welfare at UCLA Luskin, is the center’s principal investigator.

PrEP is an HIV prevention strategy in which HIV-negative individuals take a daily medication to reduce their risk of becoming infected. When taken every day PrEP is up to 99 percent effective. Truvada, the only medication currently approved for PrEP, is expensive and so it is important for individuals who are considering PrEP to carefully examine their options before enrolling in a new health plan, according to Holloway.

The report, PrEP Cost Analysis for Covered California Health Plans, found that, with a co-pay card from the drug manufacturer, PrEP could cost individuals less than $400/year on all Covered California health plans except Bronze plans. These costs do not include monthly premiums and assume that medical and pharmacy deductibles have not been met. Covered California recently announced average premium increases of 13.2 percent for 2017.

“It is very important for consumers to find a plan that best meets their health needs and budget,” Holloway said.

Before enrolling in a new health plan, individuals who are considering taking PrEP should consider a number of factors: monthly health plan premiums, co-pays for the medication and co-pays for regular doctor visits and laboratory tests. These costs vary significantly, however, depending on age, income, area of residence and other factors.

The report includes examples of the total costs (both out-of-pocket costs and monthly premiums) associated with accessing PrEP via Covered California for individuals of different ages and incomes from different regions of California.

Earlier this year, the California Legislature approved the development of a PrEP financial assistance program. The program, set to launch in spring 2017, will cover all PrEP-related out-of-pocket costs for qualified individuals with annual incomes below 500 percent of the federal poverty level.

A downloadable version of this report is available online.

The California HIV/AIDS Research Program supports two collaborative HIV/AIDS Policy Research Centers for research and policy analysis that address critical issues related to HIV/AIDS care and prevention in California. These centers include UCLA, APLA Health, Los Angeles LGBT Center, UC San Francisco, San Francisco AIDS Foundation and Project Inform.

 

2016 California Voter Issues — A Lot More Than Just Hillary and Trump UCLA Luskin Social Welfare faculty members analyze the potential impact of a slew of state and local ballot initiatives

By Stan Paul

On issues that include condoms, juvenile justice reform and housing for the homeless, California voters will be making important decisions in Tuesday’s national election.

Judging from this year’s unusually hefty state voter’s guide, a lot of those issues will have a great deal of impact closer to home — it’s not just about Hillary and Trump.

“This election is more than just about the presidential election, which has taken all of the oxygen out of the political room,” said Fernando Torres-Gil, professor of Social Welfare at the UCLA Luskin School of Public Affairs. Torres-Gil served as moderator at a faculty panel discussion held just a week before the general election.

Holding up a full-page news article listing the 17 propositions on the California ballot, Torres-Gil started the discussion highlighting a few key state and countywide initiatives and their impact on social work, justice and quality of life issues. “This does not end on Nov. 8; the issues continue,” he said, acknowledging California’s “extraordinary influence” on the rest of the country.

Voting can be good for you — and habit forming — according to new Luskin Social Welfare faculty member Laura Wray-Lake, encouraging the students in attendance to exert a bit of peer pressure.

“The election is obviously really interesting to me from a research perspective,” said the assistant professor, whose work focuses on youth civic engagement and draws on several disciplines to understand social development among young people.

“When young people start voting, this goes a long way to establishing lifelong habits,” Wray-Lake said. “So, if you get into the habit of voting, you will become a more habitual voter across your adult life, which is important for democracy and is important for you in terms of having your voice be heard.”

Citing Pew Research Center data, Wray-Lake said that there are now as many eligible millennial voters as baby boomers for the first time ever. This translates into millennials being one of the most powerful voting blocs in the country. But, she pointed out, the potential of this powerful voting bloc is offset by the lowest voting rates across all generations. She said this had real implications in both the 2008 and 2012 presidential elections, when youth voting influenced several swing states.

“If young people had voted at a slightly lesser rate, then Romney would have won the [2012] election,” Wray-Lake said. “Young people really carried Obama to victory.”

She cited a recent poll showing that 70 percent of young people have not been contacted by presidential candidates. Candidates, she said, are putting campaign dollars where they think the reliable voters are, and they’re dismissing young people and their issues, including education, poverty and the environment.

On a positive note, Wray-Lake said that the voter registration rate in California has surged to the highest levels in modern history at almost 74 percent.

“That’s more registered voters in California than 46 other states combined,” she said. “You’ll do your demographic proud if you go to the polls,” pointing out that 10,000 new voters were recently registered on the UCLA campus.

Among the state’s initiatives with health implications is Proposition 60, which would add a condom requirement to the California Labor Code for the adult film industry. According to information provided in the voter guide, the primary argument for the proposal is that “Nobody should have to risk their health in order to keep their job!” Opposition to the proposal argues that it would be costly to voters, is opposed by lawmakers and is largely supported by a single special interest group.

Ian Holloway, assistant professor of Social Welfare at UCLA Luskin, said that Proposition 60 had its origins in L.A. County’s Measure B last year — which passed — and is now being rolled out at the state level. Proponents say that Proposition 60 will stem the rise of HIV in California, said Holloway, whose applied behavioral health research looks at factors that contribute to health disparities among sexual and gender and minority populations.

“When it comes to the adult film industry, the majority of adult films that are distributed throughout the United States are made in California and the majority of films made in California are made in Los Angeles County,” said Holloway, who also directs the Southern California HIV/AIDS Policy Research Center. He explained that there could be a significant economic impact because the adult film industry brings a lot of revenue to the state. He noted that one of the fears is that the making and distribution of adult films will move outside of the state if the proposition passes.

While the goal is to protect the health and well-being of adult film actors, Holloway said that many in the community feel that the proposition is misguided.

“When we think about the HIV epidemic in the state of California, we’re talking about 5,000 new infections a year that disproportionately impact gay and bisexual men and racial-ethnic minority communities,” Holloway said. “So, adult film actors, while an important constituency, are a very small proportion of HIV cases in California.”

Holloway argued that if there is a real interest in focusing on reducing HIV among people living in California, the focus should be making prevention technologies more accessible to low-income communities, racial-ethnic minority communities, gay and bisexual men, transgender women, and other sexual and gender minority communities.

“If we’re thinking about this as an HIV-prevention measure, then we have many more tools at our disposal besides condoms,” Holloway said.

Laura Abrams, professor of Social Welfare, has applied her research to improving the well-being of youth and young adults with histories of incarceration. She provided analysis of Proposition 57, which considers criminal sentences and parole as well as juvenile criminal proceedings and sentencing. The proposition, if passed, would make a change to the state constitution that would “increase the number of inmates eligible for parole consideration,” as well as “make changes to the state law to require that youths have a hearing in juvenile court before they can be transferred to adult court.”

“Prop. 57 means a great deal to juvenile justice reform in California,” Abrams said. “It would help to prevent many youth from being directly tried in the adult criminal court system, and instead allow them to go before a judge to determine if they are indeed fit to be tried as an adult.”

Abrams said that, without the previous process known as “direct file,” many youth will be more likely to be offered rehabilitation within the juvenile system instead of languishing in the adult prison system.

Proposition 57 would amend the state constitution to provide the possibility of parole hearings for nonviolent offenders who have served their minimum sentence and incentives toward release for adults within the state prison system who participate in education and rehabilitation programs.

“This likely means that county services will need to be more attuned to those who are released, often with long sentences behind bars and coming home on parole,” Abrams said, and that will have implications for those in the social work field.

“Social workers will need to be attuned to the trauma that people can experience with many years of imprisonment, mental health needs, and to develop appropriate housing, transition, and other types of programming,” Abrams said.

Finally, two Social Welfare faculty went head-to-head on Proposition HHH, a City of Los Angeles initiative that aims to provide permanent supportive housing for the chronically homeless.

W. Toby Hur and Michelle Tally, members of Luskin’s Social Welfare field faculty, discussed the pros and cons of approving a $1.2 billion general obligation bond. It would be supported by a property tax levied on homeowners to create 10,000 affordable housing units over 10 years for the homeless, including veterans, senior citizens, foster youth and those living on the streets due to mental illness and disability.

Hur, whose interests include ethnic communities, poverty and homelessness, argued that a tax levied on L.A. homeowners would be less than $10 per $100,000 of the value of a home or $50 for a home valued at half a million dollars, although it would increase over subsequent years.

“Initially when I read Proposition HHH it sounded really good and something that I would support,” said Talley, whose interests are in child and family welfare, as well as domestic violence and substance abuse. “Then it talked about increasing property taxes.”

Hur sees minimal burden for homeowners, but Talley said the tax could greatly affect low- and fixed-income residents and even contribute to homelessness for “those who are barely making it,” she said.

“Fifty dollars may not be a lot to you, but there are a lot of people on fixed incomes,” Talley said. “So it’s $50 they would have to take from somewhere else — food on the table, daycare programs. You might potentially have other kinds of consequences.”