A Push to Protect Angelenos From Mpox Infection UCLA's Hub for Health Intervention, Policy and Practice leads community effort to bring vaccinations to vulnerable populations

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The Hub for Health Intervention, Policy and Practice (HHIPP) at UCLA Luskin is leading an effort to ensure that vulnerable populations in Los Angeles are protected from the mpox virus.

HHIPP has teamed up with nonprofits, grassroots groups, health care providers and government agencies to provide mpox information and free vaccinations at a summerlong series of events serving the LGBTQ+ community. Nearly 1,000 Angelenos have received the vaccine since the campaign launched in June, LGBTQ+ Pride Month.

Now, HHIPP will take the campaign to the rest of California, thanks to a $100,000 grant from the Centers for Disease Control and Prevention Foundation, an independent nonprofit that helps to marshal resources to support the CDC’s public health priorities.

“We particularly want to focus on Black and Latinx folks, as we were seeing lower rates of vaccination in those groups, and on people living with HIV who are out of care, who are particularly vulnerable to complications related to mpox,” said HHIPP Director Ian Holloway, professor of social welfare at UCLA Luskin.

Holloway was named a scientific advisor to the California Department of Public Health in 2022, after the first case of mpox was reported in the United States. In spring of 2023, the CDC and local and state health agencies called for renewed efforts to protect people from the virus, which is typically spread through sexual activity or skin-to-skin contact.

In June, HHIPP and its partners launched a social media campaign called stickitin.la to share information about mpox, invite the community to pop-up vaccination clinics and offer other health services, including testing for HIV and sexually transmitted infections.

“In true HHIPP fashion, this was a co-creation led by and for our community and facilitated by us,” Holloway said. “Very quickly, we were able to get a lot of large and small community-based organizations working on sexual health to come on board and to help cross-promote and co-sponsor events and provide financial support.”

To date, around 20 community partners have joined the campaign. “They’re all working multiple angles to continue to get the word out about the importance of mpox vaccination and then actually bring it to communities where it may not have been as readily available,” Holloway said.

The campaign also invited the community to an End of Summer Celebration on Aug. 31 at the APLA Health in Baldwin Hills to share information about the vaccination effort and promote diversity, inclusion and sexual health awareness.

Holloway on Stigmas Surrounding HIV/AIDS and Mpox

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Ian Holloway, professor of social welfare and director of the Southern California HIV/AIDS Policy Research Center, spoke to the Los Angeles Times about parallels between the stigmas associated with HIV and AIDS in the past and the recent outbreak of the virus mpox. Public messaging around health threats plays a vital role in how people affected by such conditions are treated. Misinformation and stigma surrounding mpox can discourage people from getting proper care, Holloway said. “The effect that it has is similar to the early days of HIV/AIDS because it kept people away from testing and treatment, and overall created a lot of shame and mental health challenges,” Holloway said. “It’s unfortunate to see those parallels play out.” However, Holloway said messaging around the mpox outbreak has been more inclusive than it was around AIDS, showing that government leaders are doing a better job of responding to new viral threats.

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Holloway on HIV Prevention Among People Who Inject Drugs

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Ian Holloway, professor of social welfare, spoke to TheBodyPro about a cross-sectional survey of over 1,000 participants aimed at determining whether people who inject drugs would take an injectable medication to prevent HIV infection. The medication, known as LA-PrEP, or long-acting pre-exposure prophylaxis, is given by injection at three-month intervals. While the medication is very effective at preventing HIV infection, less than 2% of people who inject drugs have received a prescription. Holloway’s study showed that over 25% of participants did not have access to health insurance or other government benefits, further restricting their access to PrEP. The survey was conducted right before the COVID-19 pandemic, and Holloway recommended that more research be done to understand the effects of the pandemic on HIV prevention. “We think it will be important to assess what attitudes, perceptions and behaviors have remained unchanged,” as well as identify interventions that promote use of effective treatments among high-risk populations, he said. 

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Monkeypox Outreach Based on Science and Messaging

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A story by The 19th about strategies used on college campuses to reduce the spread of monkeypox cited the work of Social Welfare Professor Ian Holloway. In addition to leading UCLA’s Hub for Health Intervention, Policy and Practice and Gay Sexuality and Social Policy Initiative, Holloway serves on the scientific advisory committee to the California Department of Public Health. As monkeypox cases began to rise over the spring and summer, Holloway’s team quickly launched a multipronged campaign focused on science and messaging. This outreach provided accurate information about monkeypox to gay and bisexual men while noting that anyone can contract the virus, to avoid the stigmatizing language used to discuss HIV in past decades. In partnership with the Los Angeles LGBT Center, the team created an infographic explaining monkeypox transmission, symptoms and interventions. Holloway has emphasized that monkeypox outreach to men who have sex with men should be equitable, with a focus on queer men of color. 

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Holloway on Lowering Risk of Monkeypox Infection

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Social Welfare Professor Ian Holloway spoke to the Los Angeles Times about strategies Californians are using to protect themselves from the monkeypox virus as they await vaccination. More than 1,300 monkeypox cases have been reported across the state, prompting an emergency declaration from Gov. Gavin Newsom. Men who have sex with men have been disproportionately affected, and many have changed the ways they socialize, celebrate, and seek love and sex. Sexual expression “is a huge part of gay culture and building gay community,” Holloway said. But “in the face of a pathogen that’s spreading in a way that we haven’t seen before … it’s not a bad idea to press pause for a period of time. We know the vaccine is on its way.” Holloway is director of UCLA’s Gay Sexuality and Social Policy Initiative, which has shared practical guides to help sexually active people reduce their risks.

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Facts on Monkeypox and the Gay Community

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Amid a global outbreak of the virus monkeypox, the Gay Sexuality and Social Policy Initiative (GSSPI) at UCLA Luskin launched an outreach campaign to share accurate information with gay and bisexual men. Monkeypox is not exclusive to LGBTQ communities, stressed the initiative’s directors, Ian Holloway and Alex Garner. However, “anxiety about contracting monkeypox among many gay men is compounded by negative messaging being disseminated about gay men and the virus, some of which echoes the stigmatizing rhetoric from the early days of the HIV epidemic,” they said. GSSPI collaborated with the Los Angeles LGBT Center to produce an infographic explaining how monkeypox is spread, what symptoms to look for, and what steps to take if an infection is suspected. It also encourages its audience to be wary of stigmatizing language. “At GSSPI, we remain committed to conducting research to understand health issues that impact our communities, and challenging stigma about gay sex and gay sexuality,” said Holloway, a professor of social welfare who also directs the UCLA Hub for Health Intervention, Policy and Practice. “We also remain committed to education and community empowerment.” Holloway and Garner advised the LGBTQ community to stay up to date with changing information about monkeypox, and stick to sources that are reliable and evidence-based, such as the U.S. Centers for Disease Control and Prevention.

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How Telehealth Can Expand Access to HIV Prevention Strategies

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In 2020, only 25% of people who could benefit from pre-exposure prophylaxis (PrEP), a medication that reduces the risk of acquiring HIV, were prescribed it. Using telehealth to provide PrEP — an approach known as “tele-PrEP” that predates the COVID-19 pandemic — shows potential for expanding access to PrEP use in the United States. A new report from the Kaiser Family Foundation, funded in part by the Southern California HIV/AIDS Policy Research Center (SCHPRC), takes a deep dive into the tele-PrEP landscape, from the types of providers offering the service to the successes of the approach and the barriers that remain. “This report marks an important step forward in understanding how tele-PrEP is being implemented in California, the state with the largest number of tele-PrEP users,” said Ian Holloway, a UCLA Luskin professor of social welfare and co-director of SCHPRC. “This novel approach to providing PrEP services has the potential to increase access to this HIV prevention strategy.” Drawing from in-depth interviews with representatives from major telehealth companies and other providers that offer PrEP, the study identifies a wide range of operational models and financing structures — differences that have implications for clients, providers and businesses. While tele-PrEP offers an additional avenue for some people to access services, significant challenges remain, including insurance barriers, policies that hamper uptake, and knowledge gaps among both individuals and providers, the study concludes.

 

Tobacco Use Among Transgender Young Adults

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In honor of LGBTQ Health Week and Transgender Day of Visibility, UCLA Hub for Health Intervention, Policy and Practice, in partnership with the Los Angeles LGBT Center and WeBreathe, is hosting a free one-hour webinar to share information from our study on tobacco use among trans and gender-nonconforming young people in California and the marketing strategies that target LGBT people. The study is funded by the Tobacco-Related Disease Research Program.

Featured speakers include Evan Kruger (Tulane University), Dannie Ceseña (WeBreathe) and Ian Holloway (UCLA).

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Vulnerable Communities Slow to Adopt Key Strategy to Stop HIV’s Spread

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Taking a daily pill to prevent HIV transmission is one of the most effective biomedical strategies available to combat the virus’ spread, yet use of this health regimen remains low among vulnerable communities, according to a new paper by Ian Holloway, associate professor of social welfare. The research showed that more than 90% of sexually active gay and bisexual men are familiar with the regimen, known as PrEP, or pre-exposure prophylaxis, yet fewer than 8% use it. Black and Latino men have particularly low usage rates, according to the paper just published in PLOS ONE. To measure attitudes toward PrEP, researchers commissioned the Gallup analytics firm to conduct three surveys of gay and bisexual men across the United States between 2016 and 2018. During this time, the study found:

  • Awareness of the regimen increased from 59.8% to 92%.
  • Uptake by those eligible for PrEP rose from 4.1% to 7.8% — a rate that remains disappointingly low.
  • Of those who reported using PrEP, 33.3% discontinued the regimen.

While further research is needed to fully understand reasons for low usage and high discontinuation rates, factors likely include stigma, medication costs, concerns about side effects and lack of access to health care. In addition, “the COVID-19 pandemic has created further obstacles to PrEP access but also opportunities to talk about the sexual health and well-being of gay and bisexual men,” said Holloway, faculty director of the Gay Sexuality and Social Policy Initiative at UCLA Luskin. Data for Holloway’s paper came from the Generations Study focusing on LGBTQ health and well-being, which is led by Ilan H. Meyer of UCLA Law’s Williams Institute.

Holloway Studies Cannabis Use in LGBTQ Community

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Associate Professor of Social Welfare Ian Holloway was mentioned in a High Times article about rates of cannabis use within the LGBTQ community. Most of the data pertaining to cannabis consumption relies on self-reporting, and there is still much to learn about consumption patterns among LGBTQ people. Last year, Holloway was awarded $400,000 for research into tobacco and cannabis use among sexual- and gender-minority young people. While previous studies of tobacco products have shown higher frequency of use within LGBTQ communities, less is known about specific subgroups of LGBTQ people or their use of cannabis. Holloway said his research, conducted in partnership with the Los Angeles LGBT Center, aims to achieve “better understanding of tobacco and cannabis-related health disparities among LGBT young people, which is crucial to improve both short-term and long-term health in LGBT communities.”

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