Coming Together for Sexual Health

In this episode, Rodney McCoy, a Black queer man with over four decades of experience in HIV prevention and education, shares his journey as a Leatherman of color and discusses the intersection of BDSM, kink, and HIV prevention. From his entry into the kink community to becoming a titleholder in the American Leatherman competition, Rodney emphasizes how the kink community provided a safe space for self-discovery and empowerment. The episode explores the link between pleasure, power dynamics, and HIV prevention, highlighting the importance of honest conversations, sex positivity training, and the destigmatization of "risky behavior."  

Rodney, a health educator, program director, adjunct professor, and researcher, emphasizes the partnership between healthcare professionals and patients in promoting sexual health. Rodney says, “I am about encouraging people to embrace all pleasure: sexual pleasure, pleasure that comes from good mental health, from good physical health and from good social connections. I believe as healthcare professionals, regardless of the field we're in, we are arbiters to help assist our clients explore and enhance that pleasure, that good health in their lives.”  Rodney shares personal experiences as an HIV/STI testing specialist, addressing the impact of stigma and the importance of open communication. 

Download the transcript of this episode.

Resources from Rodney:

Beyond the Red Ribbon training & other services: https://rodneymccoy.info/services

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Bio:

Rodney “Rod” McCoy, Jr. brings his expertise of nearly four decades in HIV prevention and education, as well as his real-life experience as an African American gay/queer man living with HIV. An Oberlin College graduate with his Bachelors in Sociology and Black Studies, Rod has worked in a variety of capacities in the field of HIV Prevention, from Health Educator and HIV Counselor to Program Director. As an Adjunct Professor at George Mason University, Rod established the “HIV, Culture and Sexuality” course for the school’s Global and Community Health Department. Rod created a sex positivity training for public health professionals called Beyond the Red Ribbon in collaboration with Louis Shackelford of the HIV Vaccine Trials Network. He currently works at Us Helping Us in Washington, DC, as a Research Assistant. 

Tanagra Melgarejo Pulido, Director of Capacity Building at the National Harm Reduction Coalition, speaks with host Tammy Kremer about the landscape of harm reduction programs and policies around the world and in the US, with a focus on the impacts of racism and colonization. She explains how harm reduction began with “communities of people who used drugs looking at each other, saying wait a minute, ‘We love each other, we care for each other. We need to build power and we need to work together.'” 

Download the transcript of this episode.

Resources:  

National Harm Reduction Coalition 

Harm Reduction International Conference

The Chicago Recovery Alliance

Positive Women's Network

Sister Stone 

CAPTC-Related Training and Resources:  

S3 E2: Sex, Drugs, and Rock & Roll: Harm Reduction Strategies with Jen Jackson

Drugs 101 Series

Harm Reduction Resources 

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Tanagra Melgarejo Pulido was born and raised in Puerto Rico and is a daughter of immigrants from Mexico and Cuba. She leads the National Harm Reduction Coalition's capacity, building, and technical assistance efforts across the United States and its territories. 

Host Tammy Kremer chats with UCSF Infectious Disease Specialist Dr. Peter Chin-Hong about the current state of the Mpox outbreak: how it reflects contemporary health inequities, how stigma can be a barrier to people accessing treatment, and how lessons learned from past public health crises shaped the clinical and community response. Dr. Chin-Hong speaks about his experience caring for Mpox patients over the course of the outbreak, and how the stigma surrounding the virus has discouraged individuals from seeking out the necessary care, creating invisible populations of patients who are disconnected from diagnosis and treatment. Finally, he breaks down the social and behavioral interventions that have been effective in slowing the spread of the virus over the past months. They explore the role of public health education and messaging in the Mpox outbreak and how Dr. Chin-Hong anticipates the outbreak may proceed. 

Read the transcript of the episode here. 

CAPTC-Related Training and Resources: 

S3 E8: Monkeypox in California: A Personal Story and Public Health Perspective 

S3 E3: Monkeypox, What's the Hype?

CAPTC Monkeypox FAQ’s

CDC Monkeypox Resource Center 

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Peter Chin-Hong, MD, is a professor of medicine and associate dean at UCSF. He specializes in treating infectious diseases, especially in immunosuppressed patients such as recipients of organ and stem cell transplants and HIV-positive recipients of organ transplants. He is regularly featured in the media discussing COVID-19 and Mpox. 

Host Tammy Kremer interviews Jenn Rogers, director of the National Coalition for Sexual Health (NCSH), and Bryce Furness, MD, CDC Epidemiologist, about their work developing a toolkit for primary care providers to use in order to center sexual pleasure, problems, and pride as a part of all wellness visits. The CDC encourages taking sexual history by asking about 5 Ps: Partners, Practices, Past STI History, Protection From STIs, and Pregnancy Intention. The National Coalition for Sexual Health recently released a video series called “A New Approach to Sexual History Taking,” along with a set of new questions for providers to ask patients in all wellness visits that add a 6th P: Pleasure, Pride, and Problems.  

Jenn and Bryce discuss the 6th P, which re-centers patients’ needs, enjoyment of their sexual lives, and social stigma attached to sex. As Jenn elaborates, “A satisfying pleasurable sex life is really a key element to sexual health and well-being for most people. So our sexual history taking questions really should reflect that." Bryce uses his specialized experiences providing sexual health care to LGBTQ+ populations to argue that we must recognize health disparities and address stigma around sexual health. Together, they discuss the creation of a freely accessible toolkit for all providers to use. They recognize that the current method of sexual history taking doesn’t incorporate enough discussion of issues such as gender identity, sexuality, shame, and stigma, and how these can affect sexual activity and sexual health. 

Read the transcript of the episode here. 

Resources: 

National Coalition for Sexual Health 

NCSH Membership Application 

NCSH Health Care Action Group, Communications Actions Group, Policy Action Group 

NCSH 6th P Video Series 

NCSH Medical Provider’s Guide 

NCSH Sexual Health History Questions  

CDC guide to taking a sexual history 

CDC’s Rachel Kucher et al. , “Sexual History Taking in Clinical Settings: A Narrative Review”  

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Jennifer Rogers, MPH, is the co-director of the National Coalition for Sexual Health (NCSH), a robust Coalition of over 200 members where she works collaboratively to promote high-quality sexual health information and health services. She also leads the Coalition’s Health Care Action Group to develop evidence-based and practical provider tools and materials.  

Bryce Furness, MD, MPH, is a Medical Epidemiologist with the CDC’s Division of STD Prevention. He has been embedded within the Washington, DC Department of Health since 2002. Highlights of his tenure include establishing a transgender health clinic, leading gay men’s health & wellness clinics, and improving the PrEP Clinic. He has recently published several articles on transforming primary care for LGBT people. 

Director of the CAPTC Dana Cropper sits down with Gail Bolan, MD, and Alice Gandelman to discuss the founding of the CAPTC and its work in supporting sexual healthcare providers over the last 33 years. We learn about the forces that shaped the sexual healthcare field. Our guests unpack how the CAPTC developed alongside the HIV/AIDS epidemic in the late 1980s, the surprising relationship between HIV work and STI response, strategies to meet sexual healthcare needs both within and outside of sexual health clinics, and the ever-present need for greater training for providers around testing and treatment of STIs. We learn about how behavioral interventions were centered in response to the HIV/AIDS epidemic, and the importance of centering social determinants of health and larger structural forces in prevention and treatment efforts. They also discuss their hopes for opening up discussions about sexual health and de-stigmatizing the topic in the greater community. 

Read the transcript of the episode here.

Resources:  

HHS/Viral Hepatitis Action Plan 

Ending the HIV Epidemic in the US (EHE) 

Provision of Quality of STD Services (CDC) 2020 

San Francisco City Clinic 

Health HIV

National Coalition for Sexual Health 

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Gail Bolan, MD, was the Director of the Division of STD Prevention at the Centers for Disease Control and Prevention (CDC) from 2011 through 2020. Prior to joining CDC, she directed the California Prevention Training Center for 23 years. She served as the Chief of the STD Control Branch at the California Department of Public Health and the Director of the San Francisco City and County STD Prevention and Control Program from 1997 to 2011 as well as Medical Director of the San Francisco City Clinic from 1987 to 1997.  

Alice Gandelman was the Director of the CAPTC from 1994 through 2021. She oversaw growth and development of CAPTC in numerous training and capacity-building programs in STD, HIV, sexual, and reproductive health.  

CW: Transphobia, Racism 

Zami Hyemingway and Dr. Tatyana Moaton sit down with Tammy to discuss their personal and professional experiences with medical care for transgender folks and medical mistreatment. Together, they reflect on the need for medical providers to become responsive to transgender people's individual needs and advocate for them in a setting that has often been unsafe for them. Transgender folks need medical providers who will take risks and be true allies. Healthcare providers must rethink care amidst a system in which they occupy positions of power.  

Our guests also argue for de-coupling all healthcare from any sort of police or criminal systems, emphasizing the impact this has on people with marginalized identities. Their discussion dives into the colonial roots of the gender binary and the transgender identity category, and how these constructs lead to a misunderstanding of what it means to be transgender and navigate trans healthcare.  

Last March, Zami Hyemingway co-organized the conference on "See All of Me: The Intersections of Medical Mis/Distrust and its Impact on Transgender Health, HIV Care and Prevention” with Dr. Tatyana Moaton as a plenary speaker.  

Download the transcript of the episode here. 

Resources:

“See All of Me: The Intersections of Medical Mis/Distrust and its Impact on Transgender Health, HIV Care and Prevention” 

Zami Hyemingway 

Tatyana Moaton 

CBA Resources https://californiaptc.com/programs/capacity-building-assistance/  

U.S. Trans Survey: New survey, open to trans people at any stage, launching 10/19/22 https://www.ustranssurvey.org/  

STD Expert Hour: This training focuses on the sexual health needs of transgender and gender non-conforming people. https://californiaptc.com/training/std-expert-hour-transgender-sexual-health-what-you-should-know/  

Improving Transgender Services for Trans and Gender Diverse People: https://californiaptc.com/resources/improving-prep-services-for-trans-and-gender-diverse-people/  

Higher Education Scholarship Opportunities for LGBTQ+ students listed at EduMed, Peterson's, GoGrad  

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Zami Hyemingway is the Capacity Building Assistance Gender-Affirming Project Manager at the Denver Prevention Training Center where he leads a team of identity consultants that provide technical assistance to clinics, health departments, and community-based organizations. Zami has over 10 years of experience in developing and implementing health behavior and health promotion programs. He also hosts personal wellness workshops via his organization, Spiritus Wellness. 

Dr. Tatyana Moaton is the CEO and Principal Consultant for Envision Consulting, one of the first black trans-led consulting firms in the country. She is also a senior capacity-building specialist with San Francisco Community Health Center. Tatyana is a veteran of the U.S. Armed Forces, serving honorably as an intelligence officer in the US Army. She recently obtained her Doctorate of Philosophy In Management Science. She has worked with the American Civil Liberties Union, LAMBDA Legal, the U.S. Center for Disease Control, AIDS United, NMAC, Gilead, Merck, Elton John AIDS Foundation, and The Black AIDS Institute. 

CW: Sexual Trauma 

Psychotherapist Sam Kendakur talks with host Tammy Kremer about the intersections of sexual health and mental health. Listen in for nuanced conversations about the gray areas and messiness of consent; how to piece apart our own understandings of sexual pleasure, desire, and attraction; the impacts of stigma on sexual and gender identity and those who choose non-monogamous relationship styles. We learn about the unexpected impacts healthcare providers can have on the well-being of folks with marginalized sexual, gender, and racial identities, especially when there are stark differences between the provider and client’s lived experiences.

Download the transcript of this episode. 

Resources: 

Sam Kendakur’s website 

The Best Polyamory, Sex, and Queer Books   

The Body Keeps the Score 

Polysecure: Attachment, Trauma, and Consensual Nonmonogamy

Higher Education Scholarship Opportunities for LGBTQ+ students on EduMed, Peterson's, GoGrad 

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Sam Kendakur has worked in the mental health field for the past 12 years in a variety of settings across college campuses, inpatient psychiatric hospitals, alternative peer support networks, clinics, institutes, and currently private clinical practice. He’s invested in creating spaces that make healing accessible and relevant to people from different realms of experience, especially those that inhabit marginalized spaces. The social structure and health care system have failed so many, and he tries to address and combat these shortcomings through a commitment to client-centered anti-oppression practices that honor that suffering is most often nested within inequitable and unjust systems and their consequences rather than individual lack. He specializes in working with the LGBTQIA community, BDSM and kink, race and ethnicity, trauma, and alternative relationship styles. 

Dr. Mai Fleming sits down with host Tammy Kremer to discuss what she sees as the provider’s role in supporting patients, now that Roe v. Wade has been overturned. They review the multitude of situations in which a pregnancy is not optimal and how abortion stigma is one of the biggest barriers to medically safe abortion. At the core of her work, Dr. Fleming seeks to ensure her patients are empowered and find joy in their own reproductive health decisions.  

Download the transcript of this episode.

Follow Dr. Mai Fleming on Twitter.

Resources:  

Aid Access 

Hey Jane 

Plan C Pills 

TEACH

Benioff Children's Hospital—Abortion Access Post-Roe

CAPTC-Related Training and Resources: 

S3 E5: Trauma-Informed Pregnancy Care with Becca Schwartz, LCSW

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Dr. Mai Fleming has a breadth of experience working in primary care settings and providing reproductive health services across the gender spectrum. Her work includes telemedicine abortion services via Hey Jane. As a family doctor, she helps people consider reproductive health and family planning within the broader context of their lives. In taking an expansive view of what reproductive care encompasses - including fertility counseling, abortion, and gender-affirming hormone therapy - Dr. Mai Fleming works to help her patients meet their goals. 

Stephan Ferris, a Bay Area activist lawyer, received one of the first 40 reported diagnoses of Monkeypox after attending a Pride celebration in San Francisco, California. Here, Ferris sits down with host, Tammy Kremer, and Dr. Akanksha Vaidya, a clinical fellow responding to the health crisis, to share his experience and discuss the need for improving treatment accessibility and provider education concerning a Monkeypox diagnosis.  

This is a follow-up to S3 E3: Monkeypox, What's The Hype? with Dr. Ina Park at a very different stage of the spread of monkeypox. With the USA and WHO declaring this a public health emergency, Ferris and Dr. Vaidya use their respective lenses to reflect on the representation of this disease in the media, transmission, and the stigma associated with those who receive a diagnosis. As commercial labs begin to provide greater testing capacity, the group discusses improving messaging about limited vaccine supply and other treatment options for groups most vulnerable and individuals experiencing moderate symptoms.  

Download the transcript of this episode.

Resources: 

Stephan Ferris's Website

Reading is Fundamental Podcast 

CDPH About Monkeypox and California Data 

CDPH Monkeypox Clinical Assist Evaluation Tool 

CDC Monitor Monkeypox Exposure 

CDC Monkeypox Updates and Topics

"What You Need To Know About Monkeypox" 

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Stephan Ferris is an openly queer and activist lawyer who focuses on entertainment law with an emphasis on uplifting LGBTQ+ voices. Stephan is also the producer and co-host of the entertainment law podcast Reading is Fundamental. He volunteers with various Bay Area LGBTQI+ organizations and is on the board of directors for Bay Area Lawyers for Individual Freedom.

Dr. Akanksha Vaidya is a clinical fellow trained in internal medicine and infectious diseases at the California Prevention Training Center. She completed her medical degree at Cornell University and her residency in Internal Medicine at Emory University in Atlanta. She came to UCSF in July 2020 for her Infectious Diseases Fellowship. Her research and professional interests include improving health equity and access to care for people with STIs and HIV.  

CW: Suicide, Suicidal Ideation 

Courtney Brame, the founder of Something Positive for Positive People (SPFPP), sits down with guest host Dr. Ina Park to discuss the ongoing need to foster spaces that destigmatize STI diagnoses. In the ninth year of his HSV-2 diagnosis, Courtney speaks on navigating life with the virus and what drove him to connect with people struggling with mental health issues as a result of their herpes status. What started as informally providing solidarity to those living with herpes, quickly became a podcast and platform for sharing the experiences of those battling societal stigma and self-shaming, creating pathways to disclosing their status and tools that can make waiting for a vaccine more manageable.  

Courtney says that “sexual health is mental health.” He hopes to expand the mental health resources available to those living with herpes and use the collective stories of the SPFPP community to inform healthcare practices, especially the delivery of an HSV diagnosis. Courtney engages those living with a positive diagnosis and their allies to transform the stigma that often works to silence them. 

Download the transcript of this episode.

Resources:  

• Something Positive for Positive People 
• SPFPP podcast 
• HSV Survey  
• Dr. Ina Park's Instagram, Twitter, and website 
• Strange Bedfellows by Dr. Park  
• Penny For Your Thoughts campaign 

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Courtney Brame is the founder of Something Positive for Positive People, a 501c3 nonprofit organization highlighting the intersections of sexual health and mental health stigma. After discovering that many people diagnosed with herpes struggled with suicide ideation, Brame decided to interview those living with herpes and share their stories with other folks navigating herpes stigma. Something Positive for Positive People also works to give healthcare professionals tools they can use to provide anti-stigmatizing, identity-validating, sex-positive health care. He also hosts a podcast, called Something Positive for Positive People, where you can hear these stories and experiences directly. 

CW: Racism, Genocide, Violence

Dante King, author of The 400-Year Holocaust: White America’s Legal, Psychopathic, and Sociopathic Black Genocide - and the Revolt Against Critical Race Theory, sits down with guest host Duran Rutledge, CAPTC's Capacity Building and Technical Assistance Trainer, to reflect on what it means to be a Black person in a country where the colonial legacy of anti-Blackness and conceptions of whiteness and white supremacy have engrained racism into our legal structures, healthcare system, and more. He offers concrete examples of how these intergenerational and ongoing traumas show up, and examines the roles of empathy, re-education, and narrative in promoting transformation. This conversation illuminates the structures that reinforce America’s blatant anti-Blackness that need to be seen, but so often are not.

Download the transcript of this episode. 

Resources mentioned: 

• The 400 Year Holocaust: 12 Week Series
• Equal Justice Initiative  
• Dante’s reading list 

Books mentioned: 

• The 400-Year Holocaust: White America's Legal, Psychopathic, and Sociopathic Black Genocide and the Revolt Against Critical Race Theory by Dante King 
• The Shaping of Black America by Lerone Bennett Jr. 
• Black Reconstruction in America by W.E.B. Dubois  
• Narrative of the Life of Frederick Douglas by Frederick Douglas 
• Post Traumatic Slave Syndrome: America’s Legacy of Enduring Injury and Healing by Dr. Joy Degruy Leary 
• The Color of Law by Richard Rothstein 
• Not in My Neighborhood: How Bigotry Shaped a Great American City by Antero Pietila 

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Bio: Dante King is the author of The 400-Year Holocaust: White America's Legal, Psychopathic, and Sociopathic Black Genocide and the Revolt Against Critical Race Theory; winner of the Bookfest Award. Dante also teaches a course at the UCSF School of Medicine called Understanding the Roots of Racism and Bias: Anti-blackness and Its Links to Whiteness, White Racism, Privilege, and Power. Dante was the previous Deputy Director for the San Francisco California Department of Public Health Office of Health Equity, where he led the development and implementation of workforce and health equity policies and programs. You can find out more about Dante by going to www.danteking.com and connecting via Twitter @danteking2020. 

Becca Schwartz, LCSW, speaks about Team Lily, a pregnancy clinic for people experiencing significant barriers to care located at Zuckerberg San Francisco General Hospital. We focus on trauma-informed care: how past trauma can show up for patients in the medical setting, ways providers can practice trauma-informed care, and how these issues present and are addressed in San Francisco and at Team Lily. We’d like to note that this episode contains occasional gendered language when talking about pregnant people. We recognize that not all pregnant people identify as women. We also acknowledge the national events taking place that are magnifying the pre-existing reproductive injustices in our country and recognize the disproportionate effects anti-abortion legislation has on low-income people of color in rural areas. We stand with abortion activists, abortion providers, and abortion seekers globally. We firmly believe that abortion should be provided on demand, and without apology, for all people.   

Download the transcript of this episode. 

Resources: 

Team Lily  

The HIVE Clinic  

Ana Delgado, CNM, MS, listen to Ana’s episode from season 1  

Homeless Prenatal Program 

San Francisco’s Nurse Home Visiting Programs

Introduction to trauma-informed care for Disease Intervention Specialists, from the CAPTC 

Stop the Hidden Epidemic: Five Steps to Prevent and Treat HIV, HCV, and STDs Among People Experiencing Homelessness, from the CAPTC  

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Becca Schwartz has been working as a clinical social worker at San Francisco General Hospital since 2004, in a joint position with the HIV Division and the Department of OB/Gyn. In 2018 she helped to launch Team Lily, a low-barrier pregnancy care clinic for people experiencing barriers such as homelessness, substance use disorders, mental illness, and intimate partner violence. As the social worker for HIVE Clinic and Team Lily, she provides complex care coordination, psycho-social support, risk reduction counseling, and linkage to mental health and substance use treatment to women living with HIV, or at risk for HIV, in and around pregnancy. For the past 15 years, Becca has provided these clinical services as well as practical help accessing housing and homeless services, healthcare, financial and nutritional benefits to pregnant women and their families. Becca is trained in Infant-Parent psychotherapy and brings this clinical lens to her work with families. 

We speak with Terrance Wilder and Nikole Trainor, two people who were intimately involved in PrEP Supports, a campaign launched by the San Francisco Department of Public Health in 2018. PrEP Supports was a community-engaged campaign that specifically focused on PrEP access and education in Black communities in San Francisco. 

Download the transcript of this episode. 

Resources: 

See images and video from the PrEP Supports campaign at Ask About PrEP or by texting “Ask PrEP” to 21201 

510 Media

Instituto Familiar de la Raza and Sí a la Vida

Get connected to Have Good Sex on Instagram and their website 

Get free at-home testing kits from takemehome.org 

Learn more about San Francisco’s Getting to Zero Campaign  

PrEP and PEP self-paced online learning opportunities from the CAPTC

PrEP printable pocket guide for providers 

View the CAPTC’s HIV and PrEP resources

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Terrance Wilder is an Equity Training Coordinator at the San Francisco AIDS Foundation where he’s worked for 5 years. In addition to putting in work at SFAF, Terrance is an avid basketball player, hiker, and comedy fan. 

Nikole Trainor currently works full-time for the San Francisco Department of Public Health (SFDPH) as the Getting to Zero Program Coordinator/Contract Manager, while also teaching part-time at SJSU in the School of Public Health. Nikole has worked for SFDPH in the STD Prevention and Control Branch for the past 13 years. She is responsible for spearheading several innovative initiatives which included the launch of the San Francisco PrEP Supports Campaign (2019), launch of Have Good Sex Campaign (2020), implementation of the first Pharmacist Delivered One-Stop PrEP Program at Mission Wellness Pharmacy in San Francisco CA (2018-present), and the implementation of the first official lab-based HIV/STI/HCV home-testing program (2021). For the past 15 years, Nikole has been dedicated to improving quality of life for all communities of color and speaking boldly about inequities that negatively impact the communities in which she serves.