Coming Together for Sexual Health

A small leak during a big laugh might hint towards a bigger story. In this episode exploring the pelvic floor, Dr. Olga Ramm and patient Nicole Curutchet answer the age-old question- what's really going on down there? Nicole Curutchet starts off by sharing her experience of developing pelvic floor prolapse, which felt like a “tampon that's halfway coming out.” She tackles the issue of finding the right provider, and shares about her surgery and recovery. On speaking out despite stigma, she says, “this is our bodies and it's the truth, and we don't want people to suffer, so why not talk about it?”   For many people with vaginas, pelvic floor leakage, pain, and other symptoms, are often dismissed as just a fact of life. Dr. Ramm and Nicole argue that it doesn't have to be that way. A variety of treatments exist for managing pelvic disorders, including physical therapy, insertable devices, and surgery.   As Dr. Ramm reveals “birth remains the most common inciting injury to the pelvic floor...It's something that affects a whole lot of us.” Dr. Ramm also discusses research that shows that trauma of all kinds impacts the pelvic floor, “almost like a linear relationship between the number of adverse events that you report and the prevalence of chronic pelvic pain.”  In a topic often characterized by silence, Dr. Ramm encourages providers to proactively ask about the pelvic floor. She emphasizes the value of informing patients about all the types of care available to them and respecting patient autonomy: “You don't have to follow a specific algorithm. Let the patient make the choice based on their individual values, their goals for themselves and their own personal case scenarios that they want to avoid.”   Dr. Olga Ramm's Website: https://www.ucsfhealth.org/providers/dr-olga-ramm   UCSF Center for Urogynecology and Women's Pelvic Health: https://www.ucsfhealth.org/clinics/center-for-urogynecology-and-womens-pelvic-health Study That Links Duration of Pushing Phase to Degree of Obstetric Anal Sphincter, Led By Dr. Olga Ramm Injuries: https://pubmed.ncbi.nlm.nih.gov/29324610/ Chronic Pelvic Pain Society of North America: https://www.pelvicpain.org/public The Body Keeps the Score: https://www.besselvanderkolk.com/resources/the-body-keeps-the-score   Past episodes of our podcast to follow this one up:   Vagina Obscura: A Conversation with Rachel E. Gross  The Clitoris and Its Friends with Rachel Gross  Dr. Olga Raam is the director of the UCSF Center for Urogynecology and Women's Pelvic Health. She specializes in pelvic floor disorders and performs reconstructive pelvic surgeries with a focus on minimally invasive and robotic techniques. In her research, Ramm investigates topics related to urogynecology and reconstructive pelvic surgery, including surgical outcomes, birth trauma, care equity, and patient consent. In addition to patient care, Ramm is passionate about surgical education. She has held leadership roles in undergraduate and graduate medical training for urogynecology and reconstructive pelvic surgery at UCSF.  Nicole Curutchet is an accomplished senior customer success manager. She has over 25 years of experience working with C-level relationships for a variety of Fortune 500 companies. 

In this episode, Dr. Eleanor Bimla Schwartz and Dr. Kelly Treder discuss the misconceptions of tubal sterilization, including debunking notions that is it 100% fool-proof, that the surgery is reversible, that it is more effective than other contraceptive options, or that there is little to no pain post-surgery. “I think we do have fairly widespread misunderstanding of what it means to have your tubes tied. A lot of people seem to have the understanding that that would be something you could easily untie and that it would be a procedure that you could undo,” Dr. Schwartz says. They highlight how important it is for providers to be transparent with patients about long-acting contraception options (arm implant, IUD, vasectomy) and their effectiveness with preventing pregnancy, side effects, cost, accessibility, and longevity compared to surgery. Because of this, it is crucial for providers to be informed about the nuances of different contraceptive options. Dr. Schwartz and Dr. Treder provide firsthand insight into what difficult conversations surrounding contraceptives with patients can look like. “I think it's just our obligation to make sure that they know about all available options, that they're not arriving at this decision that they need to have a surgery because they think it's the only thing that's safe for them or the only thing that will work well for them,” says Dr. Schwartz.   This episode is a follow up to S4 E5 Lesser-Known Forms of Birth Control and Downplayed Side-effects: Providing Empowering Contraceptive Carewith Dr. Karlin and health educator Mariana Horne. Click here to view the episode transcript.  Resources recommended in the episode:   Bedsider.org is an online resource designed to help individuals explore, compare, and access birth control options. Bedsider offers a comprehensive description of various contraceptive methods, such as IUDs, implants, pills, and sterilization using interactive tools, real-life stories, and educational content.   Advancing Access is a UCSF resource that provides clear, evidence-based information on long-acting reversible and non-reversible birth control methods, including costs, benefits, and where to access care.   https://www.cdc.gov/nchs/nsfg/index.htm - National Survey of Family Growth     CAPTC related trainings and resources  - Shared Decision Making in Contraceptive Counseling   - Person-Centered Contraception Counseling for Family Pact Clients   - Same-Day Placement of LARC: Solutions to Common Barriers     Brief Bio   Dr. Eleanor Bimla Schwartz Dr. Schwartz, MD is a professor of medicine at UCSF and the chief of the Division of General Internal Medicine at the San Francisco General Hospital. She has a particular interest in identifying ways to meet the needs of diverse populations, including women with chronic medical conditions and other underserved populations.   Dr. Treder Dr. Kelly Treder, MD, MPH, is a board-certified OB-GYN at Boston Medical Center and an assistant professor of OB-GYN at Boston University School of Medicine. She specializes in family planning and is committed to health equity.  

Marnina "the Queen" Miller- a human rights activist and co-executive director at the Positive Women's Network (PWN)- recounts her journey living with HIV as a young woman in the American South, finding a sense of belonging in the national community of PWN, and spearheading initiatives for HIV advocacy and treatment for people of all backgrounds. Marnina discusses some of the unique challenges that Black women face within their communities as they search for inclusive care and acceptance after HIV diagnosis. She also delves deep into the world of policy, closely examining how political advocacy can impact HIV criminalization and reproductive rights. Marnina highlights the importance of coming together to provide comprehensive sexual health education. She emphasizes moving past equity and towards liberation from HIV stigma: “I want liberation... I don't want equity. I don't want equality. I want liberation. I want to be free of HIV stigma.”  Read the transcript of the episode. About Positive Women's Network  Marnina Miller's LinkedIn & Instagram  Marnina Miller is a highly accomplished human rights activist, speaker, trainer, and social media strategist with a profound commitment to fostering positive change in society. She is currently the Co-Executive Director of the Positive Women's Network- a nationwide group that fosters support, care, and community for women living with HIV.   Link to Past Episodes with Similar Content:  Monica Gandhi, MD: HIV as a Movement, Not Just an Infection  The Clitoris and Its Friends: The Anatomy of Pleasure with Rachel Gross    Intimacy Starts with I: Women, Self Love, and HIV with Michelle Lopez     

Check out a compilation of three previous episodes on pleasure. After you hear what each of our guests has to share, take a listen to one (or all!) of the full episodes:  Dan Savage on the Magic Question “What are you into?” & Dr. Ina Park on How Providers can Help   Intimacy Starts with I: Women, Self-Love, and HIV with Michelle Lopez  From Red Ribbons to Leather Straps: Rodney McCoy's Trailblazing Tale of HIV Prevention and Pleasure  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu  Don't forget to leave us a review on Spotify, or wherever you get your podcasts. 

In this episode of Coming Together for Sexual Health, host Tammy welcomes Dr. Bethany Golden, a nurse midwife, to discuss the many ways midwives support sexual and reproductive health beyond childbirth. Bethany shares how midwives provide holistic, patient-centered care, including contraception, abortion, STI treatment, gender-affirming care, and primary healthcare for people of all genders and ages. She talks about studies that show that most midwives provide reproductive health services and almost half provide primary care: "...so this is a large portion of what we do. And so the public perception...is that we are doing pregnancy-related care. Again, that is part of what we do, but we spend a lot of time focused on other moments in people's lives."  Bethany also talks about her work with the Reproductive Health Service Corps, which is training more midwives and clinicians in abortion care. Tune in for an insightful conversation on reimagining reproductive healthcare for a more inclusive and equitable future.  Guest Bio:  Bethany Golden, RN, CNM (she/her), is a registered nurse and a certified-nurse midwife with deep clinical experience and knowledge of comprehensive reproductive health including abortion. As a clinician, consultant, and lecturer, and as part of research teams, she has worked in clinics, hospitals, universities, and villages in New York City, SF Bay Area, Chicago, Fiji, and Nicaragua. Most recently, as a member of the Future of Abortion Council's workforce committee and the policy advisor at Training in Early Abortion for Comprehensive Healthcare (TEACH), she initiated, co-developed, and advocated for the successful passage of bill AB1918. The law created the CA Reproductive Health Service Corps to train and diversify the entire health care team, which she currently co-directs at TEACH with Megan Kumar. Since 2002, she co-founded and continues to operate ICAS/Juntos Adelante, a not-for-profit that focuses on health and human rights in Nicaragua.  Read the transcript of the episode. Check out Bethany Golden's website  Connect with Bethany Golden on LinkedIn and Instagram  Bethany's Publication: Emerging approaches to redressing multi-level racism and reproductive health disparities  Related episodes of Coming Together for Sexual Health: Trauma-Informed Pregnancy Care with Becca Schwartz, LCSW & Abortion and Reproductive Justice Across State Lines  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu   Don't forget to leave us a review on Spotify, or wherever you get your podcasts.   

Monica Gandhi, MD, reflects on her decades-long work in HIV care, from providing care early in the epidemic to leading implementation of today's groundbreaking medical advances. She discusses the science behind HIV (including how 7 people have been cured), the groundbreaking shift from complex pill regimes to long-acting injectable therapies, and how these innovations help patients facing medication challenges. Monica also draws parallels to COVID-19 as she underscores the importance of harm reduction; encourages bipartisan support while talking about policy and funding; addresses social determinants of health that impact HIV prevention and treatment. For her, HIV is not just an infection, but a movement driving healthcare and equity forward.  Read the transcript of the episode. Connect with Dr. Monica Gandhi on Twitter and LinkedIn  Endemic, by Monica Gandhi  CAPTC HIV & PrEP Resources  Long-Acting Injectable PrEP  Previous episode with Dr. Monica Gandhi: S1 E7: How Effective Are COVID-19 Vaccines? with Dr. Monica Gandhi  Monica Gandhi, MD, MPH, is a Professor of Medicine and an Associate Chief in the Division of HIV, Infectious Diseases, and Global Medicine at the University of California, San Francisco. She is the director of the UCSF Center for AIDS Research and the Medical Director of the HIV clinic (Ward 86) at SF General Hospital. Dr. Gandhi also serves as the Associate Program Director of the Infectious Diseases Fellowship at UCSF. Her research focuses on HIV treatment and prevention optimization, HIV in women, adherence measurements in HIV and tuberculosis, adherence interventions, and optimizing the use of long-acting antiretroviral therapy. Dr. Gandhi has been in the HIV workforce since 1996 and brings an extremely important level of expertise to the field. Her book, Endemic, illustrates the lessons to be learned and applied to future epidemics from the HIV epidemic.   Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu  Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  

Ina Park, MD, is back again for a focused look at her (second) favorite sexually transmitted infection: syphilis (favorite because it's fascinating). She says, “it's one of the most challenging conditions to diagnose in clinical medicine because it literally can look like anything.” Join Ina and Tammy as they explore how syphilis was almost eliminated around 2000 and then surged again to current rates of infection in the US. Ina spotlights how a rise in congenital syphilis has fueled a mobilization in public health efforts, even while she celebrates declines in rates of the most infectious types of syphilis. As national syphilis screening guidelines are adapted to increase screening, including in emergency departments, Ina is optimistic for a reduction in future syphilis rates. But here's the takeaway for healthcare providers and patients alike: keep syphilis on your radar. A quick shot of penicillin early-on can save everyone a lot of trouble.  Links:  Connect with Dr. Ina Park on her website, LinkedIn,  X, and Instagram  Resources mentioned in episode  CDC Geographic Risk Calculator  Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs  CAPTC related training and resources  STI Clinical Update Webinar – Introduction to Syphilis and Congenital Syphilis CAPTC Disease Intervention Trainings  Previous episodes with Dr. Ina Park  Dr. Ina Park Unwraps the CDC's New 2023 STI Report  S4 E7 Dan Savage on the Magic Question “What are you into?” & Dr. Ina Park on How Providers Can Help  S3 E7: Breaking Down STI Stigma with Dr. Ina Park & Courtney Brame   S1 E6: Fighting STIgma With Humor & Honesty with Dr. Ina Park    Ina Park MD, MS, is the author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs. She is the Principal Investigator at the California Prevention Training Center. Ina is a Professor in the Department of Family and Community Medicine at the University of California San Francisco School of Medicine and a Medical Consultant in the Division of STD Prevention at the Centers for Disease Control and Prevention. She is a co-author of the 2021 CDC STD Treatment Guidelines, the country's premier resource for diagnosis and treatment of sexually transmitted infections.    Read the transcript of the episode here.  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu  Don't forget to leave us a review on Spotify, or wherever you get your podcasts

Check out a compilation of three previous episodes on reproductive justice and family planning. After you hear what each of our guests has to share, take a listen to one (or all!) of the full episodes:  S4 E4: When People Have or Are Denied Abortions: The Turnaway Study with Dr. Diana Greene Foster  S4 E5 Lesser-Known Forms of Birth Control and Downplayed Side-effects: Providing Empowering Contraceptive Care  S4 E6 Family Planning as Gender Affirming Care with Trans and Nonbinary Patients  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu  Don't forget to leave us a review on Spotify, or wherever you get your podcasts. 

Did you know the visible part of the clitoris is less than one-third of its actual size? In this second part of our series with Rachel Gross, Rachel and Tammy banter about this understudied organ, including that (gasp) all sexual organs differentiate from the same embryonic root. Rachel describes how the interconnectedness between the clitoris and its friends--the vagina, vulva, and the entire pelvic floor--leads to pleasure. Taking an interdisciplinary approach to sexual health, Rachel calls attention to the whole-person approach of gender affirming care doctors to the clitoris as part of a person's overall experience of their bodies. She makes connections across issues that can arise with menopause, vulvodynia, and the pelvic floor, and the need for more medical education including training on vulva checks. Links: Check out Rachel Gross's website  Connect with Rachel Gross on LinkedIn,  X, and Instagram  Scientific American Glowing Clitoris Video  Sophia Wallace Artwork  S3 E13: Centering Pleasure, Problems, and Pride in Sexual Healthcare with Jenn Rogers & Bryce Furness  S4 E8: Intimacy Starts with I: Women, Self-Love, and HIV with Michelle Lopez  Taking a Sexual Health History  Sexual Health Educator Training Program  Rachel Gross has been a science reporter for over 10 years, determined to share educational resources and information with the public. Rachel's work has been published in The New York Times, The Guardian, BBC Future, National Geographic, and more. Rachel is also the author of Vagina Obscura: An Anatomical Voyage, a novel dedicated to re-mapping the female body based on meticulous research and exploration. Rachel is a committed sexual health educator, having lectured at various organizations and top universities in the nation.  Read the transcript of the episode here.  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu. 

CDC's 2023 STI Report is in, and for the first time in years, there's good news. Tune in to our latest episode with Dr. Ina Park, a nationally recognized expert on STIs, to learn why she is cautiously optimistic about the new data trends in chlamydia, gonorrhea, and syphilis. Dr. Park expertly navigates the report with our host, Tammy Kremer, explaining how the previous surge in STIs has begun to slow, while prevalence continues to be high in certain “STI microclimates." Dr. Park stresses the importance of maintaining momentum through increased testing, focused prevention efforts for disproportionately impacted communities, and reducing stigma around STIs. Listen in to discover how disease intervention specialists are battling syphilis on Native American reservations with plenty of penicillin, a trusty car, and heroic determination. Overall, Dr. Park envisions a world where discussing infections is as routine and stigma-free as talking about the common cold.   Read the transcript of the episode.  Links:  Connect with Dr. Ina Park on her website, LinkedIn, and Instagram  Resources mentioned in episode  CDC 2023 Sexually Transmitted Infections Report  Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs  CAPTC-related training and resources  CAPTC Disease Intervention Trainings  CAPTC STI Clinical Training  Previous episodes with Dr. Ina Park  S4 E7 Dan Savage on the Magic Question “What are you into?” & Dr. Ina Park on How Providers Can Help  S3 E7: Breaking Down STI Stigma with Dr. Ina Park & Courtney Brame   S3 E3: Monkeypox, What's The Hype? with Dr. Ina Park  S1 E6: Fighting STIgma With Humor & Honesty with Dr. Ina Park  Bio of Guest:  Ina Park MD, MS, is the author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs. She is the Principal Investigator at the California Prevention Training Center. Ina is a Professor in the Department of Family and Community Medicine at the University of California San Francisco School of Medicine and a Medical Consultant in the Division of STD Prevention at the Centers for Disease Control and Prevention. She is a co-author of the 2021 CDC STD Treatment Guidelines, the country's premier resource for diagnosis and treatment of sexually transmitted infections.     Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu.  Don't forget to leave us a review on Spotify, or wherever you get your podcasts. 

Meet Rachel E. Gross, science journalist and author of Vagina Obscura: An Anatomical Voyage. In this first part of a two–part conversation, Rachel shares how her personal experience with bacterial vaginosis inspired her to write a book that investigates what we know about different parts of female anatomy and how that knowledge (and lack thereof) has been developed. Vagina Obscura is Tammy's favorite read of the year! Rachel highlights the often-overlooked clitoris and vagina, exploring how these body parts are still unfamiliar or awkward for many, including healthcare professionals. We also delve into the systemic marginalization of female and LGBTQ+ voices in science, and how this has influenced society's understanding of the female sexual and reproductive system. Our discussion covers topics like vaginal pH balance and why it varies across different racial groups, and the use of boric acid—a common rat poison—as a treatment for bacterial vaginosis. Rachel also shares the story behind her book's title, Vagina Obscura. Part two of the episode with Rachel is all about the clitoris. Stay tuned! Check out the transcript of the episode.  Guest Bio:  Rachel Gross has been a science reporter for over 10 years, determined to share educational resources and information with the public. Rachel's work has been published in The New York Times, The Guardian, BBC Future, National Geographic, and more. Rachel is also the author of Vagina Obscura: An Anatomical Voyage, a novel dedicated to re-mapping the female body based on meticulous research and exploration. Rachel is a committed sexual health educator, having lectured at various organizations and top universities in the nation.   Links: Check out Rachel Gross's website  Connect with Rachel Gross on LinkedIn, X, and Instagram  Rachel's book: Vagina Obscura: An Anatomical Voyage  CAPTC related training and resources:  S3 E13: Centering Pleasure, Problems, and Pride in Sexual Healthcare with Jenn Rogers & Bryce Furness  S4 E8: Intimacy Starts with I: Women, Self-Love, and HIV with Michelle Lopez  Taking a Sexual Health History  Sexual Health Educator Training Program    Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at captc@ucsf.edu.  Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  

Check out a complilation of three previous episodes on harm reduction. Hear from each of our guests and then go back and listen to one of the full episodes:  S4 E1: Narcan Queen Kochina Rude on Drag and Harm Reduction S4 E2: Harm Reduction by Heart with Braunz Courtney S4 E3: America's War on Drugs and Harm Reduction Around the World with Tanagra Melgarejo Pulido

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 Listen to Daddy Podcast on YouTube 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. 

CW: Mention of abuse, sexual abuse, physical abuse, incest, molestation  At 24 years old, in the early 90's, Michelle Lopez was riding a train in New York with her newborn baby and saw an advertisement that spoke to her. It said, “If you're a woman and you're enduring substance abuse, homelessness, or battery, call this number.” Michelle picked up a phone and began her new life. Her and her daughter were diagnosed with HIV, and it was her mission to get clean, understand her own trauma, and help others with similar stories.  Michelle, a bisexual Caribbean woman, realized that women living with HIV continue to be ostracized for both wanting and having sex. Michelle knew she had to combat this and teach herself and others about self-love, pleasure, and intimacy.  She has spent her career advocating for HIV prevention and treatment, women's health, mental health, sexuality, and how to unlearn feelings of shame. She says, “I recognized getting clean would give me more power to fight against situations and circumstances and stand up for my rights. I had to learn what it is to love Michelle and deal with the trauma that I endured.” Michelle shares how she utilizes her experiences from childhood to the present to educate others through clinical work, research, and advocacy. Her story is one of empowerment, celebration, and making lemonade with the lemons she was given.  Download the transcript of this episode. Resources:   Michelle Lopez LinkedIn CAPTC World AIDS Day Page HIV.gov  Bio:   Michelle Lopez is a tireless advocate for public health among Black and Latinx communities. Over the last 30 years, Michelle has worked in HIV and AIDS prevention and health care navigation and substance use services. Michelle has served on boards of directors and advised on policy development that impacts the lives of marginalized communities. Michelle is now focusing on research designs methodology to meaningfully engages community members.

Dan Savage is a sex-advice columnist and podcaster, and Ina Park is a sex positive STI researcher, physician, and author. The two come together in this episode to discuss desire, pleasure, and how to communicate about what feels good with partners and providers. Dan delves into discovering kinks, pleasure as we age, and trying new things alone and with partners. Ina reflects on her experiences as a provider, having conversations with patients around sex and pleasure as bodies, needs, and abilities change.   Dan says that gay people might be better at sex, “not because we're magic...we use the 4 magic words ‘what are you into?'” Ina explains that honest communication with a partner, a physician, a sex columnist, or a therapist knocks down barriers to explore sex and discover pleasure. The two emphasize the importance of both having providers and friends (with a good sense of judgment) with whom you can discuss sex freely.   This is our first episode of the 3-episode mini-series on pleasure.  Resources:   Connect with Dan: https://savage.love/, @dansavage on Instagram, and @fakedansavage on Twitter/X  Connect with Ina: https://www.inapark.net/ and @InaParkMD on Twitter/X  Learn how to include pleasure in sexual health history-taking from the National Coalition for Sexual Health: https://nationalcoalitionforsexualhealth.org/tools/for-healthcare-providers/video-series    Bios:   Dan Savage is a sex-advice columnist, podcaster and author whose graphic, pragmatic, and humorous advice has changed the cultural conversation about monogamy, gay rights, religion, and politics. “Savage Love,” Dan's sex-advice column, was first published in 1991 and is now syndicated across the United States and Canada. He also hosts the Savage Lovecast, a weekly, call-in advice podcast that has tens of thousands of paying subscribers for premium Magnum content. Both his podcast and column can be found on his website Savage.Love.  Ina Park MD, MS, is the author of Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs. She is the Principal Investigator at the California Prevention Training Center. She is a Professor in the Department of Family and Community Medicine at the University of California San Francisco School of Medicine and a Medical Consultant in the Division of STD Prevention at the Centers for Disease Control and Prevention. She is a co-author of the 2021 CDC STD Treatment Guidelines, the country's premier resource for diagnosis and treatment of sexually transmitted infections.  

Director of Gender-Affirming Care for UC Davis Health, Miles Harris, FNP-BC, advocates for the integration of gender-affirming care with primary care and family planning. He shares that “so much of gender affirming care is not about hormones” and that “it is often so easy as a health care provider to do the thing that someone needs that changes their life.” He breaks down misconceptions: hormone therapy and contraception for trans folks is relatively simple, taking testosterone and not having a period does not prevent pregnancy, and there are no contraceptive methods that are contraindicated due to testosterone use.    He emphasizes the importance of not making assumptions about someone's body parts or those of their partners, as well as not assuming that people are having types of sex that can result in a pregnancy. In choosing a contraceptive method, he says, “we want to remember that this person is a whole person, more than just their trans or non-binary identity.” This is the last episode in our mini-series on family planning and reproductive justice.   Download the transcript of this episode.    Resources:  Contraception Across the Transmasculine Spectrum Article co-authored by Miles Harris  Guidelines for the Primary and Gender-Affirming Care of Transgender and Gender Nonbinary People UCSF website  National Transgender Health Summit Biannual conference  National LGBTQIA+ Health Education Center Online learning from the Fenway Institute  LGBTQ+ Healthcare Directory Created by GLMA   Queer Doc & Plume Remote providers of gender affirming care    CAPTC-Related Training and Resources:   S3 E9: Abortion and Reproductive Justice Across State Lines  Podcast episode  S2 E2: Speaking Frankly: Supporting Youths' Choice to Parent with Dr. Aisha May Podcast episode  Reproductive and Sexual Health Considerations for Trans and Non-Binary People Recorded webinar  Turn on notifications to never miss an episode of Coming Together for Sexual Health.  Follow Coming Together for Sexual Health on Instagram and Twitter.  Miles Harris is a trans and non-binary identified family nurse practitioner. He serves as the founding Director of Gender-Affirming Care for UC Davis Health and as an assistant clinical professor at the UC Davis Betty Irene Moore School of Nursing. His research focuses on sexual and reproductive health needs of transgender and gender nonbinary people, including contraceptive options for transgender and gender-nonbinary people assigned female at birth. 

Family doctor Jennifer Karlin, MD, PhD, and health educator Mariana Horne, join host Tammy Kremer to talk through forms of birth control that are not as well-known, including self-injectable Depo Provera, internal condoms, and the fertility awareness method. They go into side effects of birth control methods that are not always named, such as changes in mood and blood pressure. Mariana shares how she has supported clients who've faced coercive birth control practices in getting the care they want and how her background helps her connect with monolingual Spanish-speaking communities. Meanwhile, Jennifer shares how her family's experience with healthcare led her to focus on empowering her patients, making the connection between how experiences in the clinic can impact people outside of the clinic: “I want them to take that feeling of autonomy, of like ‘oh, this is my body, I get to make choices about it,' I want everybody to walk around the world knowing that and feeling that and acting that when they're not in the clinical space.”  Read the transcript of the episode.  Resources:  Plan C Pills  M&A Hotline  UCSF New Generation Health Clinic  CAPTC Related Training and Resources:  S3 E9: Abortion and Reproductive Justice Across State Lines  Reproductive and Sexual Health Considerations for Trans and Non-Binary People  Shared Decision Making in Contraceptive Counseling  Emergency Contraception  Prevention and Management of IUD Complications  Turn on notifications to never miss an episode of Coming Together for Sexual Health.   Follow Coming Together for Sexual Health on Instagram and Twitter.   Mariana Horne is a health educator and outreach lead at UCSF New Generation Health Clinic. She is committed to addressing racial inequities and disparities in reproductive health care and is an advocate for anyone in need of reproductive care, including monolingual Spanish-speaking communities. Her expertise encompasses birth control, sexually transmitted infections, minor consent laws in California, and reproductive justice initiatives.  Jennifer Karlin, MD, PhD, is a board-certified family physician and family planning specialist whose primary care practice is anchored in caring for patients in ways that encourage their empowerment and autonomy. At UC Davis and beyond, she is committed to medical and resident education that aims to encourage physicians-in-training to approach their practices from an historical, trauma-informed, and self-reflexive perspective. Her research aims to understand how social, political, and institutional structures affect people's experiences with diagnosis, treatment, and health care.  

Welcome to our mini-series on Reproductive Justice and Family Planning! Diana Greene Foster, PhD, author of The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having - or Being Denied - an Abortion, sits down with host Tammy Kremer to advocate for reproductive justice and bodily autonomy. She explains that the Turnaway Study found that, “When people are making the decision about what to do with an unexpected pregnancy and they decide on abortion, all the reasons they give us are exactly those outcomes that we see for people who are denied an abortion.” She envisions a world in which “everyone is an equal partner in sex, in childbearing, in contraception, in pregnancy decision-making.”  Download the transcript of this episode. Follow Diana Greene Foster on Twitter. Resources:  The Turnaway Study: Ten Years, a Thousand Women, and the Consequences of Having—or Being Denied—an Abortion  Global Turnaway Study  ANSIRH: Advancing New Standards in Reproductive Care  Bixby Center for Global Reproductive Health   Plan C Pills  “Black Women's Lived Experiences of Abortion"  Girlx Lab CAPTC-Related Training and Resources:   S3 E9: Abortion and Reproductive Justice Across State Lines     S2 E2: Speaking Frankly: Supporting Youths' Choice to Parent with Dr. Aisha May  Reproductive and Sexual Health Considerations for Trans and Non-Binary People  Turn on notifications to never miss an episode of Coming Together for Sexual Health. Follow Coming Together for Sexual Health on Instagram and Twitter. Diana Greene Foster is a professor at the University of California, San Francisco, in the Department of Obstetrics, Gynecology, and Reproductive Sciences and a researcher at Advancing New Standards in Reproductive Health. She is the principal investigator of the Turnaway Study in the United States and Nepal, a nationwide longitudinal prospective study of the health and well-being of women who seek abortion including both women who do and do not receive abortion.  

Content Warning: Drug use  Tanagra Melgarejo Pulido from 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.'”  Find out more about the National Harm Reduction Coalition: National Harm Reduction Coalition  Connect with Tanagra @melgarejo@harmreduction.org  Resources:   Harm Reduction International Conference  The Chicago Recovery Alliance  Positive Women's Network  Sister Stone  CAPTC Related Training and Resources:   S3 Ep2: Sex, Drugs, and Rock & Roll: Harm Reduction Strategies with Jen Jackson  Drugs 101 Series  Harm Reduction Resources  Don't forget to follow us on Spotify or wherever you get your podcasts, and turn on notifications to never miss an episode.  Send us a message on Instagram @comingtogetherpod, Twitter @californiaptc, or email us at comingtogetherpod@ucsf.edu.  Bio: Tanagra M. Melgarejo Pulido was born and raised in Puerto Rico and is a daughter of immigrants from Mexico and Cuba. Through her position as the National Capacity Director at the National Harm Reduction Coalition, Tanagra leads the organization's capacity, building, and technical assistance efforts across the United States and its territories.   

Content Warning: Drug & Alcohol Use, Overdose  Host Tammy Kremer sits down with Braunz Courtney to speak on how he practiced strategies of harm reduction at the age of 11 before he knew what the term meant. He went from dancing shirtless to raise awareness of the prevalence of HIV/AIDS in queer Black communities to serving as the Executive Director of the HIV Education Prevention Project of Alameda County. He touches upon the importance of organizations that understand the lived experiences of the populations they serve.   Connect with HEPPAC on Instagram and Twitter.  Resources:  National Harm Reduction Coalition  Cal-Pep  Oakland LGBTQ Center  CAPTC-Related Training and Resources:  Syringe Services Programs Workshop Breakout Session 6: Mobile Harm Reduction, Street Medicine as a Medical Home   Don't forget to follow us on Spotify or wherever you get your podcasts, and turn on notifications to never miss an episode.  Send us a message on Instagram @comingtogetherpod, Twitter @californiaptc, or email us at comingtogetherpod@ucsf.edu.  Bio: Braunz Courtney is the Executive Director of the HIV Education Prevention Project of Alameda County. He serves PWUDs, the unhoused homeless, LGBTQ+, youth, and the recently released/reentry of the Alameda, Contra Costa, and Solano Counties. He creates, implements, and markets culturally appropriate programs that provide services in non-clinical settings to BIPOC communities throughout Northern California East Bay with a goal of having long lasting public health impacts.   Read the transcript of this episode.  

Content Warning: Molestation mentioned from 9:20-10 minutes into the episode, Opioid Overdose discussed throughout  Welcome to Season 4! Host Tammy Kremer sits down with drag queen Kochina Rude, based in the Bay Area, to share how she uses her performances to educate the LGBTQ+ community about Naloxone administration, safer partying, and overdose prevention. At her show “Princess,” cohosted with Lisa Frankenstien, Kochina Rude has provided training and 2,000+ doses of Narcan in San Francisco's South of Market neighborhood. This is the first episode in our 3-episode mini-series on harm reduction.  Connect with @KochinaRude on Instagram,  Twitter, and TikTok  Resources:  National Harm Reduction Coalition  Remedy Alliance For The People  NEXT Distro  DanceSafe  CAPTC-Related Training and Resources:  Unconditional Positive Regard–Intersectionality of Harm Reduction & Spirituality  Syringe Service Program Community of Practice  Drugs 101  Send us a message on Instagram @comingtogetherpod, Twitter @californiaptc, or email us at comingtogetherpod@ucsf.edu   Don't forget to rate and review us on Spotify, or wherever you get your podcasts, follow, and turn on notifications to never miss an episode.  Bio: Kochina Rude is a Bay Area-based drag queen, harm reduction advocate, and public health worker. She cohosts the drag show “Princess” with Lisa Frankenstein at SF Oasis, where she established a naloxone distribution and overdose prevention education project for LGBT+ nightlife, providing over 2,000 doses of Narcan for community members in San Francisco's South of Market neighborhood since 2021.  Read the transcript of the episode.  

In this week's episode, host Tammy Kremer chats with UCSF infectious disease specialist Dr. Peter Chin-Hong about the current state of the monkeypox/mpox outbreak: how this outbreak 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 mpox 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.    Guest Bio :  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 and mpox.  Resources  Coming Together Season 3 Episode 8: Monkeypox in California: A Personal Story and Public Health Perspective  Coming Together Season 3 Episode 3: Monkeypox What's the Hype? CAPTC Monkeypox FAQ's  CDC Monkeypox Resource Center     

Tammy interviews Jenn Rogers, director of the National Coalition for Sexual Health (NCSH), and Bryce Furness, MD, CDC epidemiologist, about their work developing a new 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 NCSH 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 visit that add a 6th P  specifically focusing on patients' pleasure, pride, and problems.   In this episode, 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 in the episode, “we really thought 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.  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.    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”   Guest Bios  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 evidenceg 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. 

Guest host Dana Cropper, current director of the California Prevention Training Center, sits down with two former CAPTC directors, Gail Bolan, MD, and Alice Gandelman, to discuss the founding of the CAPTC and the organization's 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 PTC developed alongside the HIV/AIDS epidemic in the late 1980's; 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. The three directors also discuss their hopes for opening up discussions about sexual health and de-stigmatizing the topic in the greater community.  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  Bios:   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 from 1997 to 2011, and as the director of the San Francisco City and County STD Prevention and Control Program, and as medical director of San Francisco City Clinic from 1987 to 1997.   Alice Gandelman was the director of the CAPTC from 1994 through 2021, where she oversaw growth and development of CAPTC in numerous training and capacity building programs in STD, HIV, sexual and reproductive health.   Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts. 

Trigger warning: transphobia, harassment in medical settings, 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 both guests participated in the conference “See All of Me: The Intersections of Medical Mis/Distrust and its Impact on Transgender Health, HIV Care and Prevention.” Zami Hyemingway co-organized it and Dr. Tatyana Moaton was a plenary speaker.   Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  Resources: Recordings from conference 2022 Medical Mistrust Symposium: “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, petersons, gograd   Guest Bios  Zami Tinashe Hyemingway (he/him) is the Capacity Building Assistance (CBA) 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 (she/her) 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. 

Trigger warning: sexual trauma  Psychotherapist Sam Kendakur talks with Tammy 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 wellbeing of folks with marginalized sexual, gender, and racial identities, especially when there are stark differences between the provider and client's lived experiences. Find the transcript for this episode at comingtogetherpod.com. Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.   Resources:  Sam Kendakur's website  Reading Guide from Shrimp Teeth: The Best Polyamory, Sex, and Queer Books    The Body Keeps the Score by Bessel van der Kolk  Polysecure: Attachment, Trauma and Consensual Nonmonogamy by Jessica Fern  Higher Education Scholarship Opportunities for LGBTQ+ students listed at edumed, petersons, gograd  Guest Bio:  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 marginalizedspaces. 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 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. Fleming works to help her patients meet their goals.  In this episode, Dr. Fleming sits down with host Tammy to discuss what she sees as providers' 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.  Resources mentioned:   AidAccess  Hey Jane  PlanCPills.org  Training in Early Abortion for Comprehensive Healthcare (TEACH)  Not mentioned but helpful:  Benioff Children's Hospital—Abortion Access Post-Roe Also, be sure to follow Mai Fleming on twitter and take another listen to episode 5 on trauma-informed care.  

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 current 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 on an episode we put out on June 1st of this year with Dr. Ina Park at a very different stage of the spread of monkeypox. With the US and the World Health Organization declaring this a public health emergency, Ferris and Dr. Vaidya use their respective lenses to reflect on 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 Mentioned:  Stephan Ferris's Website and Reading is Fundemental Podcast  CDPH About Monkeypox and California Data  CDPH Monkeypox Clinical Assist Evaluation Tool  CDC Monitor Monkeypox Exposure  CDC Monkeypox Updates and Topics Also be sure to check out Dr. Justin Lehmiller's great monkeypox explainer, too!  About: 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 (“BALIF”), a community of LGBTQI+ legal professionals.    About: 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.   Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu   Don't forget to leave us a review wherever you get your podcasts. 

Trigger Warning: This episode mentions suicide and 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 herpes (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 health care 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. Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  Show notes:   Donate to Something Positive for Positive People  SPFPP website   SPFPP podcast  HSV Survey results mentioned  Dr. Ina Park's Instagram, twitter, and website  Strange Bedfellow by Dr. Park   Penny for your thoughts campaign  Guest Bio:   Courtney Brame (he/him) 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 health care professionals tools they can use to provide anti-stigmatizing, identity validating, sex-positive health care. Courtney also hosts a podcast, called Something Positive for Positive People, where you can hear these stories and experiences directly. 

Listening within a month of this episode's release? Fill out the form to enter our raffle and win a copy of Dante's new book! Four winners will be selected.   Episode description:  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 (capacity building and technical assistance trainer at CAPTC) 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.   King 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 and more courses from Dante.   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  About Dante:  Dante King is the author of the new book 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 specifically at the Team Lily clinic. 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. Download the transcript of this episode.  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.    Resources from Becca and the CAPTC:  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   Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  About Becca:   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. 

In this episode of Coming Together for Sexual Health, 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 from Terrance, Nikole, and the CAPTC:  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 Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts.  Guest Bios:  Currently based out of Stockton, California (but Oakland born and raised), 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.   

This special episode features Dr. Ina Park discussing monkeypox: what it is, what's the hype, and how worried (hint: not very) she is about the spread. Note that we recorded on May 31, 2022. Check out the CDC's website for up-to-date information about monkeypox.  Follow Ina on Instagram and Twitter @inaparkmd for timely (and often entertaining) updates on sexual health. Check out Dr. Park's book, Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs.  Dr. Ina Park, MS, is the medical director at the California Prevention Training Center. She is a professor in the Department of Family and Community Medicine at the University of California San Francisco and a medical consultant in the Division of STD Prevention at the Centers for Disease Control and Prevention.    Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu  Don't forget to leave us a review on Spotify, or wherever you get your podcasts.

This episode of Coming Together for Sexual Health features the wonderful Jen Jackson, a disease intervention specialist and harm reductionist. Jen walks us through the history of harm reduction, the principles that guide the movement, and gives us some personal examples of disease intervention and harm reduction values in action. Listen in to learn how theories of harm reduction apply in myriad settings, and how a foundation in these theories is essential to providing effective sexual healthcare. Download the transcript for this episode.  Resources from Jen Jackson:  UNAIDS   Open Society Foundation Report on the UN stance on harm reduction Drug Policy Alliance Harm Reduction International National Harm Reduction Coalition The National Network of Disease Intervention Training Centers Cultural Humility Collaborative Article mentioned on HIV, race, sex, and stigma The Harm Reduction Journal HealthHIV  Resources From the CAPTC:  Disease intervention resources from the CAPTC  Disease Intervention Specialist Virtual Summit 2020   Drugs 101 Training Series from the CAPTC and National Harm Reduction Coalition   Harm reduction resources from the CAPTC Virtual Syringe Services Workshop from the CAPTC  Have any questions, concerns, or love letters? Send us a message on Instagram @comingtogetherpod or email us at comingtogetherpod@ucsf.edu. Don't forget to leave us a review on Spotify, or wherever you get your podcasts. 

Andrew Gurza is an award-winning Disability Awareness Consultant and the Chief Disability Officer and Co-founder of Bump'n, a sex toy company for and by disabled people. Andrew uses they/he pronouns and identifies proudly as disabled. Their work has been featured on BBC, CBC, Daily Xtra, Gay Times UK, Huffington Post, The Advocate, Everyday Feminism, Mashable, Out.com, and several anthologies. They were the subject of an award-winning National Film Board of Canada Documentary “Picture This”. Andrew has guested on a number of podcasts including Dan Savage's Savage Love and Cameron Esposito's Queery. They have spoken all over the world on sex, disability and what it means to be a Queer Cripple. They are also the host of Disability After Dark: The Podcast Shining a Bright Light on Disability Stories which won a Canadian Podcast Award in 2021, a Queerty Award, and was chosen as an Honoree at the 2020 Webby Awards. The show is available on all platforms. Andrew is also the creator of the viral hashtag #DisabledPeopleAreHot. You can find out more about Andrew by going to www.andrewgurza.com and connecting via social media @itsgurza. Resources mentioned in the episode:  Andrew's podcast, Disability After Dark, their Website, and Instagram Hot, Wet, and Shaking: How I Learned to Talk about Sex by Kaleigh Trace  Purchase or financially support The Joystick: The World's First Accessible Sex Toy by Get Bump'n  Download a link to this episode's transcript.

We speak with Dr. Rosalyn Plotzker about her work with UCSF's ANCRE Center, the world's first clinic devoted to anal cancer prevention. Anal cancer incidence is on the rise despite it being associated with HPV, a highly preventable (and extremely common!) virus. Roz takes us through her work with the clinic, anal cancer screening and risk factors, and debunks many of the stereotypes and stigmas surrounding anal cancer and its causes.  Listen and learn how you, too, can play a role in normalizing cancer prevention and better anal health! Want to chat with Roz directly? Email her: Rosalyn.Plotzker@ucsf.edu

If you work in sexual health, you have probably had the experience of becoming the "sexpert" for your friends and family. In this special episode we have gathered some (but by no means all!) of the questions Dr. Rosalyn Plotzker has received from her various circles to try and demystify at least some of these aspects of sexual health. 

We continue our conversation with Dr. Paul Nash, Associate Professor in Gerontology at USC. In Part 2 of this discussion about ageism, host Duran Rutledge and Paul dive into the harmful stigma surrounding sex and aging, particularly for people at the intersections of various identities and life experiences. 

In this episode, we talk with Dr. Paul Nash, Associate Professor in Gerontology at USC. His research spans over a decade and focuses on ageism, discrimination, sexual health, and the built environment.  He partners with several non-profit organizations on his research into HIV and aging as well as ageism and intergenerational communication. Paul currently serves as a Commissioner on the Los Angeles County Commission on HIV, and he consults with the World Health Organization on ageism. He is active in teaching and recently published the book, Critical Questions for Ageing Societies.

We talk with anti-racist activist, Dante King. He's worked with organizations like the San Francisco Metropolitan transportation agency and the San Francisco Department of Public Health to cultivate environments that are anti-racist and inclusive. He discusses how capitalism reinforces racism, the creation of anti-blackness through policy, and the systems and structures that have led to white supremacist ideology.

"Sex positivity" has become quite a buzzy phrase in sexual health and advocacy spaces in the last decade. But what does that actually mean in practice? Today we will talk with JaDawn Wright of the Pacific Aids Education training Center, about just that. JaDawn is the Deputy Director of the organization and a long-term trainer in the world of sexual health. She tells us why creating healthcare experiences that are welcoming, nonjudgmental, and unbiased can go so far in helping us realize positive health outcomes.

Ana Delgado, CNM, is a Clinical Professor in the UC San Francisco Department of Obstetrics, Gynecology and Reproductive Sciences, San Francisco General Hospital Division. Ana acts as the Assistant Director of Inpatient Obstetrics and Co-Director for Anti-Racism, Equity, Inclusion and Structural Change. Ana talks with us about racial inequities in healthcare, how structural racism permeates every facet of life, and why "race is always an issue for folks who are racialized.”

Dr. Aisha Mays is a Family Physician who focuses on Adolescent Medicine. She is the Founder and Medical Director of the Dream Youth Clinic of Roots Community Health Center, in Oakland, California -- a youth-led, youth-engaged adolescent clinic co-located within Oakland's two youth shelters. Dr. Mays' work centers on adolescent reproductive health, reproductive justice for highly vulnerable youth, and the health risks associated with childhood commercial sexual exploitation. Her research focuses on exploring reproductive justice barriers and supporting sexual health for youth. On this episode, we talk with Dr. Mays about her important work.

Dana Cropper recently took the helm of the California Prevention Training Center as its new Director, after Alice Gandelman's retirement. Dana previously served as Director of Education at HealthHIV. In this debut episode of Speaking Frankly season two, we talk with Dana about her new position, why Oprah and Sojourner Truth are two of her heroes, and why she thinks to reduce stigma, we must each engage in deep and ongoing self-reflection “about how we navigate through the world”.

On Jan 21, 2021, the FDA approved Cabenuva, the first once-monthly injectable HIV treatment for adults. Dr. Kelly Johnson, a fellow in infectious diseases and in sexually transmitted diseases at the University of California, San Francisco, explains the implications of this new treatment and how it affects the 1.2 million Americans living with HIV. Dr Johnson is a physician focused on HIV at San Francisco General Hospital Ward 86.

Dr. Monica Gandhi is an infectious disease physician and professor of medicine at UCSF, and the Medical Director of the Ward 86 clinic. She talks about the efficacy of the Johnson & Johnson vaccine (that was submitted to the FDA for Emergency Use Authorization on 2/8/2021), and theorizes as to when we may return to some normalcy.

In Dr. Ina Park's new book, Strange Bedfellows, she helps readers understand the broad impact of sexually transmitted infections (STIs), while removing the unfair stigma. She speaks with us about the writing process, tackling sex ed with her own kids, and how stigma impacts mental and physical health.

Congenital syphilis (CS) is up 900% in California since 2012. UC San Francisco's Dr. Rosalyn Plotzker speaks with us about CS prevention and treatment and about the complex issues contributing to the spike, like systemic racism.          

Dr George Rutherford, Professor of Epidemiology at UC San Francisco, talks with us about COVID-19, the Pfizer and Moderna vaccines, and why anti-microbial resistance is the next public health threat.        

We continue our discussion with Lidia Carlton, Director of Community Education at Planned Parenthood Pasadena and San Gabriel Valley, about the CA Healthy Youth Act and how it's changing sex ed. She tells us why some parents are pushing back against gender diversity discussions, and why sex ed is a natural place to teach about race and ableism.