Kenyon Farrow

Entries tagged as ‘HIV’

Drug War Update: Global, National, & New York

March 12, 2009 · 3 Comments

This week,the world’s got drugs on the mind. Here’s what’s happening at the global level, nationally, and then here in New York State.

GLOBAL

Days after the President of West African country Guinea-Bissau was assassinated (rumored to have been supported by South American drug cartels), the new UN Political Declaration on Drugs was announced this week as a follow-up to the 10 year plan to reduce global drug use and trade (HAHAHAHA!). Many NGOs (including Human Rights Watch & the International Harm Reduction Association (IHRA)) and editorial pages across the globe concurred that it does not go far enough in moving UN members to adopt less punitive, and more public health approaches to drug abuse, which factors in the fight against HIV/AIDS. In fact, the Human Rights Watch (in a press release I received from the media department of the International AIDS Society) noted that:

“What is at issue is a series of measures known collectively as ‘harm reduction services,’ which have been endorsed by UN health and drug-control agencies, including the UN Office on Drugs and Crime, UNAIDS and the World Health Organization. These measures include needle and syringe exchange and medication-assisted therapy (for example, with methadone), both inside and outside prisons, as essential to address HIV among people who use drugs. The groups noted that a wealth of evidence proves harm reduction is essential to HIV prevention for people who use drugs. The action was taken against the direct advice of UNAIDS, the Global Fund to fight AIDS, Tuberculosis and Malaria, and the UN special rapporteurs on health and on torture.

Not only that, but The Economist published an editorial (which is also its cover story) detailing why a global war on drugs is a failed project to reduce drug use. The write:

Indeed, far from reducing crime, prohibition has fostered gangsterism on a scale that the world has never seen before. According to the UN’s perhaps inflated estimate, the illegal drug industry is worth some $320 billion a year. In the West it makes criminals of otherwise law-abiding citizens (the current American president could easily have ended up in prison for his youthful experiments with “blow”). It also makes drugs more dangerous: addicts buy heavily adulterated cocaine and heroin; many use dirty needles to inject themselves, spreading HIV; the wretches who succumb to “crack” or “meth” are outside the law, with only their pushers to “treat” them. But it is countries in the emerging world that pay most of the price. Even a relatively developed democracy such as Mexico now finds itself in a life-or-death struggle against gangsters. American officials, including a former drug tsar, have publicly worried about having a “narco state” as their neighbour.

The failure of the drug war has led a few of its braver generals, especially from Europe and Latin America, to suggest shifting the focus from locking up people to public health and “harm reduction” (such as encouraging addicts to use clean needles). This approach would put more emphasis on public education and the treatment of addicts, and less on the harassment of peasants who grow coca and the punishment of consumers of “soft” drugs for personal use. That would be a step in the right direction. But it is unlikely to be adequately funded, and it does nothing to take organised crime out of the picture.

National

It seems as though the US’ policy on the War on Drugs is going to somewhat shift to a conversation less about public health, and more about “national security.” Over the last week, media stories about the possibility of Mexico becoming a failed state due to the violent drug cartels that are wreaking havoc on the country, and that the government is failing to control. Fears, and what is somewhat true, that Mexican gangs that have ties to the drug trade are spreading across the US in major cities. The US government seems to be signaling a fear of the kinds of violence seen in Mexico spreading to the US, and with an increase in Mexican immigrants if drug cartels do succeed in rendering the existing government powerless. (There is evidence that many of the weapons are coming from the US, and we’re not likely to have an gun reform laws anytime soon.) Notice that Department of Homeland Security Chief Janet Napolitano’s recent appearances on television talking about this problem.

Secondly, yesterday, Obama nominated Seattle Police Chief Gil Kerlikowske as Drug Czar, while he removed the post as a Cabinet-level position. I don’t know much about this new Czar, but being a police chief doesn’t give me much hope of a real shift in policy. However, Drug Policy Alliance’s Ethan Nadelmann in a Huffington Post piece, remains cautiously optimistic based on what’s happened in Seattle during the police chief’s tenure:

What gives me hope is the fact that Seattle has been at the cutting edge of harm reduction and other drug policy reform developments in the United States over the last decade. The city’s syringe exchange programs are well established and harm reduction is well integrated in Seattle’s approach to local drug policy. Marijuana has been legal in Washington State for medical purposes for a decade. In 2003, Seattle voters passed a ballot initiative making marijuana arrests the lowest law enforcement priority. And the King County Bar Association has demonstrated national leadership in exploring alternatives to current prohibitionist policies.

While Kerlikowske has not spoken out in favor of any of these reforms, he is clearly familiar with them and has not been a forceful opponent. Given the high regard in which he is held by other police chiefs around the country, Kerlikowske has the potential to provide much needed national leadership in implementing the commitments that Barack Obama made during the campaign. He also surely recognizes that substance abuse or run-ins with the law can touch anyone, including his own family. He will hopefully advocate for treatment instead of incarceration for nonviolent drug law offenders.

New York State

Almost 2 weeks ago, the NYS Assembly passed a bill that would basically gut the Rockefeller Drug Laws, and after nearly 40 years, return discretion to judges for sentencing and not give these automatic stiff penalties for petty drug charges (although racist judges will still mean racial disparity in sentencing. That’s how we got talked into mandatory minimums in the first place.). Now the problem is what the NYS Senate and Governor Patterson is going to do with this bill. Will they leave it as written, or cut the scope of it so it becomes another whack reform that means nothing. Assembly Speaker Sheldon Silver wrote yesterday in an op-ed for The Daily News:

By now it should be beyond debate that these laws have failed. One serious consequence: massive racial disparity in sentencing. According to the U.S. Health and Human Services Department, the rate of drug use in America is generally 8.2% for whites, 7.2% for Latinos and 8.7% for African-Americans. Yet the Rockefeller laws have filled New York’s prisons with tens of thousands of drug offenders, 90% of whom are African-American or Latino.

The laws have also failed to curb drug abuse. According to statistics from the National Survey on Drug Abuse conducted by the Health and Human Services Department, illicit drug use among New Yorkers has not abated since the passage of the drug laws in 1973.

Finally, 35 years of unambiguous data make clear that the Rockefeller laws have had no appreciable impact on combating violent crime. All evidence shows no correlation between the Rockefeller laws and the subsequent increase, followed by an equally precipitous decrease, in crime in New York.

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My Plenary Remarks at Creating Change

February 3, 2009 · 3 Comments

Hey folks, sorry  I been gone so long, but I was in Denver al last week for the 21st annual Creating Change conference, this year in Denver. Bilerico.com just published the speech I delivered at the HIV/AIDS plenary at Creating Change on Saturday, January 31, 2009. My other co-panelists, Marjorie Hill, PhD (Executive Director, Gay Men’s Health Crisis), Bishop Yvette Flunder (UCC Ark of Refuge, San Francisco), & David Ernesto Munar (VP of Development & Communications, AIDS Foundation Chicago), were quite brilliant!

Excerpt below. Go to Bilerico to get the full text:

First and foremost, the time where we can pretend that there is no viable, credible or visible Black (or other POC) queer leadership is over. While we certainly need to be developing leaders, leadership per se, is not the problem. We have lost of leaders, but leaders with no base that they’re accountable to. Because what little Black LGBT infrastructure that exists, is largely due to HIV/AIDS service delivery, we are able to reach lots of people in our organizations as “clients”, but are rarely engaged as potential leaders, organizers or members of our organizations. We need the investment of both progressive philanthropy and LGBT funders to help build the capacity and infrastructure of organizations to move from strict service delivery to doing community organizing, leadership development, and base-building.

Lastly, as long as the White-led mainstream LGBT movement is invested in seeing itself as the only credible leadership or it’s organizations the only ones doing “the real work” or having “real impact” we will continue to invisibilize the work that Black and other POC organizations are doing on the ground, in spite of real material obstacles. So every time the gay news media and organizations promote ideas of the gay community vs. the Black community, Black queers will continue to remain invisible, and assumes that Black queer people are not engaging in a battle against homophobia and transphobia in the Black community.

Here’s the last 3 minutes of the speech on Youtube:

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Senegal Sentences 9 Gay HIV Activists to Prison. For Being Gay.

January 10, 2009 · Leave a Comment

Despite my celebrating the recent Uganda high court decision in favor of several lesbians abused by police, we still obviously have a long way to go. This past week, a Senegalese court sentenced 8 gay men who worked for AIDES Senegal (an organization that provides condoms and HIV treatment, in a country that has one of the lowest prevalence rates on the continent) to 8 years in prison for “homosexual acts.” Ironically, the country just played host to a regional gathering of the International AIDS Conference. The BBC reports:

“This is the first time that the Senegalese legal system has handed down such a harsh sentence against gays,” said Issa Diop, one of the men’s four defence lawyers. Mr Diop said he would be appealing against the sentences.

The IGLHRC’s Cary Alan Johnson said he was “deeply disturbed” by the case.

“There have been pretty consistent human rights violations… in Senegal,” he told the BBC’s Network Africa programme from Cape Town in South Africa.

“But the extremity of this sentence [and] the rapidness of the trial all really shocks us in a country which has been moving so positively towards rule of law and a progressive human rights regime.”

According to the website Behind the Mask (which documents what’s happening to LGBT people on the African continent.), the law governing “homosexual acts” reads (in English) as follows:

“Without prejudice to the more serious penalties provided for in the preceding paragraphs or by articles 320 and 321 of this Code, whoever will have committed an improper or unnatural act with a person of the same sex will be punished by imprisonment of between one and five years and by a fine of 100,000 to 1,500,000 francs. If the act was committed with a person below the age of 21, the maximum penalty will always be applied”

Human Rights Watch has also issued a statement demanding their release.

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New Study: 95% of HIV Positive Don’t Transmit HIV

December 4, 2008 · 2 Comments

Even though we’ve talked over the last year about the new HIV infections rate (incidence) in 2006, I haven’t given any thought to the issue of transmission–how many people actually transmit HIV to an HIV negative person every year? And what does the looking at the rate of transmission over the course of the epidemic tell us about what’s working or not working with prevention, testing, treatment or care efforts?

Well that’s why we have smarty pants like David Holtgrave, PhD at the Bloomberg School of Public Health at the John Hopkins University. His study, which JAIDS released online ahead of the publication date, looks precisely at HIV transmission rates over the course of the epidemic. They conclude that the highest rates of transmission occurred in the early years of the epidemic–in the early/mid 80s, and then began to drop off at several different points, particularly from 1985-1986 (31.4-17.4), and 1990-1991 (11.7-6.6). By 2006, the transmission rate declined to 5.0.

In other words, 95% of all people with HIV did not transmit the virus to people who are HIV negative.The study goes on to explain the possible causes for this drop in transmissions:

The general decline in HIV transmission rates over time could be considered a rough measure of prevention success, in that even as prevalence grew over time incidence did not grow proportionately. HIV diagnosis is known to significantly reduce HIV risk behavior, and in the past decade, there has been an increasing emphasis on prevention programs for persons living with
HIV that further reduce HIV risk behavior and 2006.

Another interesting thing they note is that AIDS drugs (anti-retrovirals) didn’t have a grand impact on transmission rates, as transmission was declining long before ARVs were on the market.

Could it be that marginalized communities with no access to treatment is where those transmission rates did not decrease or increased?

Could it be that the prison boom and/or Welfare Reform Act of 1996 (when prison construction peaked and we hit the 2 million prisoner mark for the first time) disrupted or changed sexual networks enough to create new HIV transmissions (and sexually transmitted infections in social networks where they had been stable?

Holtgrave doesn’t ask these questions, but notes that further research needs to happen to explain why ARVs do not seem to have significantly decreased transmission of HIV. But in a Q & A on Johns Hopkins’ website, he addresses the impact of housing stability on HIV risk, and also says what he would do if he was AIDS Czar in the Obama Administration:

I think it is critical to address unmet HIV prevention needs in the U.S. As I testified recently before Congress, my wish for a five-year plan would be for $1.3 billion in prevention funding per year. I might front-load that a bit, so maybe it’s $1.6 billion in the first year, and so on. Over that five-year period, I estimate that as a nation we could reduce transmission by half—but we’d need that substantial investment. And if we really saw a drop in new infections, that higher level of funding might sunset in several years, so we wouldn’t necessarily have to continue to fund it at $1.3 billion per year.

Let’s hope we’re as lucky to have this come to fruition.

UPDATE: The CDC has published a factsheet and podast on HIV Transmission Rates in the US, based on the release of this data.

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World AIDS Day: We’re Still Living With AIDS

December 1, 2008 · 3 Comments

(originally written for the NGLTF Policy Institute)

December 1, 2008 8:40 am

Today, many of us will dust off those red ribbons, and “remember” to remember the people who we’ve lost, and who are currently living with HIV/AIDS.

Some of us may even donate money to an AIDS charity doing work in some far flung place. But red ribbons and prayer services that commemorate only hide the reality that here in America, we are still living with AIDS.

Despite major advances in treating the virus, the HIV/AIDS epidemic didn’t go anywhere and in fact, it seems to be getting worse for people in our community. At the International AIDS Conference, the Centers for Disease Control and Prevention (CDC) stunned the international AIDS community by announcing that the richest nation on earth had over 56,000 new infections in 2006. While this may not seem like a huge number, this revision also included a back-calculation revealing that, for the 15 years from 1991-2006, infection rates were approximately 25-50 percent higher than the long-held 40,000 annual estimate.

Not only have we been under-counting the growth of the epidemic, men who have sex with men (MSM — that public health category that includes gay and bisexual men, and transgender women) continue to bear the greatest increases in new infections. In 2006, 53 percent of all new infections were among MSM. More stunning, it found the number of new infections of black MSM ages 13-29 to be the highest of all MSM groups. Even though CDC officials are typically conservative in its public statements, CDC Behavioral Scientist Greg Millett has stated publicly that black MSM are the only group in the U.S. with HIV rates similar to Sub-Saharan African nations, despite similar or lower rates of risky sex or substance abuse than white MSM. While black MSM certainly bear the brunt of the virus, gay and bisexual men and transgender women of all races are disproportionately impacted by the virus.

Though many of us are celebrating a new administration, we are still living with HIV/AIDS policies that reflect the reactionary Reagan era, where politics, not public health science, dominates our approach to HIV prevention, treatment and care. We still fund abstinence-only sex education, ban federal funding for syringe exchange programs, and there’s no coordinated national AIDS strategy for the United States. This lack of concern for our lives shapes the ability of people with HIV to accessing quality services, but also makes many in our community more vulnerable to contracting the virus.

And the HIV negative still live with the virus — lovers, friends, relatives, are positive, have died, and the spectre of HIV still shapes our current sexual lives.

So instead of silently commemorating this World AIDS Day with a red ribbon, I urge of us to continue to fight the public policies that make us more vulnerable to contracting the disease or that prevent people who are positive from staying healthy. President-elect Barack Obama will be making key appointments in the coming weeks that will demonstrate whether his promises for policy change for the domestic HIV epidemic will put public health over politics. We have an opportunity to do something different. Let’s hold him to his word.

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Stephanie Mills’ “Home”: So Black and So Gay!

October 9, 2008 · Leave a Comment

If you’re a Black gay of the Classic Era (meaning you’re over 30, or at least have Classic Black Gay Sensibilities, or CBGS), you’ll know that Stephanie Mills‘ “Home” is really the Black gay anthem. The song, written for the 1975 Broadway play The Wiz for which Mills was cast as Dorothy (and Diana Ross played in the 1978 film version and does a lackluster version of the song. In fact, it is Lena Horne’s “Believe” that becomes the showstopper in the film. But I digress.), is the “Somewhere Over the Rainbow” of this black version of the Wizard of OZ.

Why is this song, so Black and so gay, you might ask?

One reason that the Black gays of the classic era love this song, in my opinion, is that it speaks to the pain of feeling cast out of the larger Black community–we have no “home” in a sense. The song is about a stateless person–someone who has dreams of a physical place, but the lesson that they learn is that home has to be made in the family and community we create.

But Mills re-recorded the song for her 1989 album “Home” (with a Capella group Take 6 singing the background vocals). She has said that she recorded the song after the deaths of Kenneth Harper (The Wiz Producer, whose mother told the New York Times he died of cancer at age 48 in 1988)  and Charlie Small, The Wiz Composer who died in 1987 of a burst appendix.  I think that many Black gay men from the Classic Era were in the throes of so much death due to HIV (and sometimes violence) that this song became a song about the losses they were feeling too. I started going to gay clubs when I was 18 or so, and this song was a staple drag performance for about a decade. I think the part that really cinches it for the Black gays, me included, is at the end of the 1989 recording, when she sings “I can hear my friends tellin’ me, Stephanie, please, sing my song.”

Because it so much speaks to the Black gay experience, Stephanie Mills’ Home is So Black and so gay! The video below is a live verson from the Apollo in the 1980s. To see yet another un-embeddable music video from the theives at Universal Music Group, click here.

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Blacks, Gay Men At Highest Risk for HIV

September 19, 2008 · 3 Comments

New infections in Men

New infections in Men

The US Conference on AIDS has begun in Fort Lauderdale, unfortunately I couldn’t afford to go, but just as well because I am going to see my southern friends at Southerners on New Ground’s 15th Anniversary. But given the CDC’s recent release of the of the subpopulation data of the new infections for 2006 (called incidence), I thought I’d share some of the data with you. If you click on the link above you’ll find a lot of other tools to help you understand the data including a fact sheet, a Q&A, and a podcast:

CDC’s August 2008 data showed that gay and bisexual men, referred to in CDC’s surveillance systems as men who have sex with men (MSM)2, represented the majority of new infections in 2006 (53%, 28,720).

Now, in the more detailed analysis, CDC further examine new infections among whites, blacks, and

New Infections by Race

New Infections by Race

Hispanics/Latinos. The findings reveal that the ages at which MSM become infected vary by race:

  • Young Black MSM: Among MSM overall, there were more new HIV infections in young black MSM (aged 13–29) than any other age/racial group of MSM. The number of new infections among young, black gay and bisexual men was roughly twice that of whites and of Hispanics/Latinos (5,220 infections in blacks vs. 3,330 among whites and 2,300 among Hispanics/Latinos).
  • White MSM in their 30s and 40s: Among MSM in the analysis, white MSM accounted for close to half (46%) of HIV incidence in 2006. Most new infections among white MSM occurred in those aged 30–39 (4,670), followed by those aged 40–49 (3,740).
  • Hispanic/Latino MSM: Among Hispanic/Latino MSM, most new infections occurred in the youngest (13-29) age group (2,300), though a substantial number of new HIV infections were among those aged 30–39 (1,870)

Walt Senterfitt, in this month’s HHS Watch (a publication of Community HIV/AIDS Mobilization Project (CHAMP)), writes about what the new data means for gay men in his piece called Where’s Our National Campaign Against Homophobia?

There has also been a consistent tendency over at least the last 15 years within much of the AIDS community itself – and certainly by the media and other institutions of civil society enlisted in the struggle against HIV/AIDS – to “de-gay-ify” HIV/AIDS. For example, messages stress that HIV is an “equal opportunity virus” and that anyone can be at risk, emphasize children and women at risk, and stress that HIV/AIDS is, in its majority, now an epidemic in communities of color (while simultaneously neglecting to stress that those most disproportionately impacted in communities of color are gay and bisexual men).

This direction in messaging was in part well intended, to combat the widespread assumption that if you are not a white gay man, AIDS is not your problem and you are not at risk. It was also meant to get beyond the intensified stigmatization of gay men and focus on the behaviors that put one at risk. This approach has been embraced by many HIV positive and other gay men who fear the added stigmatization of having “gay” remain widely associated with “HIV/AIDS” in public consciousness. Even from the start though, this approach was a capitulation to rather than a confrontation of societal stigma and prejudice against gay people, against transgender people, against all people who are sexually “non-normative.” And it didn’t work. Homophobia still is rampant, dollars have gone elsewhere, and, alone among the exposure categories, HIV infection rates among gay men are rising.

Here’s video from a panel CHAMP sponsored (that I moderated) back in February on the issue:

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GMHC Launches New Campaign Targeting Fathers of Black Gay Men

August 15, 2008 · 9 Comments

Some people don’t dig social marketing campaigns, but I think that, when done well, they can be a good way to disrupt the many silences around our lives and put them into the public sphere for conversation. When it comes to homophobia and the consistent invisibility of Black queers in the Black community (though that is beginning to change slowly) having posters in subways or wheat-pasted, they can be good ways for us to disrupt the silence and be situated in the geography of the city.

This is the second of a series GMHC has been doing this year, and though I am less giddy about this one as I was the I LOVE MY BOO campaign, this one is damn cool too!

“Families are critically important to young men of color and this campaign builds on the strength and resiliency of those bonds,” stated Dr. Marjorie Hill, Chief Executive Officer of GMHC. “We recognize the complexities in the lives of young men of color who have sex with men. Thus, HIV prevention efforts should speak to the realities faced by these young men on a daily basis. We cannot simply deliver a message of “use condoms” or “be tested for HIV. It is imperative to address the myriad of underlying factors which contribute to the transmission of HIV, including homophobia, racism, poverty, isolation, stigma, poor body image, and inadequate access to health care.”

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CNN’S BLACK In America: On Black LGBT Folks

July 29, 2008 · 3 Comments

….yes. We weren’t there. At best, we got Phil Wilson of Black AIDS Institute, who was interviewed but was not talked about as a Black gay man, but who’s observations on HIV/AIDS were made about the whole community. Secondly, the family they profiled, the Rands, the first family had a son who was a dancer studying at Julliard who’s only appearance was in a photo wearing a purple unitard. I am not certain he’s gay, but I’m just sayin!

As usual, we were marginal, sidelines, and noticeably invisible–not to say anything of lesbians, and transgender folks, who were completely absent.

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American Prospect: Best HIV/AIDS Reporting This Year!

July 11, 2008 · 1 Comment

It is hard to find good reporting on the domestic AIDS epidemic in the US that isn’t sensational, or focuses nearly entirely on individuals who contract HIV–as if it’s only their fault and that there are no policy decisions that are also complicit in driving the US epidemic. When was the last time you read a feature story that focused on the Centers for Disease Control & Prevention (CDC), National Institutes of Health (NIH), Congress, Health & Human Services or any of the other federal agencies responsible for AIDS treatment, care, prevention, and research?

Well, The American Prospect, the liberal monthly policy magazine published not one, but TWO stories on domestic HIV policy, and both do a really great job of reporting what’s going on in terms of national HIV policy.

Kai Wright, the best AIDS reporter in the biz, has a story on AIDS in the South that shows his strength as a writer, and his enormous ease with a very complex subject as he deals with virtually every angle of the issue from history to prisons, to homophobia to government funding. He writes:

What was once considered an urban, coastal epidemic — centered in gay havens like New York City, San Francisco, and Los Angeles — is now a surprisingly rural, Southern one. More than half of all new infections logged between 2001 and 2004 were found in the South. Those infections are far more likely to be found among Southerners who are black, low-income, and diagnosed with advanced conditions they do not have the resources to control.

What’s being done? Adam Green’s story focuses on the work by AIDS activists in the US to push the government to have for a coordinated National AIDS Strategy. In case you didn’t know, part of Bush’s much celebrated (and highly problematic) PEPFAR prorgam is that any country applying for PEPFAR dollars must have a national strategy for AIDS prevention, treatment & care. THE UNITED STATES HAS NO SUCH PLAN. In addition, the nation’s capital has an HIV prevalence rate worse than many countries in sub-Saharan Africa. Green writes:

Instead, the domestic response is built on a loosely connected network of local, state, and federal programs. Authors and activists often describe this existing HIV/AIDS programming as a safety net. But the metaphor is not quite apt. There’s only a tenuous connection between the organizations. There’s little strategic coordination and no clear goals. The result is that people who are at risk or infected don’t know where or how to access care. In 2002, an estimated half of people with HIV/AIDS were not receiving care.

For more information on the National AIDS Strategy visit their website. Also, in early August I will be in Mexico City with CHAMP at the International AIDS Conference blogging on issues pertinent to the domestic AIDS epidemic at the conference, so be sure to check us out at www.AIDS2008.com

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