What is C2EA and what do we do?

The Campaign to End AIDS (C2EA) is a diverse, exciting coalition of people living with HIV & AIDS, their advocates and their loved ones. Together, we're demanding that our leaders exert the political will to stop the epidemic, in the U.S. and abroad, once and for all.

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From our friends at HIV Health Reform

Are you or a client having problems accessing HIV care or services with a health plan? We want you to Speak Up!

The Speak Up project wants to hear about difficulties people living with HIV are having accessing health care, such as:

~ Problems getting prescription drugs
~ Trouble accessing primary care
~ Difficulty accessing HIV specialists

Go to our Speak Up web page, and report any problems you or a client face with new Affordable Care Act health plans, or existing plans.

When you Speak Up, you’ll help thousands of others across the country.

This national project, led by AIDS Foundation of Chicago and the Center for Health Law and Policy Innovation at Harvard Law School, will monitor, catalogue, and analyze the problems experienced by people with HIV in the new system.

Speak Up will identify issues that need to be addressed, bring them to the attention of state and federal policymakers, advocate for change, and report back to the community.

Let your voice be heard. If you can’t get the care you need, Speak Up!

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About the Project

The HIVHealthReform.org “Speak Up” project will help people living with HIV get the care they need through health care reform. This national project will monitor, catalog, and analyze the problems experienced by people with HIV in the new health care system.

We will identify issues that need to be addressed, bring them to the attention of state and federal regulators and policymakers, advocate for change, and report back to the community. Beyond helping individuals, information collected through this project will ultimately serve the entire HIV community, as it will help educate state and federal officials as they review and refine key aspects of the Affordable Care Act in coming years.

Click here to report a problem.

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Join the Campaign to End AIDS today!

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By the San Francisco AIDS Foundation, originally posted on their blog — BETA

For people living with HIV, effective antiretroviral therapy (ART) not only suppresses the virus and protects immune system health but has the added benefit of reducing the risk of transmitting HIV to sex partners. This side benefit, known as “treatment as prevention,” has been established by recent studies with mixed-HIV-status couples.

For example, in the PARTNER study, zero new HIV transmissions occurred through more than 44,000 condomless sex acts within 767 mixed-HIV-status couples in which the HIV-positive partner’s viral load was suppressed below 200 copies/mL, and where the HIV-negative partner did not use PrEP or PEP to prevent infection.

Standard viral load tests look for HIV RNA (genetic material from the virus) in blood, not semen—and the amount of RNA in these two fluids doesn’t always match. And as researchers report in the March 3 online edition of PLoS ONE, not only can individuals with undetectable blood viral load have detectable levels in semen, those levels can change from hour to hour.

Xavier Ferraretto and colleagues from the Bichat-Claude Bernard Hospital in Paris looked for HIV RNA in 306 seminal plasma samples (SPSs) from 88 men enrolled in the hospital’s assisted reproduction program. All participants were on ART and had undetectable blood viral load (defined here as below 50 copies/mL) for more than six months. Semen samples were obtained by masturbation after two to seven days of sexual abstinence, and each man provided, if possible, two samples within a one-hour interval.

The results? “HIV RNA was detected in at least one SPS for 17 patients (19.3%) during the study period, corresponding to 23 SPSs (7.5%).” HIV RNA levels ranged from 200 to 3,000 copies/mL, with a median (middle of the range) of 705 copies/mL.

In addition, researchers analyzed viral load in 129 samples given by the same individuals one hour after their original sample. Of these, 12 (9.3%) showed a different seminal plasma viral load, or spVL: “In 8 cases, a spVL was undetectable in the first [sample] and detectable in the second. In 4 cases, a spVL was first detectable and later undetectable.” In these 12 cases, spVL ranged from 200 to more than 1,000 copies/mL, with a median of 918 copies/mL.

The researchers found no association between detectable spVL and participants’ age, geographic origin, sperm characteristics, CD4 cell count nadir, route of HIV transmission, or co-infection with hepatitis B or C.

Interestingly, more men on protease inhibitor (PI)–based ART had at least one sample with detectable HIV RNA, compared with men taking non-nucleoside reverse transcriptase inhibitors (NNRTIs) and other antiretroviral drugs; however, the association did not reach statistical significance. “The tendency towards a higher risk of a detectable spVL in patients given the PI-containing [ART] regimen compared to a regimen containing an NNRTI might be explained by the poor diffusion of most PIs in the male genital tract,” the researcher team writes.

What do these findings mean for HIV transmission risk? While the results show that viral “shedding” can occur within a one-hour interval among men with undetectable blood viral load, “this timing should not be considered to place individuals at greater risk for HIV transmission than previously reported,” the authors state. They do conclude, however, that the nearly 20% proportion of men with detectable HIV RNA in semen despite stable undetectable blood viral load “should balance messages on the individual risk of HIV transmission through unprotected sex as an exclusive preventive strategy in serodifferent couples with procreation desires.”

That said, no study to date has identified a seminal viral load “threshold” at which HIV transmission becomes likely. Questions clearly remain about the links between HIV viral load, viral load in semen, and risk for HIV transmission in the setting of antiretroviral treatment.

Source
Ferraretto, X. and others. Timing of intermittent seminal HIV-1 RNA shedding in patients with undetectable plasma viral load under combination antiretroviral therapy. PLoS ONE. March 03, 2014.

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Image: indiegogo – FREE CeCe documentary

By Harper Jean Tobin for HuffPost

“[T]here’s a big chunk of [today’s] prison population that is involved in nonviolent crimes. And it is having a disabling effect on communities. You have entire populations that are rendered incapable of getting a legitimate job because of a prison record. And it gobbles up a huge amount of resources.” —Barack Obama

“When one in every 31 Americans is under correctional supervision, it’s clear that something is very wrong. The United States stands above all for freedom, and yet we have by far the highest rate of incarceration in the world.” —Newt Gingrich

These statements were made in 2012 and 2013 by President Obama and former House Republican leader Newt Gingrich. While it’s well-known that we incarcerate African-Americans at shockingly disproportionate rates, less well known is the disparate impact on the LGBT community. The recent case of CeCe McDonald has helped bring this discussion to the fore. The transgender and LGBT movements must make this issue a higher priority. The National Center for Transgender Equality (NCTE) hopes to make a contribution to these efforts with our new publication, “Standing with LGBT Prisoners: An Advocate’s Guide to Ending Abuse and Combating Imprisonment.”

A history of systemic bias, abuse, and profiling toward LGBT people by law enforcement has contributed to disproportionate contacts with the justice system. Moreover, while people may find themselves in jail or prison for many reasons, people who are poor are more likely to be imprisoned, and LGBT people are disproportionately poor. It’s therefore not surprising to find that LGBT people are more likely to end up behind bars. While an estimated 4-8 percent of youth are LGBT, a major study found that as many as 13-15 percent of youth in detention are LGBT. According to the National Transgender Discrimination Survey, 16 percent of transgender adults have been in a prison or jail for some reason. This compares with 2.7 percent of all U.S. adults who studies say have been in prison during their lives, and 10.2 percent of all U.S. adults who have ever been under any kind of criminal justice supervision, including probation. Transgender people, especially the poor and trans people of color, report facing harassment, discriminatory arrests, and assault by police at alarming rates.

The Constitution guarantees that people deprived of their liberty must be provided with adequate food, shelter, safety, and medical care, yet these standards are rarely met. LGBT people are especially vulnerable to abuse and mistreatment. More than 200,000 youth and adults are sexually abused in prisons, jails, and juvenile detention facilities each year according to federal estimates. In the same federal survey, prisoners who identified as “non-heterosexual” were three times as likely to report sexual abuse. A study of California prisons found that transgender women in men’s prisons were 13 times as likely to be sexually abused as other prisoners.

LGBT people often face constant humiliation and degradation from staff and prisoners alike. Staff may blame them for their own victimization, claiming they are “flaunting themselves,” and refusing to take reports of abuse seriously. If their vulnerability is recognized at all, it may be by placing them in indefinite solitary confinement, with little or no activity or human contact — conditions that medical experts have found to amount to torture.

Transgender and gender nonconforming people can face additional forms of mistreatment. Most jails still routinely house transgender women with men, a virtual invitation for abuse. Trans men and women alike face constant denial of their identity, including denial of appropriate undergarments to punishing them for their hair length of beard growth. In addition, some facilities still place decisions about healthcare for transgender people in the hands of administrators rather than doctors, in defiance of court rulings and accepted medical standards.

Fortunately, advocates across the country are working to change this. New national standards intended to prevent abuse behind bars, published by the U.S. Justice Department in 2012, include key protections for LGBT prisoners, including directing that trans people be considered for housing based on their gender identity. Jails from Maine to Texas are beginning to implement these standards, and courts are increasingly ruling in favor of LGBT prisoners’ rights to safety and adequate care.

At the same time, LGBT activists are joining with racial justice, faith, disability, and other groups to demand alternatives to America’s addiction to incarceration. Efforts are also underway at the local and national levels to end police profiling based on race, religion, and LGBT status. Driven as much by fiscal pressure as moral clarity, politicians of both parties are pressing for reforms to sentencing, drug laws, probation, parole, and other laws at the state and federal levels, leading prison populations to edge downward since 2010 for the first time in four decades.

But there is clearly much, much farther to go.

Combating mass incarceration and abuse behind bars belongs much higher on the LGBT movement agenda. We can only move forward as a movement if more people prioritize this work, and we hope NCTE’s new guide can help energize and inform that work. The trans and LGBT movements are filled with amazing people and we know that working together with our allies, we can make the world a more just place.

Follow Harper Jean Tobin on Twitter: www.twitter.com/TransEquality

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Join the Campaign to End AIDS today!

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By Bryan Jones, C2EA Great Lakes Regional Co-Chair

C2EA Cleveland, in conjunction with The Proving Ground group, hosted their first roundtable discussion focused on a new initiative of C2EA – “End Aids by 2025.” Over dinner sponsored by BMS, a very diverse group of individuals – both negative and positive – engaged in a very intense conversation about the real issues that are keeping us from effectively combating new infections. At the table various demographics including transgenders, high school students, men who have sex with men, heterosexual men and women, and the religious community were all well represented.

As we began to talk about viral suppression and community viral load, I invited a gentlemen to the table who found himself constantly in and out of treatment due to substance abuse issues. He spoke openly and candidly about the issue that he has been faced with – barriers to medical adherence.

Another area that was heavily discussed was the transgender community. The transgender woman at the table has been a long-standing leader of the LGBTQ community for years and is HIV-negative. She spoke on many issues that are prevalent in the transgender community. One issue that sparked conversation is the issue of positive transgenders’ battle in choosing hormonal adherence over antiretroviral treatment.

Due to the success of this group it will be held every three months with a community wrap-up forum with the health department, AIDS service organizations, and other stakeholders to discuss how we can devise a more effective strategy to end AIDS.

I started the group “Proving Ground” as a way to have a real conversation with a diverse group of individuals about what the real issues are in the fight against AIDS. When I learned that C2EA was involved in this new initiative I knew that this was the perfect marriage. At each group we are not just talking, we are also gathering data so that when we meet with the city we will have a complete spreadsheet of issues and statistics. Every three months the dynamic at table will be different. For instance, the table next time will be all transgenders, the group after that all high schools students, etc. It is through these candid and real conversations we develop a more practical and effective strategy to end AIDS.

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Join the fight! Join the Campaign to End AIDS!

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From our friends at AIDS United

Your action is important: Members of Congress have drafted three letters currently circulating in the House of Representatives to request increased domestic HIV funding. Ask your Representative today to sign these letters before their approaching deadlines. We have your Congressmember’s telephone number ready to go – just click on the link below to learn how to take action.

CALL NOW!

The letters are being circulated in the House of Representatives calling for support of Fiscal Year (FY) 2015 federal funding for domestic HIV programs. Your Member of Congress needs to know that this funding is essential to the prevention, treatment, and care of HIV by addressing all issues that affect the epidemic.

Click on the links below to read the letters:

“Support the Minority AIDS Initiative”
Sign-on Deadline: March 28, 2014
Congressional Contact: Kathleen Sengstock
Office of Rep. Maxine Waters

“Support the Ryan White HIV/AIDS Program”
Letter covers funding for the Ryan White Program, HIV prevention at CDC, STD prevention at CDC, HIV funding at NIH, and language to allow use of federal funds for syringe exchange programs.
Sign-on Deadline: March 31, 2014
Congressional Contact: Alyssa Penna
Office of Rep. Bill Pascrell

“Support AIDS Housing in FY15”
Sign-on Deadline: March 31, 2014
Congressional Contact: Melissa Connolly
Office of Rep. Jerrold Nadler

These three “Dear Colleague” letters have been sent to each Member of Congress. Ask your Congressmember to sign the letters by their respective deadlines, listed above. Please have them contact the Congressional staff listed as the contact for each letter to add their name. These letters are signed only by Members of Congress.

The deadlines for these letters are approaching fast. Your immediate action is needed.

CALL NOW!

Thank you for your participation. Your involvement makes a difference!

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From our friends at SHNNY

Call Congress Today to Sign On to Support HUD Programs!

With an Executive Budget proposed by President Obama earlier this month, our attention has now turned to the House and Senate budgets for the 2015 fiscal year. Several “Dear Colleague” letters are now in circulation to support funding increases for key programs that impact the supportive housing world. We urge you to call your elected officials and call on them to sign on in support. For a rundown of key programs within the US Department Housing and Urban Development (HUD), see below.

How? Call the Capitol Switchboard at 202-225-3121 and ask for your Senator or Representative’s office!

McKinney-Vento Homeless Assistance
Rep. Gwen Moore is leading a sign-on letter for her colleagues in the House of Representatives in support of the President’s request of $2.405 billion in funding for HUD’s McKinney-Vento Homeless Assistance Grants in FY 2015. The deadline for representatives to join the letter is April 4. Members of the House can sign on to the letter by contacting Sean Gard of Rep. Moore’s office.

Similarly, Senator Jack Reed is circulating a sign-on letter in the Senate in support of funding for McKinney programs in FY 2015. The deadline for senators to sign on to the letter is April 1. Members of the Senate can join by contacting James Ahn in Senator Reed’s office.

Housing Choice Vouchers
New York Rep. Jerold Nadler’s Dear Colleague letter supports increased funding for Housing Choice Vouchers. In order to restore all lost Housing Choice Vouchers (HCV) due to sequestration, HUD needs an additional $320 million above the President’s budget request. The deadline for the letter is March 31. The contact in Rep. Nadler’s office is Melissa Connolly.

HOME Program
Rep. Marcia Fudge and Sen. Patrick Leahy are both circulating Dear Colleague letters on the HOME Program. The House letter requests a return to fiscal year 2011 levels of $1.6 billion for the HOME Program. The Senate letter requests a funding increase to $1.2 billion for fiscal year 2015. Both letters represent an increase over the President’s request of $950 million. The deadline for the House letter is March 26, and the contact in Rep. Fudge’s office is Jacob Gelman. The deadline for the Senate letter is March 28, and the contact is Lauren Bracket.

Veterans Affairs Supportive Housing (HUD-VASH)
New York Rep. Michael Grimm is leading a bipartisan effort with Rep. Al Green and Rep. Mike Michaud to support the President’s request of $75 million for 10,000 new HUD-VASH vouchers. The deadline to sign on is March 27. The contact at Rep. Green’s office is Gregg Orton.

Time is of the essence for these programs. Please call your representative and senators TODAY and urge them to sign on to these four important letters! Call the Capitol Switchboard at 202-225-3121 and ask for your Senator or Representative’s office!

If you have questions, please call:

Stephen Piasecki
Upstate Coordinator
Supportive Housing Network of New York
518-465-3233

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Image: UNAIDS

By Claire Hughes for the Times Union

Albany

The state has negotiated a deal with a major pharmaceutical company to cut the price of anti-retroviral drugs to treat HIV, state Health Commissioner Nirav R. Shah said Wednesday.

The move is part of an evolving state plan to reduce the number of New Yorkers infected with the virus that causes AIDS.

On Wednesday, Shah told cheering AIDS activists at the Legislative Office Building that the state aims to cut the number of newly diagnosed cases from about 3,400 in 2012 to under 730 by 2020.

About 130,000 New Yorkers currently live with HIV or AIDS.

Activists said the deal with California-based drugmaker Gilead Sciences Inc., which Shah estimated has a 40 percent market share in anti-retrovirals for HIV, should push other manufacturers to follow suit.

State health officials are “doing a very bold move of pressuring drug companies to lower the price of AIDS drugs,” said Sean Barry, executive director of New York City-based Voices of Community Activists and Leaders (VOCAL-NY).

The state is a high-volume purchaser of the drugs. More than 60,000 New Yorkers with HIV are covered by the government-sponsored Medicaid program. More may seek HIV testing or treatment with the expansion of Medicaid through the Affordable Care Act.

Controlling the illness and its spread is cost-effective, the health commissioner said.

“Every new case of HIV results in $379,000 in additional lifetime costs” to treat the patient, Shah said.

Other goals, he said, include reducing by half the number of New Yorkers progressing from HIV to AIDS and addressing social conditions that contribute to the prevalence of the disease among low-income people.

Key to reaching the objectives is increasing the number of New Yorkers with HIV who have the virus under control, said Dan Tietz, executive director of the New York City-based AIDS Community Research Initiative of America. This means they are receiving treatment, retain an undetectable level of the virus and have a minimal chance of infecting others. Tietz called for doubling the percentage of patients who fall into this category, now at 40 percent to 50 percent of infected people.

Shah touted the progress made fighting AIDS in New York, which was “the leading incubator of the disease” 30 years ago, he said. Prevention and treatment efforts have led to a 40 percent reduction of new HIV cases and AIDS-related deaths in the last decade. Out of 240,000 births in New York last year, just two babies were born with HIV transmitted from their mothers, he said.

The state’s plan also would simplify the consent needed for HIV testing — from written to verbal — and the sharing of medical data, Shah said.

The health commissioner’s remarks were met with deafening applause and exuberance — a far cry from the antagonism in past interactions between state officials and AIDS activists.

“That Dr. Shah can stand there and get this applause is another step forward — it’s huge,” Barry said.

Gov. Andrew Cuomo’s proposed state budget calls for $9 million to support a rent cap for disabled New York City residents with AIDS.

With the Gilead deal sealed, the governor may disclose further details of the state’s plan to reduce HIV infection to point where the virus would no longer be deemed epidemic, Shah said.

“It’s going to happen,” Shah said. “It’s a matter of ‘when,’ not ‘if.’”

chughes@timesunion.com • 518-454-5417 • @hughesclaire

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Ready to see a commitment to the end of AIDS in your state?? Join the Campaign to End AIDS today!

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Image: ‘Violence against women’, by Gaetano Salerno, 80×60cm, 2013

By Catherine Russell & Deborah von Zinkernagel for HuffPost

Addressing Violence Against Women and Children Is Critical to Achieving an AIDS-Free Generation and the Millennium Development Goals

During this week’s 58th session of the United Nations Commission on the Status of Women, the global community will come together to reflect on key achievements and challenges in advancing progress toward the Millennium Development Goals (MDGs) for women and girls. This provides an opportune moment to examine the impact of one such challenge: violence against women and girls.

Violence against women and girls has impeded progress on nearly every MDG. This includes efforts to reach the MDG 6 target of halting and beginning to reverse the spread of HIV/AIDS—an epidemic that still disproportionally affects women and girls in many countries. According to the World Health Organization (WHO), one in three women worldwide has experienced physical and/or sexual violence in her lifetime. Women who experience violence also often face serious health consequences, including higher rates of unintended pregnancies, mental health problems, and sexually transmitted infections (STIs), including HIV.

Significant evidence linking violence against women and HIV has emerged over the past decade. A recent analysis by the WHO shows that intimate partner violence increases women’s risk for HIV infection by more than 50 percent, and in some instances by up to four-fold. Violence also affects women’s willingness to seek HIV testing and counseling or to stay on lifelong anti-retroviral treatment. Studies in multiple countries have also found that adolescent girls who experience sexual violence are up to three times more likely to acquire HIV or other STIs. These are among the many reasons why, through a new consolidated Gender Strategy, the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) will require all its country programs to report the number, age, and sex of people that they support in accessing post-gender-based-violence care, as part of a comprehensive HIV/AIDS response.

We also recognize that every year up to one billion children face some form of violence. These experiences can impede their progress toward realizing healthy and productive futures—affecting everything from their ability to succeed at school to their vulnerability to infectious diseases, such as HIV. As girls enter adolescence, they are more vulnerable to the same types of violence experienced by women—namely sexual violence and intimate partner violence. Young and adolescent girls are also vulnerable to early or forced marriages and harmful practices such as female genital mutilation/cutting.

Early marriage is devastating to a girl’s health and education, and exposes her to greater risk of abuse and violence. Girls who marry young and bear children are five times more likely to die during pregnancy or childbirth than women over the age of 20. The UN Population Fund states that every year 2 million girls between the ages of 10 and 14 give birth, and over 90 percent of these take place within marriage or some other form of union. Further, women who experienced violence as children are more likely to be in violent relationships as adults. Boys who experience or witness violence as children are also more likely to perpetrate violence in adulthood.

Launched in 2009, Together for Girls (TfG) is an innovative public-private partnership that is supporting efforts to addresses violence against children, particularly girls, by gathering data on its magnitude, nature, and consequences, and using these data to help mobilize national governments to take greater action. TfG brings together private sector partners, United Nations agencies, and the U.S. Government—through PEPFAR and the U.S. Centers for Disease Control’s (CDC) Division of Violence Prevention, and in collaboration with the State Department’s Office of Global Women’s Issues.

Working with the CDC, TfG has provided national data on violence against children through the Violence Against Children Survey (VACS). For the first time, VACS have already been completed in four countries, and are at various stages of development and implementation in seven more, including in Haiti and Malawi. Results from completed VACS reveal that 26 to 38 percent of women and girls have experienced sexual violence before age 18, and well over half of them experienced more than one such incident. Moreover, 23 to 53 percent of women and girls reported that their first sexual intercourse before the age of 18 was unwanted. This is simply unacceptable.

Due in part to these findings, countries are stepping up their efforts to address violence against women and girls. Swaziland has launched a database to track cases of violence, has established courts that are friendly to women and girls, and is increasing post-rape care through one-stop centers. Governments in Tanzania, Kenya, and Zimbabwe are scaling up national violence prevention and action plans. In Nairobi, Child Protection Centres have been expanded to reach more than 2,200 children with protective services.

The U.S. government and its partners are deeply committed to helping address violence against women and girls, including by supporting countries that want to tackle these issues head-on. This is critical not only to ensure that all individuals can participate fully and safely in their families and communities, but also can access HIV-related and other essential health services. We are pleased to see the growing momentum around these issues, and hope that additional governments and partners will take similarly strong steps so that, ultimately, we can bring the global scourge of violence against women and girls to an end.

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Join the Campaign to End AIDS today!

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By Gus Cairns for HuffPost United Kingdom

The PARTNER study doesn’t just tell us that HIV-positive gay guys on treatment are pretty safe. It tells us that they’re safer than a lot of ‘HIV negative’ guys.

The big news at last week’s HIV conference in Boston was a thing that didn’t happen. A trial, the PARTNER study, found that no one, gay or straight, who had HIV but was on successful treatment transmitted the virus to their partner over the two years the trial has so far lasted. And that’s in people largely not using condoms. As Tyler Curry writes in his blog, this is big news.

One of the researchers said that they’d have expected 86 transmissions between partners, or thereabouts, if none of the HIV positive people was on treatment. It was no big surprise that instead they saw none, since successful HIV treatment reduces the amount of HIV in your system ten-thousandfold or more.

To those less acquainted with the workings of HIV, and more surprised by the news, you’d think this would be cause for celebration. In the gay community, however, the news was received by many with disbelief (“This is bullshit science” said one) or downright fear.

Take someone Tyler Curry quotes. “HIV undetectable (people) will use it as excuse to bareback” [Yes, but terms solely of HIV risk, the PARTNER study is telling us it won’t matter if they bareback] “or skip their daily antiviral meds” [Why in God’s name would they want to do that?] “Then become re-infected creating a super bug of HIV that current meds can’t treat” [Run for the hills].

A couple of ‘Yes, But’s. Firstly, the reason the trial does need to be continued in gay men is because so far we only have relatively few people in it.

A proper scientist, unlike me, would say something like this: “Seeing zero transmissions allows us to estimate that the true risk of transmission lies somewhere between zero and 1% a year” – not that comforting if taken over ten years.

But that caveat is about the fuzziness of the picture we have, and not about the thing it shows, namely nothing. Researchers expect that with more people and time, and barring nasty surprises, the maximum estimate of risk will probably edge ever closer to zero.

A bigger ‘Yes, But’ is this: the PARTNER scientists are keeping another figure close to their chest: the number of HIV infections the negative guys actually got. They hinted there were quite a few, and probably a lot of other STIs too. A smidgeon of HIV may come from the 5% or so of positive partners who were unlucky enough to have treatment failure. But the vast majority will come from sex with guys outside the main relationship. Mainly, probably, guys who thought they were HIV negative.

And here we get to the heart of the meaning of the PARTNER study. It confirms that we gay men have to change our ideas about infectiousness and HIV radically if we are to stand a chance of reducing HIV infection in our community.

Valerie Delpech is one of British science’s hidden treasures (except she’s Australian), an epidemiologist who sifts through every shred of evidence from her lab at Public Health England (do epidemiologists have labs? I’m not sure).

Last September she showed a presentation at a conference – it’s here. Now, readers, turn to slide 14. What this shows is that of HIV-positive guys you might encounter while dating, two-thirds will know they’re positive but won’t be infectious: but of the infectious ones, two thirds will think they’re HIV-negative.

I’ll repeat that. If you’re a gay Brit, two-thirds of the guys who could give you HIV think they don’t have it.

Given that in London one in seven gay men has HIV, this means that [taps calculator]:

~ one in every 32 men you may meet dating thinks he’s HIV negative and can’t give you HIV when, in fact, he can;
~ one in every 44 men you may meet dating knows he has HIV, and is infectious. The other poz guys aren’t.
Ergo: Guys who tell you they’re positive are safer than guys who tell you they’re negative. QED.

So, with all this new-found knowledge, the way to avoid HIV is simple, eh?

[At this point someone usually says “Yes, use a condom every time,” so I will interrupt this broadcast with this brief message. Ahem:

- CONDOM DISCLAIMER: Condoms are a jolly good idea. They protect against lot of other nasty diseases as well as HIV. If I had casual sex I’d use a condom. They should be widely available and cheap. Nothing in this article should be construed as hostility to condoms or undermining gay men’s motivation to use them. If you use condoms 100% of the time, great. This isn’t about you or for you. It’s for the 40% or so of gay guys who have sex with new partners without condoms. Thank you.

Now back to our broadcast]:

So, with all this new-found knowledge, the way to avoid HIV is simple, eh? If you’re an HIV negative guy and you don’t use condoms every time with a new date, then just date HIV-positive guys on treatment. They’re very unlikely to infect you.

Hahahahahah. Excuse me while I pick myself off the floor.

Because we all know how most HIV-negative guys who don’t use condoms with new partners avoid HIV, don’t we? They ask if you’re ‘clean’ or ‘disease free’ and then won’t touch you with sterilised tweezers if you fess up to being poz.

Don’t take my word for it. Another study at last week’s HIV conference looked at all the gay guys attending the Seattle HIV clinic who were at risk of HIV (meaning that they had buttsex but weren’t monogamous and didn’t always use condoms). Most of these tried to take steps avoid HIV in other ways.

By far the most popular way – a strategy adopted by 42% of all the HIV negative men in the survey – was to never, ever have sex with a poz guy, period.

I’m not saying that HIV-negative guys aren’t allowed to think twice and ask questions if someone discloses HIV. No-one’s entitled to sex, least of all this greying 57-year-old here.

But I do wish the message would get across that if I say I’m vanishingly unlikely to infect you because I’m on the pills, I’m telling you the simple truth, not using my evil seductive wiles to get you into the poz club.

A lot of poz guys do lie about their status – because they’re afraid of rejection. The saddest study at the conference was a German one. It asked poz guys if they believed their undetectable viral load made them non-infectious and if so, whether they based condom decisions on it.

Only 10% admitted to doing this but that 10% were far more likely to have condomless sex (natch – they don’t think they’re infectious). But they were also far less likely to disclose they had HIV, far less likely to raise the subject at all, far more likely to have anonymous sex.

‘Undetectable=uninfectious’ wasn’t, for them, a belief that spurred discussion about HIV status and viral load. It was an excuse to avoid any discussion at all, and the rejection that comes with it.

When the first study came out showing the power of HIV treatment to reduce infectiousness, the hope was expressed that it might reduce the stigma against people with HIV. It hasn’t happened. It’s just so much easier to avoid visible people than an invisible virus.

The real danger of the Reject All Poz Guys strategy is not so much the ‘serodivide’ it perpetuates in the gay community – though that’s damaging enough – but more that it reinforces the idea ‘If he says he’s negative he’s safe’.

In an HIV epidemic where half of those who pass on HIV have themselves had it for less than six months, basing your dating decisions on someone assuring you they don’t have HIV is downright daft. The price of that strategy may be what we see: a undiminished rate of infection in gay men.

You might call it Dangerouser Sex.

Follow Gus Cairns on Twitter: www.twitter.com/guscairns

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Join the Campaign to End AIDS today!

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Urge Your House Representative To Sign Important Dear Colleague Letter

Representatives Mike Honda, Hank Johnson, and Judy Chu are asking all House Representatives to sign an important letter supporting increased funding for viral hepatitis programs in the Fiscal Year 2015 appropriations bill (see text of letter below).

Please take a few minutes before March 25th to call your House Representative’s office in Washington, DC and ask/him to sign this letter.

You can reach your Representative through the Congressional Switchboard at (202) 224-3121. Ask to be connected to your Representative. Once you are connected to the office, ask to speak to the staff person who handles health care issues. Whether you speak to that person live or leave a voicemail, tell them (1) your name, (2) where you live and that you are a constituent, (3) that you would like the Representative to sign the “Dear Colleague” letter from Representatives Honda, Johnson, and Chu supporting increased funding for viral hepatitis and (4) a brief message why this issue is important to you. Tell them they can sign the letter by contacting Kelly Honda in Representative Honda’s office, Scott Goldstein in Representative Johnson’s office, or Linda Shim in Representative Chu’s office. The deadline for Representatives to sign is March 25th.

For more info on viral hepatitis, check out the following CDC resources!
~ Hepatitis B – General Info
~ Hepatitis C – General Info
~ HIV & Viral Hepatitis
~ Hepatitis Fact Sheet for Gay & Bisexual Men

Text of “Dear Colleague” letter from Representatives Honda, Johnson, and Chu:

Support Funding for Viral Hepatitis

March XX, 2014

The Honorable Jack Kingston
Chairman
Subcommittee on Labor, Health and Human Services
United States House
Washington, D.C., 20515

The Honorable Rosa DeLauro
Ranking Member
Subcommittee on Labor, Health and Human Services
United States House
Washington, D.C., 20515

Dear Chairman Kingston and Ranking Member DeLauro:

As you begin deliberations on the Fiscal Year 2015 Labor, Health and Human Services, Education, and Related Agencies Appropriations bill, we would like to respectfully request that you allocate $47.8 million for the Division of Viral Hepatitis (DVH) at the Centers for Disease Control and Prevention (CDC), an increase of $16.4 million over the FY2014 level.

The CDC’s 2010 professional judgment (PJ) budget recommended $90.8 million each year from FY2011-FY2013, $170.3 million annually from FY2014-FY2017, and $306.3 million annually from FY2018-FY2020 for DVH in order to comprehensively address the viral hepatitis epidemic. While past increases have been helpful, these have only been small steps toward building a more comprehensive response to viral hepatitis. Our recommendation of $47.8 million is in line with the needs determined by the PJ and the goals of the Viral Hepatitis Action Plan, but pales in comparison to the CDC’s PJ.

The need to enhance and expand these prevention efforts is growing more urgent. Viral hepatitis is the leading cause of liver cancer – one of the most lethal, expensive and fastest growing cancers in America. More than 5.3 million people in the U.S. are living with hepatitis B (HBV) and/or hepatitis C (HCV) and 65-75% of them are undiagnosed. Without an adequate, comprehensive surveillance system, these estimates are only the tip of the iceberg. Viral hepatitis kills 15,000 people each year and is the leading non-AIDS cause of death in people living with HIV – nearly 25 percent of HIV-positive persons are also infected with HCV and nearly 10 percent with HBV.

The epidemic is particularly alarming because of the rising rates of new infections and high rates of chronic infection among disproportionately impacted racial and ethnic populations, and presents a dramatic public health inequity. For example, HCV is twice as prevalent among African Americans as among Caucasians. Asian Americans comprise more than half of the known hepatitis B population in the United States and, consequently, maintain the highest rate of liver cancer among all ethnic groups. Additionally, African American and Latino patients are less likely to be tested for HCV in the presence of a known risk factor, less likely to be referred to treatment for subspecialty care and treatment, and less likely to receive antiviral treatment. Recent alarming epidemiologic reports indicate a rise in HCV infection among young people throughout the country. Some jurisdictions have noted that the number of people ages 15 to 29 being diagnosed with HCV infection now exceeds the number of people diagnosed in all other age groups combined.

Further, the baby boomer population (those born 1945-1965) currently accounts for two out of every three cases of chronic HCV. As these Americans continue to age, they are likely to develop complications from HCV and require costly medical interventions that can be avoided if they are tested earlier and provided with treatment options. It is estimated that this epidemic will increase costs to private insurers and public systems of health such as Medicare and Medicaid from $30 billion in 2009 to over $85 billion in 2024, and also account for additional billions lost due to decreased productivity from the millions of workers suffering from chronic HBV and HCV.Over the last two years, CDC and the U.S. Preventive Services Task Force (USPSTF) have begun to align their recommendations for hepatitis screening, recommending one-time testing of baby boomers and screening vulnerable groups for HCV.

We appreciate the Committee’s support for viral hepatitis prevention, in particular the increased support to prioritize the identification of HBV and HCV-positive individuals who are unaware of their status. We strongly encourage you to sustain your commitment this year. We have the tools to prevent the major causes of viral hepatitis and liver cancer – a hepatitis B vaccine and effective treatments that reduce disease progression, new diagnostics for HCV and treatments that increase cure rates over 90%, and even more medical advances in the research pipeline. Making this relatively modest investment in the prevention and detection of viral hepatitis represents a key component in addressing a vital public health inequity and will get more Americans into care, strengthen our public health infrastructure and combat the devastating and expensive complications caused by viral hepatitis.

Sincerely,
xxx

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REGISTRATION / SCHOLARSHIP APPLICATIONS NOW OPEN:

NATIONAL HIV IS NOT A CRIME CONFERENCE

June 2–5, 2014 at Grinnell College, Grinnell, Iowa

Register now! Click Here.

HIV, LGBT, AND SOCIAL JUSTICE GROUPS UNITE TO END HIV CRIMINALIZATION

GRINNELL, IA, March 14, 2014 — Registration is open for the first-ever national HIV is Not a Crime conference convened to unite and train advocates living with HIV and allies from across the country in the effort to end the criminalization of people with HIV. The gathering will be held from June 2nd to 5th, 2014, at Grinnell College in Grinnell, Iowa.

“We expect to a see diverse range of attendees who are working or volunteering for grassroots community groups or organizations across the country,” said Robert Suttle, one of the conference organizers and a person living with HIV. “We’re asking community organizations to assist us with raising funds to provide need-based scholarships, because every person that attends will help strengthen our movement to educate the community and advance advocacy for criminalization reform,” Suttle added.

The conference will empower attendees with three days of workshops and practical trainings on state advocacy, grassroots organizing, activism, and familiarity with the legal, medical, media, and public health issues related to HIV criminalization. As a result of the HIV Is Not A Crime conference, individual and organizational participants will be better equipped to initiate or advance advocacy in their home states addressing HIV-related criminalization, stigma and discrimination. The conference will help to rebuild and reenergize state-based HIV advocacy efforts.

Registration and scholarship information can be found on the conference website: www.HIVIsNotACrime.com. Scholarship applications must be submitted by April 7th.

HIV criminalization refers to the wrongful use of one’s HIV positive status in criminal prosecutions, which has led to people with HIV being charged under HIV-specific criminal statutes, or under general criminal statutes, including for behaviors that pose no or little risk of HIV transmission. Sentencing in these cases has sometimes involved decades in prison and/or required sex offender registration, including in circumstances when there was no risk of HIV transmission.

These laws, policies and practices contribute to the HIV epidemic by driving people away from public health and treatment programs and by discouraging at-risk individuals from getting tested.

To get involved or request information on the conference program, registration, and scholarship details, contact conference@seroproject.com.

Register now for the HIV Is Not A Crime Conference!

Get the latest conference news on Facebook!

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Image: sharedjustice.org

By Nazihah Siddiqui for Chicago Policy Review

Medicaid is the nation’s largest source of health coverage, providing health insurance for nearly 54 million Americans. While the program is framed as one designed to improve access to healthcare and even improve health, its impact on poverty reduction has not been as well researched. A recent study, however, reveals the significant poverty-reducing effects of Medicaid and finds that in a comparison against other government programs, Medicaid is the third largest anti-poverty program in the United States, behind only the Earned Income Tax Credit and the Supplemental Nutrition Assistance Program. These poverty-reducing effects have broad implications for families and individuals in metropolitan areas, where Census figures show that people had a higher likelihood of struggling financially; here in the Chicago metro area, 14.5 percent of residents were considered in poverty in 2012.

The data show that Medicaid reduces medical out-of-pocket spending from $871 to $376 on average per beneficiary.
In the article “The Poverty-Reducing Effect of Medicaid” economists Benjamin Sommers and Donald Oellerich use a counterfactual model to assess the impact of eliminating Medicaid on poverty. The data show that Medicaid reduces medical out-of-pocket spending from $871 to $376 on average per beneficiary. The authors attribute this reduction in out-of-pocket spending to generous benefit plans, the absence of premiums, and lower cost sharing requirements in comparison to private insurance. The data shows that the reduction in out-of-pocket spending decreases poverty rates by 1.0 percent, 2.2 percent, and 0.7 percent among children, disabled adults, and the elderly, respectively. Medicaid also kept an additional 500,000 institutionalized persons out of poverty in 2010.

In order to approximate the impact of Medicaid on finances, Sommers and Oellerich model overall out-of-pocket spending using two analytical approaches. The preferred stochastic model, which relies on random variation, uses propensity score matching to account for both the in-kind transfer and risk protection effects of Medicaid. The stochastic technique attempts to estimate the impact of Medicaid by controlling for confounding variables in order to render groups with and without Medicaid coverage more comparable. Random values of out-of-pocket spending drawn from individuals without Medicaid are then assigned to each person with Medicaid coverage. Sommers and Oellerich derive the data used in their analysis from the 2011 Current Population Survey (CPS).

Using the preferred model to estimate the net change in percentage and number of people who would be living in poverty and extreme poverty in the absence of Medicaid reveals that in 2010 the program kept 2.1 million Americans out of poverty and 1.4 million out of extreme poverty. The absence of Medicaid is also associated with a $495 increase in out-of-pocket spending from $376 to $871 on average, and a six percent decrease in family income with a disproportionate impact on disabled adults, children, the elderly, and racial and ethnic minorities. The number of people reporting Medicaid coverage in the CPS is lower than the number of people in the state enrollment files; it appears that the actual poverty-reducing effect of Medicaid may be even greater than the numbers show.

Sommers and Oellerich also performed subgroup analyses, calculating changes in poverty rates and out-of-pocket spending associated with Medicaid across race/ethnicity, gender, and Census region. The results reveal that the poverty-reducing effects of Medicaid are greatest for minorities (“blacks and Hispanics”) and women, confirming the findings that these two populations make up a disproportionate share of Medicaid enrollment. The analysis also shows some differences across Census regions, with the greatest share of poverty reduction in the Northeast and the smallest in the Midwest.

As previously noted, the implications of the poverty-reducing effects of Medicaid are significant for major metropolitan areas that are home to a large percentage of low-income families and individuals. Potential Medicaid expansion under the Affordable Care Act (ACA) would lead to a decline in out-of-pocket spending among the newly enrolled, as Medicaid expansion is expected to increase the number of poor and near poor enrolled in the program by 10-20 million. In contrast, states that have opted out of Medicaid expansion through the ACA, where eight million impoverished and uninsured Americans are therefore ineligible for help, are unlikely to see a reduction in poverty.

Further efforts to reduce benefits or increase cost sharing, as is the case in states such as Illinois, which reduced the number of prescriptions covered for enrollees to four per month and imposed a co-pay for prescriptions for non-pregnant adults in 2012, would increase the financial burden on low-income populations and may have a substantial impact on Medicaid enrollment. This, in turn, could have negative repercussions on poverty rates throughout the region. With these recent policy decisions in mind, the findings of Sommers and Oellerich reveal the importance of Medicaid as a tool for poverty reduction and provide important evidence for policy makers at both the state and federal level on the need for sustained dialogue around Medicaid expansion.

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Image: John Amis/AP Images for AIDS Healthcare Foundation

By Julie Appleby for Kaiser Health News

New treatments for hepatitis C that cost at least $66,000 to $84,000 may work better than older drugs, but their cost undermines their value to the health system, a panel of experts said during a daylong forum in San Francisco.

“The price makes it very hard for the health care system,” said Steve Pearson, who oversaw the meeting Monday for the California Technology Assessment Forum, a group affiliated with health insurers that holds public meetings to weigh evidence on new treatments.

The 15-member panel, which included representatives of hospitals, insurers and patient advocates, did not make specific recommendations on how to prioritize use of the drugs, which hit the market late last year. Sovaldi, made by Gilead Sciences, costs $1,000 a pill. Slightly less expensive is Olysio, made by Johnson & Johnson.

Panel members and outside experts nearly all agreed that for cost and medical reasons, not every patient with hepatitis C needs to be immediately treated with the new drugs. An estimated 3 million Americans carry the viral infection.

“I can’t imagine how that would be feasible without bankrupting our system,” said Rena K. Fox, a professor of medicine at the University of California, San Francisco, invited by the forum to speak as an outside expert.

“What I really wish for is that we could push back on the price, rather than make patients wait. But since we don’t have the ability to change the price, we have to decide which patients are the most urgent.”

Drugmakers defend the prices citing research costs and saying the pills are curative for many patients, thus avoiding costly complications like transplants.

Both outside experts and some panel members said that waiting might be a better answer for some patients – particularly those with little or no liver damage – because additional treatments are expected to hit the market within a year. Patients with more advanced liver damage from the virus would be treated first.

Healthier people had also waited to use the older drugs, hoping for something to come along that would have fewer side effects.

Hepatitis C is a chronic infection that can take years or decades to progress. Over time, it can lead to cancer, cirrhosis or the need for a liver transplant. At least 70 percent of those infected have no symptoms. It is spread mainly by intravenous drug use, but many people were unknowingly infected by poorly sterilized medical equipment and blood transfusions before widespread screening of the blood supply began in 1992. Some may also have been infected through tattoos and piercings with contaminated needles.

But patients may not want to wait, said Ryan Clary, executive director of the National Viral Hepatitis Roundtable, a consumer group partially funded by the drug industry. Television advertisements sponsored by Gilead are encouraging people to be screened for hepatitis and to talk with their doctors about new treatment options.

“If I was hepatitis C-positive and someone said there’s this great treatment, but can you hold off because you’re healthy and it might bankrupt the system … patients don’t think like that,” said Clary, another outside expert asked to speak at the forum.

Private insurers, as well as those serving Medicaid patients, are wrestling with how to cover the new drugs. Many say they will require prior authorization and may limit coverage to the sickest patients. Some Medicaid insurers have asked states for additional help in paying for the drugs.

A draft report prepared in advance of the San Francisco forum estimates that if every patient in California with advanced liver damage were treated, the cost would be $6.3 billion.

Recommendations that stemmed from Monday’s meeting – including the panel’s votes on a host of questions about the effectiveness of the new treatments compared with older regimens – will be released within a month.

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By Mikola De Roo for the Housing Works’ AIDS Issues Update Blog

Nine human-rights and LGBT advocates were arrested today after blocking the entrance to the Consulate General of Nigeria in Midtown Manhattan. This act of civil disobedience was to protest the draconian anti-LGBT law signed by Nigerian President Goodluck Jonathan on January 14, a law that makes gay marriage and same-sex relationships crimes punishable by up to 14 years in prison. The protestors’ demand was simple: to rescind the law and let LGBT Nigerians live their lives free of discrimination and violence.

The action was part of a larger rally attended by nearly 400 protestors, including many Housing Works staff, clients, and volunteeers. The demonstration, organized by the Nigerian Solidarity Alliance, brought together nearly a dozen prominent human rights, immigrant, and LGBT advocacy organizations to co-sponsor the event, including amfAR, Housing Works, ACT UP, GMHC, and Immigration Equality.

Among the rally speakers was Nigerian activist and Housing Works social worker Michael Ighodaro, who sought asylum in the U.S. in 2012 after a violent attack and death threats at home. Ighodaro expressed his hope that the outcry of visible and widespread public support will ensure things improve and that the hatred and violence he and other Nigerians face abroad doesn’t last. “I am Nigerian by birth, just as I am gay by birth,” said Ighodaro. “I was born gay. And I am now American, grateful to find safety and support here but far from the home where I belong, because my own government says who I am and who I love is a crime.”

In his speech at the demonstration, Housing Works President & CEO Charles King described the devastating, domino effect of these anti-LGBT laws and the culture of intolerance, homophobia, and violence being fostered by them:

“We have gathered today to demonstrate our solidarity with the lesbian, gay, bisexual, and transgender community of Nigeria and with their families and friends. We stand today not only in solidarity with this community, but also with the same communities in Uganda, in Cameroon, in Jamaica, with the young black gay man in East New York, with the young transgender Latina woman in the South Bronx, indeed, with all those around the globe, wherever they may dwell, who live in fear, who are forced from their homes, who suffer violence and indignities upon their person because of who they are or whom they love.”

King went on to note that the resulting shutdown of lifesaving HIV services at LGBT organizations in Nigeria, where an estimated 3.4 million people live with HIV, is also of grave concern. “This law has driven people who are most at risk of HIV further underground,” King asserted. “People who are living underground will not come forward to risk being tested. People who are infected with HIV will not risk coming forward for treatment. By driving people underground, we are driving the epidemic underground, where it will continue to flourish and spread…We have within our grasp the science and the technology to end AIDS as an epidemic around the globe. Sadly, we do not have the science nor the technology to end hate…That is why, at its core, the fight against AIDS is a fight for human rights and human dignity.”

WHAT YOU CAN DO TO HELP
Donate to support our advocacy work on behalf of our Nigerian friends and allies. Housing Works is taking action through its Asylum Program, which provides housing, health care, and legal support to LGBT activists from Nigeria, Uganda, and other nations who have come to the U.S. to escape imprisonment for the way they live. You can help support this program by donating today and sharing this info with your network!

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Image: AFP Photo/Jewel Samad | Getty

By Igor Volsky for ThinkProgress

House Budget Committee Chairman Paul Ryan (R-WI) released a 204-page report on Monday analyzing the effectiveness of the nation’s anti-poverty programs 50 years after President Lyndon Johnson declared a national War on Poverty.

The assessment, which is designed to kick off his campaign to revamp federal welfare programs, broadly characterizes federal aid as counterproductive and ineffective. Ryan argues that federal programs have contributed to the nation’s high poverty rate and “created what’s known as the poverty trap.” The report argues, “Federal programs are not only failing to address the problem. They are also in some significant respects making it worse.”

But a closer look at the analysis undermines the old Ronald Reagan adage, “The nine most terrifying words in the English language are: ‘I’m from the government and I’m here to help.’” As Ryan’s own analysis points out, numerous progressive-minded spending programs have helped millions of Americans and significantly reduced the nation’s poverty rate. Below are 16 examples from Ryan’s own report of how the government can help lower-income Americans make ends meet:

Veterans Health Administration is the largest single-payer health care system in the United States. The report finds that the program is “effective in providing access to inexpensive health care for low-income veterans. ”

The Child Tax Credit provides assistance to families with children. “According to the Center on Budget and Policy Priorities, the CTC protected about 2.9 million people from falling into poverty, including about 1.5 million children,” the report says.

The Earned Income Tax Credit provides cash assistance to low-income working families. Accord to Ryan, the “consensus among studies on the EITC is that it is an effective tool for encouraging and rewarding work among lower-income individuals, particularly single mothers.”

Rural Housing Assistance Grants fund the repair and improvement of rural housing units. The report finds that the grants “allow very low-income elderly homeowners on a fixed budget to remain at home and independent.”

Title X Family Planning “provides grants to states for family planning and related preventive health services, excluding abortion services.” The report found that the program is “moderately effective.” According to a 2005 OMB assessment, “women who utilize Title X (Family Planning program) services as their primary source of health care have significantly greater odds of receiving contraceptive services and/or care for sexually transmitted diseases (STDs) than women who utilize private physicians or HMOs.”

Ryan White HIV/AIDS Program provides funding to states in support of health care costs associated with HIV/AIDS treatments for individuals and families. The initiative “has been shown to fill gaps in Medicaid’s HIV/AIDS services and delivery programs,” the report found.

Housing Opportunities For Persons With AIDS provides housing assistance and supportive services for low-income people living with HIV/AIDS. The program was found to be “effective” in “assisting a vulnerable population to achieve beneficial outcome.”

Federal Health Centers provide grants to outpatient primary-care facilities. The report found “fewer racial and ethnic disparities at community health centers” and concluded that they “perform better than private-practice primary case in some cases.” What’s more, medical expenses for health center patients were found to be lower compared to patients who receive care elsewhere.

Homeless Assistance Grants provide rehousing and supportive housing to the homeless. The program has been shown to “decrease homeless and reduce costs related to health care and institutionalization.”

Low income subsidy for Medicare Part D helps low-income seniors access medications they otherwise would not use. “A 2012 study compared two groups of seniors with similar commodities and found that seniors taking advantage of the LIS subsidy were significantly more likely to take medically necessary medications than the group not enrolled in the LIS program,” the report found.

The Maternal and Child Health Services Block Grant has helped reduce infant mortality and was rated “effective” by a 2008 OMB report.

Elderly Nutrition Program funds group meals and home-delivered meals for senior citizens. “By and large, studies have found that the program is well targeted towards the low-income elderly and to those with increased risk for nutrition and health problems,” the report says.

Supplemental Nutrition Program for Women, Infants, and Children provides adequate nutrition to pregnant women, infants, and children. “Most of the academic literature supports that the WIC program increases birth weights for low-income women,” the report concludes.

School Breakfast Program increases “both nutrition and academic achievement among low-income children,” the report says, even though “it doesn’t seem to increase the likelihood that a child will eat breakfast.”

Education For Homeless Children and Youth “provides funding for states to create programs to ensure homeless children and youth have access to public education.” The initiative improves “student performance,” studies find.

Child Care and Development Fund helps low-income families afford child care. The report agrees that the subsidies “increase the likelihood of participation in the labor force” and “encourage single mothers to pursue education.”

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During AIDSWatch 2014, people living with HIV & AIDS, allies, friends, and loved ones will demand that Congress pass HR 1843 which will begin to modernize state and federal laws that criminalize and unfairly discriminate against people living with HIV & AIDS in the United States.

Join C2EA, AIDS United, Positive Justice Project, and The SERO Project for a rally on April 29th @ 11a on Upper Senate Park — We Can End AIDS: Repeal HIV Criminalization Laws Now!

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By William Petroski for the Des Moines Register

Legislation making major changes in the state’s law on the transmission of contagious and infectious diseases was approved 48-0 Thursday by the Iowa Senate.

Senate File 2297, which was sent to the House for consideration, is intended to revise a “badly outdated and draconian” law regarding the transmission of HIV, said Sen. Robert Hogg, D-Cedar Rapids, chairman of the Senate Judiciary Committee. The new law will apply to AIDS or HIV, tuberculosis, hepatitis and meningococcal disease.

The current law says that if someone exposes another person to HIV without that person’s consent, the person with HIV can be convicted of a Class B felony, punishable by up to 25 years in prison. Hogg said the present law was approved by lawmakers at a time when Americans were engaged in a hysteria over HIV and before it was known that treatment regimens could be used and appropriate precautions could be taken by people infected with HIV.

The legislation creates a revised law known as the Contagious or Infectious Disease Transmission Act and establishes crimes relating to it.

“What we are saying is that only if you intend to transmit it, and if you transmit it without the consent of the person, then you face the Class B felony,” Hogg said.

Otherwise, there are lesser penalties. In addition, there is an affirmative defense that people can use if they are doing everything their doctor has told them to do and they are doing everything that has been recommended to them by public health officials. “This is not a situation where if somebody has a disease, they have to wear a scarlet letter,” Hogg said. But at the same time, the legislation does not offer a “get out of jail free card.”

The legislation is supported by One Iowa, the state’s largest gay rights organization, and Community HIV/Hepatitis Advocates of Iowa Network, known as CHAIN. Also endorsing the bill were the Iowa attorney general’s office, American Civil Liberties Union of Iowa, the Iowa Coalition Against Sexual Assault, the Iowa Annual Conference of the United Methodist Church and the League of Women Voters of Iowa.

Sen. Charles Schneider, R-West Des Moines, supported the legislation. He said that when the justice system works best, the punishment is proportionate to the crime committed, which he believes isn’t happening now.

The legislation will encourage people to be tested and treated for infectious diseases, which will improve public health and safety, Schneider said. Furthermore, the bill will still address the most egregious cases and punish reckless transmission of diseases, he added.

Sen. Matt McCoy, D-Des Moines, said the Senate bill doesn’t make everyone happy, but he endorsed most of it. He thanked Republicans for joining Democrats in supporting the bill, saying, “We are sending a message that we will no longer stigmatize one particular group in our state.”

Supporters of the legislation cited the case of Nick Rhoades, who was diagnosed with HIV in 1998. Ten years later, he was on a potent medication that made his HIV viral load undetectable. A doctor told him he had a better chance of winning the lottery than being able to spread the virus to someone else. Rhoades wore a condom when he had sex with a partner. The other man was not infected, but the man later contacted authorities to press charges.

Rhoades was subsequently convicted and sentenced to 25 years in prison before his term was reduced on an appeal.

“This is a historic move by the Iowa Senate,” said Tami Haught, community organizer with CHAIN. She said she hopes for continued bipartisan support for the legislation in the House.

“Our work is far from over, however,” Haught added.

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Info on THIS FRIDAY’s Global Day of Action in Support of Nigeria’s LGBT Community Below the Article!

By Somini Sengupta for The New York Times

UNITED NATIONS — After Uganda criminalized homosexuality, the White House immediately warned that the law would “complicate” the country’s relationship with Washington, and the Netherlands and Norway cut off bits of development aid.

When Nigeria banned same-sex unions and began arresting those it suspected of being gay, the European Union’s Foreign Ministry sternly reminded its president of his “obligations” under international law.

And after Russia passed a measure widely seen as an effort to squelch its gay rights movement, the United Nations secretary general, Ban Ki-moon, used his speech at the Winter Olympics to condemn attacks on gays and lesbians.

The issue of gay rights has catapulted up the diplomatic agenda in recent years, as international organizations have extended rights protections to gays and lesbians and donor nations have faced new challenges in dealing with governments that discriminate.

Antigay legislation is nothing new. The United Nations estimates that 78 countries ban homosexuality, and seven countries allow the death penalty for those convicted of having consensual homosexual relationships. Until a few years ago, the issue barely registered in diplomatic affairs. Global outcry was limited to protest petitions organized by gay advocacy groups.

“What’s unique about this moment is the compassion and public attention there is at the global level,” Jessica Stern, executive director of the New York-based International Gay and Lesbian Human Rights Commission.

But to what end?

Conservative governments around the world openly flout the warnings of international leaders, developing new measures to repress their citizens based on sexual orientation. There is little that international organizations like the United Nations can do, except issue statements of concern. And rich countries like the United States confront awkward new questions about how to handle important gay-bashing allies.

Take Uganda, for instance, the recipient of significant American aid, for both the military and development. The Obama administration has said it is reviewing its aid programs to Uganda, and Secretary of State John Kerry said Friday through his spokeswoman that he had spoken to the Ugandan president, Yoweri Museveni, to reiterate that message.

Mr. Kerry earlier likened the law to South Africa’s apartheid-era ban on interracial unions. So did South Africa’s influential Anglican archbishop emeritus, Desmond M. Tutu.

But whether the United States will impose punitive sanctions on Uganda remains to be seen.

American development aid includes funding for AIDS treatment, among other things. Military cooperation is aimed in part at the hunt for the warlord Joseph Kony and dealings with terrorist groups in Somalia. A senior administration official said Friday in an interview that United States policy objectives and the interests of Ugandans were being weighed in “a thoughtful, deliberate way.”

“We have not yet made decisions,” the official said, speaking on condition of anonymity because of rules against public discussion of internal talks. “We are working on this very intensively. There will be real consequences.”

At the United Nations, Mr. Ban expressed alarm. After meeting with the Ugandan envoy last week, Mr. Ban issued a statement calling on Uganda to revise or repeal the measure, a prospect that seems unlikely. Even the United Nations needs Mr. Museveni’s cooperation on many conflicts in and around Uganda, including the one in South Sudan.

For his part, Mr. Museveni has so far played to his domestic audience, rebuffing outside meddling and saying that his country would do fine without aid. There is plenty of aid to Africa coming from China, which tends not to wag its finger about human rights.

Mr. Museveni’s bluster also showed the limits of international influence and the backlash that international support can engender.

“It’s quite common, when you see a ratcheting up of pressure from domestic groups or foreign governments,” said Laurence R. Helfer, a Duke University law professor who studies international gay rights. “There is a period of counterreaction; we’re seeing that now.”

The turning point came in 2011, when the United Nations Human Rights Council passed a landmark resolution, led by South Africa, to extend human rights principles to lesbians and gay men around the world.

Mr. Ban became known as a forceful advocate. In January, he issued a statement about the Nigerian law, calling it a breach of fundamental human rights. He also posed for a photograph holding a placard that read, “Human rights are for everyone, no matter who you are or who you love.”

Around the same time, defending gay rights became a foreign policy priority for the United States and the European Union. European donors increasingly looked askance at countries that criminalized homosexuality. And last fall at the General Assembly ministers from 10 countries and the European Union endorsed the statement “Those who are lesbian, gay, bisexual and transgender (L.G.B.T.) must enjoy the same human rights as everyone else.”

It is another thing, though, to deal with countries that violate those principles.

Nigeria’s president, Goodluck Jonathan, signed into law in January a measure that effectively outlaws pro-gay organizations; since then, arrests of gay Nigerians have multiplied. The Obama administration condemned the law but has so far taken no concrete measures against Nigeria, one of its most important partners in West Africa.

The issue is divisive not only with Africa but also with traditional American allies in the Middle East like Saudi Arabia, where homosexuality is a crime.

After India’s highest court affirmed a criminal ban on homosexuality in December, the Obama administration did not specifically condemn the court decision, except to express its concern about measures that criminalized homosexuality.

It is something of a paradox that some of today’s antigay laws reflect considerable Western influence. American evangelists have played a crucial role in fomenting Uganda’s strong antigay sentiments. The Indian law criminalizing homosexuality dates to the early days of the British colonial era.

One of the most difficult issues for donor countries is whether to cut off aid, especially when it goes to promoting H.I.V. prevention and treatment in countries like Uganda.

As for the United Nations, the issue of gay rights remains so complex that its advocates are moving exceptionally slowly. There is no treaty that enshrines gay rights, for instance, and therefore nothing to hold countries accountable to. “There is a recognition that something is needed,” José Luis Díaz of Amnesty International said. “There is also a recognition that there is huge resistance, and you need to move ahead on this very, very carefully.”

The United Nations is no more than a collection of sovereign nations. And every country is free to enact its own laws, as Jan Eliasson, the deputy secretary general of the United Nations, pointed out, even laws that clash with principles of human rights.

“Our job is to diminish the gap between the world as it should be and the world as it is,” he said in an interview, adding, “Our mechanisms of enforcement are very limited.”

~ ~ ~ ~ ~

Calling All U.S.-based Advocates! Join the Global Day of Action on FRIDAY, MARCH 7 In support of Nigeria’s LGBT Community

What You Can Do To Participate:

Be There: Join advocates this Friday, March 7 from 11am-1pm ET at the Nigerian consulates in either NYC or DC:

~~ Nigerian Consulate of New York ~ 828 2nd Ave | New York, NY 10017 ~~
~~ Nigerian Embassy DC ~ 3519 International Ct NW | Washington DC 20008 ~~

Be There Online: Tweet using the hashtag #IStandw9wjaLGBT to show your support on social media.

Get Others to Be There: Share this widely with your networks and encourage them to take action on Friday, March 7.

~ ~ ~ ~ ~

Join the Campaign to End AIDS today!

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By Jeremy Lybarger for The Advocate

The city that was once the deadly AIDS epicenter of the world is now striving to be AIDS-free. What does that mean, and why is San Francisco poised to achieve this goal the way no other American city could?

This all began with a visit to Ward 86, the nation’s oldest HIV/ AIDS clinic. Founded in 1983 at San Francisco General Hospital, Ward 86 was, for many years, a death camp with a dreamy view of palm trees and California sky. In the early ’80s, the average life expectancy of patients admitted there was 18 months—it was where people went to die. It was ground zero in America’s battle with AIDS, and where so much of the epidemic’s early iconography was crystallized: rag-and-bone bodies wasted from pneumonia or encephalitis, catatonia, seizures, bedside vigils. It seemed only appropriate to begin where the epidemic began. Jeff Sheehy, the ward’s communications director, is courteous but puzzled.

“There’s really nothing much to see,” he says. “It’s just a clinic.” Sheehy’s response would have been unimaginable 20 or 25 years ago, but something epochal has happened both in modern science and in the city of San Francisco. While there is still no cure for AIDS, and the rate of new HIV infections has remained relatively stable, the city is redoubling its assault on the disease that has claimed the lives of more than 19,000 of its residents. Inspired by Hillary Clinton’s 2011 speech at the National Institutes of Health, in which then-Secretary of State Clinton rallied for “an AIDS-free generation,” and emboldened by recent breakthroughs including PrEP and antiretroviral therapy (ART), San Francisco is committed to being the first city to reach zero—zero new HIV transmissions and zero AIDS patients.

There is fierce competition here, especially in the last decade as AIDS researchers have glimpsed a kind of epidemiological horizon. A cure seems all but inevitable. There’s the case of Timothy Ray Brown, the “Berlin patient” who was deemed functionally cured of HIV after receiving a 2006 stem cell transplant to treat leukemia. (Brown has since relapsed and returned to ART, but the treatment nevertheless renewed investigations into cures). There’s the announcement, made at the 2012 International AIDS Conference, that 14 French HIV patients who started an ART regimen months after infection subsequently quit taking the medication with no surge in their viral loads. In April 2013, London’s Daily Telegraph reported that a team in Denmark was experimenting with strategies to rout HIV from human DNA for the purpose of nuking it with immunotherapy. These are all milestones, and cities across the country have positioned themselves as beneficiaries—and, in some cases, architects—of the cure. San Francisco is arguably the most determined.

No one knows this better than Dr. Diane Havlir. She began her career at Ward 86 in the 1980s, a time she describes, somewhat demurely, as “extraordinarily formative years.” Today she is head of the ward and one of the nation’s leading HIV/AIDS researchers. In 2012 she co-chaired the International AIDS Conference in Washington D.C., whose theme, “turning the tide together,” and official declaration called unequivocally for ending AIDS. “Now, for the first time ever—we’ve never really said this before—we think we can begin to end AIDS,” Havlir said shortly before the conference.

Her optimism hasn’t faded. “It’s an exciting time,” she says. “We’ve all been re-energized by a couple of things. First, by the prospect that with earlier treatment and with PrEP we can dramatically reduce the number of new infections, and secondly, by the fact that a cure—that it can even happen—has been proven.” The case of the 14 French patients bolstered by early exposure to ART was compelling enough that last year, Havlir and her col- leagues at San Francisco General launched RAPID, a citywide program aimed at getting HIV patients on ART the same day they’re diagnosed. In some cases this means that healthcare workers escort patients to Ward 86 in a cab—what I imagine must be the most frightening and tender ride anyone can take through the city’s pastel hills. “The data would suggest that people who start treatment immediately after they’re infected will reduce the reservoir of HIV in their body, so if a cure were to become available, they’d be in a better position to benefit from it,” Havlir says.

And there’s the c word again. It’s a subsonic hum beneath any conversation about AIDS. The prospect of a cure is both intoxicating and unnerving, namely because failure is not an option. When the subject is raised with Havlir, she hedges. “No one can predict it. The fact that there is investment and commitment means it’s going to happen faster than it would have before, when we weren’t even thinking about it.”

Although there was never a time when AIDS researchers weren’t thinking about a cure, Havlir’s response indicates the extent to which it will demand deep institutional pockets. UNAIDS and the World Health Organization estimate that curbing new HIV infections—reducing transmissions, not a cure— would cost $20-$30 billion over the next half-decade. That’s a sobering tally, and perhaps one reason why local public officials, policymakers, and researchers eagerly posit San Francisco as the incubator for AIDS innovation. There’s a torrential, largely untapped artery of funds awaiting whatever city or institution offers a viable blueprint for significantly slowing transmissions or, better yet, unveiling a cure.

Havlir sees the treatment cascade as one of the city’s biggest opportunities to tout benchmarks. Sometimes referred to as the “continuum of care,” the treatment cascade is best visualized as an upside-down pyramid identifying stages of HIV treatment where patients are most likely to go AWOL. Of the 82% of people with HIV who are diagnosed, only 66% are linked to care, while 37% are retained in care. Thirty-three percent are prescribed ART, and 25% become virally suppressed. In San Francisco, viral suppression stands at 50%, a number that’s double the national average, though it’s still underwhelming to Havlir. “We can do much better than that,” she says, and goes on to envision a city in which diagnosis, treatment on demand, and outreach services such as housing, substance abuse counseling, and mental health counseling are integrated under one umbrella of care.

If this sounds like a rehash of the vintage “San Francisco model” of AIDS policy, in which a full menu of health and social services are combined under one roof, it is. Thirty years after the epidemic first broke and the model was introduced, it remains the gold standard of HIV/AIDS treatment. Justin Goforth, director of community relations at Whitman-Walker Health in Washington, D.C., praises San Francisco’s method of fast-tracking patients to care. It’s one his clinic has adopted and rebranded as the “red car- pet entry” program. “Our goal is to link all newly diagnosed individuals or new HIV-positive patients to care within 24–48 hours,” Goforth says. “Most of our newly diagnosed patients actually have the first appointment with their provider and other members of their new care team the same day of diagnosis.” That protocol mimics San Francisco’s RAPID program.

Goforth also mentions the role his clinic takes in crafting HIV campaigns that herald the not-too-distant day when D.C. is AIDS- free. “The newest prevention messages no longer include the word AIDS and speak only of HIV infection,” he says. Likewise, Randall H. Russell, CEO of the Seattle-based clinic Lifelong, frames his facility’s mission as making Seattle “an environment that will perpetuate an AIDS-free city.” Major HIV/AIDS organizations in Chicago, Los Angeles, and New York—and indeed all across the country—share the same goal. While finding a cure is a global, collaborative endeavor, wherever it happens is likely to become a tinderbox of enormous economic, political, and cultural capital. So why is San Francisco primed to take the jackpot?

According to Neil Giuliano, CEO of the San Francisco AIDS Foundation, the city’s notoriously liberal outlook is more congenial to progress. “We still have a ways to go in dealing with shame and stigma,” he says, “but I would venture to say we have gone much further than most other urban, and certainly suburban, communities in this country.” To prove his point, he hands me a sheaf of posters promoting the foundation’s various public forums. F*CK WITHOUT CONDOMS EVER? LET’S TALK ABOUT IT, reads one. RAW SEX—ARE THE RULES CHANGING? blares another in a burly, biohazard-colored font. “These are probably not posters that could go up in many communities around the country. It wouldn’t work in San Francisco if we tried to do any- thing that was other than very open, very honest.”

Giuliano is a relative newcomer to HIV/AIDS public policy. His résumé includes four terms as the openly gay Republican mayor of Tempe, Ariz.; four years as president of GLAAD; authoring a motivational memoir-cum-campaign-bio; a midlife conversion to the Democratic Party; and, since 2010, serving as CEO of the San Francisco AIDS Foundation. More recently, he’s moonlighted as the Great White Hope of Arizona politics. He seems to relish playing coy with the state’s media about a potential gubernatorial run. When I meet him at his office four stories above Market Street he’s rebounding from a nasty flu, which may explain his affable but somewhat prerecorded demeanor. He is accompanied by James Loduca, the foundation’s PR head, who chaperones our conversation.

“This was the first community where HIV was an epidemic in the United States,” Giuliano says. “It was in San Francisco, in the Castro neighborhood on Castro Street, where people literally dropped dead while walking down the street. We believe it will be in San Francisco, in the Castro neighborhood on Castro Street, where we will be able to say a new HIV infection is incredibly rare and we’re caring for people who have HIV. That’s it for us. That’s what we’re all about.”

In practice this means exceeding the goal established by the foundation’s board in 2010 to cut new HIV infections by 50% over five years. This target doubles that of President Obama’s National HIV/AIDS Strategy, also instituted in 2010, which calls for reducing new infections by 25%. San Francisco halved its number of new infections between 2004 and 2011, and now reports a little more than 300 new cases per year. The city hopes to trim that number by a further 25% this year. It’s an ambition many veteran HIV researchers dismiss. Dr. Matthew Golden, director of Seattle’s HIV/STD Control Program, deems such a downsizing in new infections as extraordinary. “Could San Francisco go down another 25% in the next five years? Maybe. In the next one year? No way,” he tells me.

Giuliano sympathizes with the skeptics. “We have an obligation to be aspirational,” he says. “Do I know that we’re going to hit that goal by 2015? I don’t know that we’re going to do that. One of the things I’ve learned in life is if you don’t set a high enough goal, you’ll certainly never come close to it.” (Behind him, a copy of Benjamin Barber’s If Mayors Ruled the World is displayed on his desk. In a 2012 interview with the Bay Area Reporter, Giuliano quipped, “Being mayor of San Francisco is a great gig, I wouldn’t mind that.”)

The centerpiece of the SF AIDS Foundation’s 2014 plan will be the ribbon-cutting for a new, $10 million gay men’s health and wellness center in the heart of the Castro. An architectural rendering is propped against the whiteboard in Giuliano’s office. It shows a glass-fronted cube inviting passersby into an interior of recessed lighting and Scandinavian furniture.

The facility, at 474 Castro St., will consolidate three separate agencies: Magnet, a sexual health clinic; the Stonewall Counseling Center; and the STOP AIDS prevention office. Its location in the Castro is a tactical move that acknowledges the city’s disproportionately high percentage of HIV-positive gay and bi men: 80% of the total HIV-positive population, by some measures. “There’s still a balance of maybe 60/40 gay and bi men to the general population in most other urban areas,” Giuliano says, a ratio that makes it difficult for other cities to hone treatment strategies. This is another reason why San Francisco has an edge when auditioning outreach initiatives: It’s a lot easier to monitor medical and behavioral intervention if your clientele is homogenous.

Still, neither the San Francisco AIDS Foundation nor the city itself denies that a variety of factors—including crystal meth and bareback sex—continue to spur infection in new communities. The average profile of a new HIV case in San Francisco is a gay, 34–35-year-old white man, but African Americans are increasingly at risk. That said, the city’s population is only 6% black, so that risk must be kept in perspective. San Francisco is nowhere near the emergency levels of Baltimore, Atlanta, or Washington, D.C., cities where black women in particular contract HIV at rates five times the national average. For Giuliano, the only plan that makes sense is a holistic health and wellness model that precludes fear. “The approach 10 years ago was ‘wear a condom, wear a condom.’ We’re way beyond that now,” he says.

San Francisco’s progressiveness can’t disguise a number of systemic flaws. Many of these aren’t unique to the city but are byproducts of America’s ramshackle economy, marked by income inequality, housing shortages, and unemployment. Michael Scarce, an activist and medical sociologist who has written two books about sexual politics, argues that these are the real blockades in San Francisco’s quest for a cure. “If you could choose one city that would be the first to become AIDS-free it could very well be San Francisco,” he says, “and yet all of the comorbidities and socioeconomic factors that intersect with HIV would need to be eliminated, if we’re going to truly be AIDS-free. I don’t know of that ever happening in the history of Western civilization.” High on the checklist of hurdles are poverty, substance abuse, and homelessness. “We can provide testing and treatment all we want,” Scarce tells me, “but if people at risk aren’t inspired and motivated to have lives worth living we can’t convince them to take advantage of something that might save their lives.”

Scarce has the bemused but edgy tone of someone who has made it out of the woods. “I’m not interested in body counts anymore,” he says, alluding to his own history of AIDS, drug addiction, and homelessness. Even now, he works two part-time jobs unrelated to his field and is trying to land a steady research gig. Three months ago he was served an eviction notice. He is burned out by PR buzzwords. “How are you going to save me if you don’t even know me or what my life is like? How are you going to help me get well? I’m not sure that I want to be saved. I just want a chance to save myself, and that’s a big difference.”

When asked what his ideal outreach model looks like, he replies that he’d like to see policy makers live a day in the life of someone with AIDS. Short of that, he’ll settle for more peer-based programs that actually administer to people with AIDS. In 2010, Scarce was interviewed by a French organization called the Warning. He used the opportunity to lambast the lack of transparency and general malaise among HIV/AIDS organizations and lobbied for the creation of a national watchdog agency. “In terms of fund- ing, Crisis = Money. Disease = Money. Risk = Money. The more AIDS organizations can portray their communities as unhealthy, sick, and high risk, the more they are rewarded financially and politically,” he said in the interview.

This is as good a time as any to point out that according to Charity Watch’s 2013 ratings guide, the San Francisco AIDS Foundation scores a C for how much it spends on programs and how much fundraising is required to raise $100. The foundation has the lowest grade of the eight AIDS organizations that are measured. There is also the matter of Neil Giuliano’s salary: $270,000 in 2012. The executive team, which in 2012 included seven members, earned a combined income of more than $1.3 million. The salaries are modest in comparison to some other nonprofits, but could they hint at a larger disconnect between organization heads and those they’d help? “When you talk about a 25% reduction in new infections, I start to zone out,” says Scarce. “A year from now I’m more worried about Am I going to have an apartment?”

In 2013, San Francisco’s housing market became the most expensive in the nation, with a median rent of $3,414. There was an 8% rent spike during a single quarter. Anxiety is palpable among long-time residents, especially since the past three years have also seen a 170% hike in Ellis Act evictions, which give retiring landlords carte blanche to evict their tenants. Gallons of ink and acres of bandwidth have gone into dissecting the city’s run- away gentrification, but little has been said about what it portends for San Francisco’s HIV/AIDS community.

Scarce sees the city’s elitism as just another reason he’ll fall through the cracks. “The city is still really behind wrapping its mind around homelessness,” he says. “When you don’t have a home, how are you supposed to get clean? How are you supposed to take your meds on a regular basis? How are you supposed to see your provider? And do you even want to do any of those things at that point?”

San Francisco is now in the uncomfortable position of having a cure within reach while being unable to offer it to many of the people who made it possible. It’s a bittersweet proposition. It’s also one that implicates front-line workers—nurses, benefits counselors, treatment advocates, case managers—who are often the lowest paid and most overworked. Scarce singles out Ellen at the San Francisco AIDS Foundation for special commendation: “God, I don’t know if I’d be here if it weren’t for her. She helped me and so many people I know in ways that are just mind-boggling. But you’re not interviewing Ellen. That’s not a criticism of you, it’s just the system.”

But should it be a criticism of anyone who presumes to talk about HIV/AIDS policy without first understanding the lives of people in the trenches? Politicians, CEOS, scientists, and researchers are all essential to orchestrating effective care, but their priorities, however well-intentioned, are generally light years away from those of people in the community. The story of HIV/AIDS is one that began on the street, and will hopefully end there as well. Whether a cure is discovered in San Francisco or some other charmed place, a happy ending is where the real demands of salvation must begin. “Personally,” says Scarce, “I would not want to be in San Francisco to hear champagne corks popping all over the city when seroconversions end and I’m living with AIDS on the street.”

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Join the fight! Join the Campaign to End AIDS today!

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By Martha Kempner, RH Reality Check

For many years, the term “unprotected sex” has been synonymous with “sex without a condom,” and we’ve been told that the only real way for sexually active individuals to protect themselves from sexually transmitted diseases (STDs), including HIV, is to use a condom every time during sex.

Though we know everyone hasn’t followed this advice, the idea became so ingrained in our conversations about safer sex that it was clear protected sex equaled sex with a condom, while unprotected sex equaled sex without one. Some HIV advocates argue, however, that in this day and age of HIV treatment, pre-exposure prophylaxis (PrEP), and behavior changes that can decrease risk, this language is no longer accurate or precise. To that end, in December, a group of advocates, spearheaded by the HIV Prevention Justice Alliance, sent a letter to the Centers for Disease Control and Prevention (CDC) requesting a terminology change.

In January, the CDC announced on a call with more than 80 advocates that it would indeed change the decades-old language. Now, instead of referring to “unprotected sex” to mean sex without a condom, the CDC will refer simply refer to it as “condomless sex.”

The advocates’ argument hinges on the fact that there are now multiple ways to have safer sex when the goal is preventing HIV transmission. Condoms obviously still play an important role, but there are other ways individuals can protect themselves as well. Many HIV experts, for example, talk about treatment as prevention. Individuals who are on antiretroviral therapy (ART), which suppresses the replication of HIV, often have an undetectable viral load (a measure of the number of copies of HIV in a given blood sample). Though it is possible to transmit HIV even when one’s viral load is very low, it is much less likely.

Another, newly available prevention method for HIV is referred to as PrEP. In 2011, the Food and Drug Administration (FDA) approved the use of an existing HIV medication called Truvada, a once-daily pill designed to prevent infection. Studies have shown that it is effective. For example, one study among men who have sex with men (MSM) found that those who were given PrEP were 44 percent less likely to contract HIV than those who weren’t. Moreover, those who remembered to take their medication every day or almost every day saw a reduction in risk of 73 percent or even more (some up to 92 percent). Similar studies of HIV discordant, heterosexual couples found that PrEP reduced the risk of the uninfected partner becoming infected by 75 percent, or as much of 90 percent among those who took the pill every day or almost every day.

Advocates also note that some couples, men who have sex with men in particular, use practices knows as serosorting and seropositioning to reduce their risk. Serosorting essentially means limiting condomless anal intercourse to those partners with the same HIV status as themselves. The CDC, however, does not consider this to be a safer sex practice:

Serosorting is not recommended because: (1) too many MSM who have HIV do not know they are infected because they have not been tested for HIV recently, (2) men’s assumptions about the HIV status of their partners may be wrong, and (3) some HIV-positive men may not tell or may misrepresent their HIV status. All of these factors increase the risk that serosorting could lead to HIV infection.

Seropositioning is the practice by which men who have sex with men choose their position (as the insertive or receptive partner) based on sero-status; the HIV-positive partner would be receptive, as there is less risk that he transmits HIV in that position. Again, this assumes partners have accurate knowledge of their own and each other’s status.

Though there is some disagreement over the safety benefits of these behavioral practices, there is agreement that the landscape of HIV prevention has changed. Suraj Madoori, coordinator of the HIV Prevention Justice Alliance at the AIDS Foundation of Chicago, told RH Reality Check via email that the language change “opens doors for us to discuss the myriad of challenges and progress on effective methods of HIV prevention. By continuing to use ‘unprotected sex’ to mean ‘condom-less sex’ you fail to acknowledge and lose the breadth of the entire prevention narrative in how individuals and groups choose to protect themselves and mitigate risk.”

Jim Pickett, director of prevention advocacy and gay men’s health at the same organization, said in an email, “Of course, there are gradations of risk and safety. The only truly ‘safe’ act is to not have sex, right? Anything else has some level of risk—even oral sex (though you are more likely to get hit by lightning twice than get HIV from oral sex).”

A spokesperson for the CDC told the Bay Area Reporter that the changes have been under assessment for some time because, as “HIV prevention strategies evolve, the terminology needs to evolve as well.”

Other HIV experts welcomed the change as well. Dr. Kenneth Mayer, medical research director and co-chair of the Fenway Institute at Boston’s Fenway Health, told the Reporter, “Unprotected sex conveys a sense of irresponsibility that may not accurately reflect a person’s decision about how to avoid HIV and other STD’s.”

“For example,” he added, “someone in a committed monogamous relationship may decide not to use condoms after having been screened for HIV and STDs, and coming to an agreement with a partner about not engaging in intimate relations with others. It would be rare to refer to a heterosexual couple trying to conceive as engaging in ‘unprotected sex.’”

Todd Heywood echoes this in his piece for HIV Plus Magazine in which he writes:

Ultimately, this change holds the opportunity to shift the conversation in the gay community about clean and dirty gays, and good and bad gays — and instead put the focus on actual risk and prevention.

How this language change will play out in the long term is not yet known. For example, it’s not clear whether the CDC will continue to use the phrase “unprotected sex” to refer to sex in which no HIV prevention methods are used or when discussing STDs other than HIV, or whether it will simply retire the term altogether. The HIV Prevention Justice Alliance says it plans to meet with the agency later this month to discuss the change further.

It is also not clear how the rest of the public health community, specifically those who focus on other STDs, will react to the change or how likely they will be to adopt it, as the new prevention methods it is designed to include apply only to HIV. Condoms still remain the only way for sexually active couples to reduce their risk of chlamydia, gonorrhea, syphilis, and other diseases, which means that sex without a condom leaves individuals unprotected against these diseases. Moreover, many public health experts have feared that as alternative HIV-prevention methods become more popular among men who have sex with men, condoms will become less popular, leaving men open to other STDs. A recent study, however, shows that this fear may be unfounded, as people on PrEP were not more likely to engage in risky sexual behavior. That said, rates of other STDs are on the rise, and men who have sex with men are disproportionately affected.

It will be interesting to see how the new language becomes incorporated in messages about HIV and other STDs and if other organizations will follow the CDC’s lead.

~~~~~

Join the Campaign to End AIDS today!

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From our friends at Health GAP

URGENT: TAKE ACTION AGAINST UGANDA’S ANTI HOMOSEXUALITY BILL; SUPPORT RECALL OF U.S. AMBASSADOR, SCOTT DELISI

We have reached a critical hour in the fight for social justice and human rights for Ugandans. On February 14th, President Museveni announced his intention to sign the Anti Homosexuality Bill into law. He hid behind quack science released in the form of a ‘Scientific Statement on Homosexuality’ endorsed – alarmingly – by his own Ministry of Health.

This Bill is considered unconstitutional by Ugandan legal and human rights experts including the Ugandan Human Rights Commission and the Uganda Law Society. It would inflict harsh punishment on lesbian, gay, bisexual and transgender Ugandans – up to life in prison for “aggravated homosexuality” – and would make it a crime to “promote” or “aid or abet homosexuality” – punishable by up to 7 years’ imprisonment. Efforts to ensure lesbian, gay, bisexual and transgender Ugandans get access to essential health services and understand their legal rights would be criminalized. Beneficiaries of such programs as well as the organizations and individuals providing those services would become vulnerable to arrest, prosecution, fines, and lengthy prison sentences. Uganda’s fight against critical health priorities, such as HIV, would be sabotaged by passage of this Bill into law.

Ugandan civil society is requesting that President Obama and other governments take action now in response. They are calling for the U.S. Ambassador to be recalled to Washington DC for strategic consultation. This temporary recall would send a strong message to President Museveni that the U.S. is standing by its commitments. They are calling for the same action for the U.S. Ambassador to Nigeria – a country where passage of a similar bill into law is already leading to a surge in persecution and violence.

We need you to take action urgently and join their call for Secretary of State John Kerry to recall U.S. Ambassador Scott DeLisi. This temporary recall is an appropriate next step as we fight back against the Anti Homosexuality Bill. Will you take action today?

1. Please call Secretary Kerry’s chief of staff’s office at: 202-647-5548. Here is a call in-script to use:

Hello, my name is ——————————— and I am calling to urge Secretary Kerry to take immediate action on Uganda’s Anti-Homosexuality Bill, and recall the U.S. Ambassador to Uganda, Scott DeLisi. The Ugandan Civil Society Coalition on Human Rights and Constitutional Law has requested the recalling of U.S., European and other Ambassadors, for urgent consultations about the way forward for human rights in Uganda as well as in Nigeria, where a similar bill was signed into law by the President. I stand with Ugandan Civil Society concerned about the safety of their LGBTQ citizens, and strongly urge Secretary Kerry to recall U.S. Ambassador Scott DeLisi immediately.

2. Want to make another call? Leave a comment for the Secretary on his comment line. Call 202-647-5291 and then dial “1”, followed by “8” to leave a comment.

The State Department is in active consultation about their next steps, and your call will make a difference in the fight against bigotry and homophobia, and for human rights and access to essential services for all Ugandans.

For your reference, here is the statement from the Ugandan Civil Society Coalition on Human Rights and Constitutional Law requesting the recall of the U.S., European and other Ambassadors.

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Join the Campaign to End AIDS today!

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For Immediate Release; Contact: Amber McCracke 202-659-0699 ×13

New Online Site, HIV-Age.org, Brings Together Resources, Research and Best Practices for Treating Older HIV Patients

Washington, DC: The American Academy of HIV Medicine (AAHIVM), ACRIA, and the American Geriatrics Society (AGS) today launched HIV-Age.org, the GO-TO online site for clinicians seeking best practices for managing the care of older HIV patients. By 2015, half of the U.S. HIV population will be age 50 and older. Other individuals, such as patients, researchers, media and HIV advocates, will also find the content and resources useful in understanding the latest in managing the care older Americans with HIV.

The website is a continuation of the HIV and Aging Consensus Project, developed to assess how the presence of both HIV and common age-associated diseases alter the optimal treatment of HIV, as well as other co-existing medical conditions. As part of this project, in 2011, AAHIVM, AGS and ACRIA released the first clinical treatment strategies for managing older HIV patients: Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV. The report, developed by a panel of experts with experience in the fields of HIV and Geriatrics, provided guidance for HIV clinicians and other health care providers who treat, diagnose and refer older patients with HIV disease.

HIV-Age.org is the natural next step in the mission to provide HIV care providers with the information, tools and resources needed to best manage the health of their older HIV patients,” stated James M. Friedman, executive director of AAHIVM. “This website will be a virtual environment of clinical information and colleague support.”

HIV-Age.org will include editorials by leading clinicians, researchers and thought-leaders in the field, scientific spotlight articles on the latest research and treatment options, thought-provoking case studies and useful medical and government resources and links. For instance, the current Scientific Spotlight piece discusses the availability of “The Quick Reference Card for Managing Older Adults with HIV” now available through the New York State Department of Health (NYS AIDS Institute).

An extensive listing of published articles on HIV and Aging for the last two years will allow any site visitor to become rapidly informed. The site requires no membership and encourages comment and ongoing dialogue.

HIV-Age.org will also house the original 2011 Recommended Treatment Strategies for Clinicians Managing Older Patients with HIV report with timely updated sections with the goal of keeping the report relevant and scientifically up-to-date. At launch of the site, nine of the 22 chapters have been updated.

“This type of content will encourage discussion among the HIV community, including medical providers seeking strategies for tackling some of the more complicated treatment scenarios,” stated Dan Tietz, executive director of ACRIA.

In 2006, 26 percent of HIV-infected adults in the U.S. were at least age 50, and in 2013 estimates place that number at almost 44 percent. Furthermore, the most recent data from the Centers for Disease Control and Prevention (CDC) shows that individuals in that age group accounted for 1 in 6 new HIV diagnoses each year.

“Thanks to medical advances, people with HIV are living longer,” stated Wayne McCormick, MD, President-elect of the AGS Board of Directors. “But with living longer comes more questions on the management of the common co-morbidities associated with aging. We have a responsibility to not only help people live longer, but live better with proper care and treatment.”

The development of HIV-Age.org was made possible through generous support from The Archstone Foundation. The grant was awarded to the American Academy of HIV Medicine to administer this program.

To arrange an interview with a representative from AAHIVM, AGS, or ACRIA, please contact Amber McCracken at 202-659-0699 ×13 or amber@aahivm.org.

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ACRIA for more than 20 years has transformed lives and strengthened communities affected by HIV in the U.S. and around the world through research, education and advocacy. Through its ACRIA Center on HIV & Aging, the organization is recognized as an international leader on the emerging issue of HIV and older adults.

The American Academy of HIV Medicine (AAHIVM) is a professional organization that supports the HIV practitioner and promotes accessible, quality care for all Americans living with HIV disease. Our membership of HIV practitioners and credentialed providers give direct care to more than three-fourths of HIV patients in the US.

The American Geriatrics Society (AGS) is a not-for-profit organization of close to 6,000 health professionals devoted to improving the health, independence and quality of life of all older people. The Society provides leadership to healthcare professionals, policy makers and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy.

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From our friends at HIV Health Reform

Breaking News: Louisiana Insurer Refuses Ryan White Payments; Legal Complaint Filed

Update: 7 PM ET, Monday, February 14: BCBS of LA released a statement saying they are reviewing the CMS FAQ released Friday, February 7. However, the statement reiterates their current policy that they will not take Ryan White premium payments.

Given the coverage gaps that still exist for people with HIV/AIDS, these individuals still need help paying for their share of premiums, even after federal subsidies. However, some insurers – most notably Blue Cross Blue Shield of Louisiana (BCBS) – have refused premium payments from the Ryan White Program.

Ensuring that people living with HIV/AIDS receive Ryan White support is important in all states, but more so in ones like Louisiana that did not expand Medicaid to cover the lowest-income people with HIV.

TO FIGHT BACK, PEOPLE WITH HIV HAVE STARTED THIS MoveOn.org PETITION, WHICH WE URGE YOU TO SIGN.

BCBS’s actions first received national attention when the HIV Health Care Access Working Group wrote to the company on January 27, 2014, urging it to accept third-party premium payments from the Ryan White Program:

Ryan White Program/ADAP insurance assistance programs that assist qualified low income clients with the purchase of health insurance are explicitly allowed (and encouraged) by the Health Resources and Services Administration (HRSA), the federal agency that oversees the Ryan White Program, as well as the Center for Consumer Information and Insurance Oversight (CCIIO).

The issue attracted national media attention in early February with a Reuters article (AIDS Patients in Obamacare Limbo as Insurers Reject Checks):

Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama’s healthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and the interpretation of federal rules about preventing Obamacare fraud.[…]

The state’s largest carrier is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.

HIV/AIDS advocates have taken to social media outlets such as Twitter using the hash tag #bcbsfail to voice their disapproval of the BCBS practices.

Earlier guidance from CMS has contributed to confusion on the issue. In November 2013, CMS issued a FAQ document encouraging marketplace plans to reject payment from third parties such as hospitals, other health care providers, and other commercial entities. The FAQ did not mention the Ryan White Program.

However, on February 7, the same day they received inquiries from the media, CMS clarified that the agency was not referring to the Ryan White Program in the November statement. CMS released a FAQ on February 7 saying that health plans and “marketplaces are encouraged to accept such payments.” An agency spokesperson noted, “Given the importance of access to care for people with HIV/AIDS, CMS is considering amending those rules to require issuers to accept these [Ryan White Program] payments.”

Amending federal rules may be a lengthy process. To spur more immediate action, Lambda Legal and AIDSLaw of Louisiana on February 10 filed a legal complaint against BCBS urging them to accept Ryan White Program premium payments. The four-page letter notes that refusing these payments “acts as a potent device to keep people living with HIV from BCBS’s insurance rolls”:

Not only is BCBS ’s unfounded policy jeopardizing the lives of Louisiana residents living with HIV, but we are concerned that BCBS in fact is engaged in actionable discrimination in violation of the ACA (as well as potentially running afoul of other federal and state laws)… We fear that BCBS’s abrupt and suspect decision to reject [Ryan White Program] premium subsidies amounts to discrimination in violation of the federal law.

TAKE ACTION

SUPPORT PEOPLE WITH HIV IN LOUISIANA AND STAND UP AGAINST INSURANCE DISCRIMINATION BY SIGNING THIS MoveOn.org PETITION TODAY.

Resources:

The New York Times February 8, 2014 “AIDS Patients in Obamacare Limbo as Insurers Reject Checks
Reuters February 9, 2014 “CMS may require Obamacare insurers to accept Ryan White payments
HIV Health Care Access Working Group Letter to Blue Cross Blue Shield of Louisiana Regarding Third Party Payers (PDF)
HIV Health Care Access Working Group Letter to Health and Human Services Regarding Third Party Payers (PDF)
November 4, 2013 CMS FAQ on Third Party Payments
February 7, 2014 CMS FAQ on Third Party Payments
Lambda Legal and AIDSLaw of Louisiana complaint

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Image: Bloomberg

(Reuters) – The U.S. Centers for Medicare and Medicaid Services (CMS), in an effort to keep insurers from denying coverage to people with HIV/AIDS, may strengthen its position on health plans accepting third-party payments, such as those under the 1990 Ryan White Act.

Hundreds of people with HIV/AIDS in Louisiana trying to obtain coverage under President Barack Obama’s healthcare reform are in danger of being thrown out of the insurance plan they selected in a dispute over federal subsidies and interpretation of rules about preventing Obamacare fraud, Reuters reported on Saturday.

Blue Cross and Blue Shield of Louisiana, the state’s largest health insurer, is rejecting checks from a federal program designed to help these patients pay for AIDS drugs and insurance premiums, and has begun notifying customers that their enrollment in its Obamacare plans will be discontinued.

The insurer insists it is not trying to keep people with HIV/AIDS from enrolling in one of its policies under the Affordable Care Act, but is instead rejecting third party premium payments in an effort to prevent potential fraud.

“Federal rules do not prevent the use of Ryan White funds to pay for health care plans,” CMS said in a statement late on Saturday, adding that it had issued guidance “encouraging issuers and Marketplaces to accept such payments.”

CMS suggested that such encouragement may not be enough to protect patients in need of expensive life-saving medicines.

“Given the importance of access to care for people with HIV/AIDS, CMS is considering amending those rules to require issuers to accept these payments,” the lead Obamacare agency said.

The 1990 Ryan White Act offered people with HIV/AIDS federal financial help in paying for AIDS drugs and health insurance premiums, especially in state-run, high-risk pools. Obamacare, which bans insurers from discriminating against people with preexisting conditions, was designed to replace these high-risk pools.

Hundreds of HIV/AIDS patients are dependent on Ryan White payments for Obamacare because they fall into a coverage gap. They are not eligible for Medicaid, the joint federal-state health insurance program for the poor, because Louisiana did not expand the low-income program, and Obamacare federal subsidies don’t kick in until people are at 100 percent of the federal poverty level.

(Reporting by Bill Berkrot and Sharon Begley; Editing by Bernard Orr)

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Image: AP, J. Scott Applewhite

By Timothy Westmoreland for POLITICO

n 1981, we were looking for the first symptom of a disaster that we feared would come. The Reagan administration had proposed huge cuts in health programs, and something had to give.

Back then, Henry Waxman—who has just announced his retirement after four decades representing his California district in Congress—was a relatively new chairman of the Subcommittee on Health and the Environment. He had asked his staff to be on the lookout, and we were. Maybe it would be a cohort of birth defects? Maybe an environmental spill in drinking water? I was an assistant counsel two years out of law school, working on the public health portfolio. I thought the disaster would be infectious diseases among children, since the budget called for cutting immunization support effectively in half (a proposal eventually rejected on a strong bipartisan basis after a Waxman oversight hearing during which a Nobel laureate showed slides of polio victims in iron lungs).

But instead, a medical investigator at the Centers for Disease Control (CDC) told me about a new and fatal disease. The first reported cases were in Chairman Waxman’s hometown of Los Angeles. They were among gay men (and Waxman represented West Hollywood, the gay ghetto of that city). CDC said they didn’t know what to say yet, but they’d keep us posted. We kept watching.

The new disease started showing up in other places. People were dying and no one knew why.

Waxman called the first hearing on this outbreak and the need for a federal response in April 1982. The extent of the disease was unknown, its causes unknown, its means of transmission unknown. There were 300 reported cases and 100 deaths. Over the decade, he held hearing after hearing as it became clear that this was an epidemic and not a one-time outbreak. This was AIDS, and it was the disaster we had feared.

New symptoms were outlined, new sub-populations were identified and new theories were advanced. Thousands of Americans died, most of them gay men. The Reagan administration’s budgets stayed stubbornly static. It took five years for the president even to acknowledge that an epidemic existed. By the time he did, about 2,000 new cases were reported a month, and the rate was accelerating.

In formal statements, the Department of Health and Human Services told Congress that everything that needed to be done was being done. But the plain brown envelopes that came to the subcommittee offices (this was long before email and everything was hard copy) contained a different message. The epidemiologists, the virologists, the oncologists, the immunologists from within CDC and the National Institutes of Health were quietly telling us they needed new studies and professional reinforcements. Public Health Service officials had proposed emergency supplemental funding repeatedly. Reagan appointees had regularly turned them down.

Waxman himself became nearly a board-certified specialist in immunology. The scientists often briefed him directly. He chaired hearings on incidence and prevalence, antibody tests, immune cells and anti-viral drugs. He met with people living with AIDS, even as others were calling for quarantine and wearing rubber gloves.

His advice to his staff stayed the same throughout: We should act as though we were colleagues of the public health professionals, except that we did not have to obey Reagan’s budget bosses. We were to look for research undone, surveys not conducted and staff jobs unfilled, and we were to bring the information back to the Congress for yet another hearing.

The subcommittee proceedings were a roller coaster from indifference to panic to indifference again. One day there were no members in the AIDS hearing at all, just the chairman presiding. The next day there were so many cameras that the networks had to band together to pool the feed of live testimony. One day there were slide presentations about white blood cells. The next day there was Elizabeth Taylor. One day there was a witness saying that he thought AIDS was spread by spores. The next day there was Surgeon General C. Everett Koop saying that this was not the flu and could not be easily transmitted.

But Waxman stayed the course: “What did the public health people say should be done next?” he asked us over and over. Along with the late Ted Weiss, who chaired investigations in a subcommittee of what is now Oversight and Government Reform, he led hearings into topics that needed to be discussed but could not then be mentioned in “polite” company. Oral and anal sex. Injection drugs. Prostitution and commercial sex work. (I’d add personally that no staff counsel expects the day he will have to explain to members of Congress what mutual masturbation is and why it is unlikely to share body fluids.) These were the thankless subjects—along with budget shortfalls and vacant lab positions—that Waxman and Weiss steered the Congress through. Reagan and most other politicians didn’t say a thing, even as projections came that more Americans would die from AIDS than had died in Vietnam.

Waxman didn’t just hold hearings on the AIDS crisis; he pushed through legislation for public education, biomedical research and health-care delivery. Other members added amendments to ban condoms, clean needles and safe-sex comic books. Confidentiality and non-discrimination protections were unfortunately deleted. Many in Congress told him that they knew he was right on the issues but that they just couldn’t face the sound-bites at home about sex and drugs. Others, both Republican and Democratic, took politically courageous votes in the cause of public health. It’s easy to forget now, but in the 1980s, AIDS and everything associated with it was politically radioactive.

Books, plays and movies have been written about how the country and the world suffered through those days, from personal tragedies to protest in the streets. But I cannot imagine how much worse the AIDS epidemic would have been (and would be now, because it is far from over) if it had not been for this smart, steady, quick study of a man who stayed for hours in the chair, assembling the record and hammering out bipartisan legislation.

For me, one small moment brings his role together: a TV interview in his Rayburn office. I’d written the talking points about all the questions the producer had told me she wanted to ask the chairman, but she took the moment to spring a new one on him: “Isn’t it true that you are working on this issue only because you represent homosexuals?” Needless to say, I hadn’t prepared him for this.

Waxman paused and then replied, “No, but would it be so wrong if that were true? You don’t question why members from Pennsylvania represent steel workers. But actually I work on this issue because it’s the largest public health crisis of our time, and I chair the subcommittee on health. Also, I work on this issue because I am a Jew, and I understand what it means if your society doesn’t care if you live or die.”

Only someone with these answers could have led the United States through the politics of inertia and hatred and through the complexity of facts and figures. We are lucky to have had him there and then. I’m sorry he’s retiring now. I pray that leaders with this clarity and compassion will be there when the country needs them next.

Timothy Westmoreland is now a visiting professor of law and a senior scholar in health law at Georgetown University Law Center. He was a staff member of the Subcommittee on Health and the Environment from 1979 through 1994. The views presented are his own.

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By Gracie Bonds Staples for The Atlanta Journal-Constitution

Her biggest hope is that a cure will come soon. But either way, Lauryn Taylor will make the 45-minute bus ride to take part in the Women’s Interagency HIV Study for as long as she lives.

Maybe it’ll make a difference in her life. Maybe it won’t. But, if her showing up twice a year will help scientists better understand why women are more susceptible to the deadly virus, if it will keep her 20-year-old daughter and other people’s children safe, Taylor said she intends to do her part.

“I’ll do it as often and for as long as I need to,” she said.

Taylor is one of 40 women age 18 and over — some who HIV positive and some who are at risk of becoming infected — currently enrolled in the study. Emory University researchers are hoping to recruit 260 more.

The study, which launched Oct.1, is the National Institutes of Health’s response to the growing HIV/AIDS epidemic in women.

“When the epidemic first broke in the ’80s, women in the U.S. comprised only 8 percent of people with HIV/AIDS,” said Dr. Igho Ofotokun, an associate professor of medicine at the Emory University School of Medicine and one of the lead researchers of the study. “Two decades later, nearly 25 percent of all people living HIV/AIDS are women in the U.S.”

Although the south has long been a breeding ground for the deadly disease, this is the first time in the two decades since the WIHS was firstlaunched in 1993 that research sites have been located here. Atlanta is one of four new southern sites, a recognition of the epidemic’s disproportionate impact on women here. The others are located in Miami, Birmingham and Chapel Hill, N.C.

Ofotokun said that he and partner Gina Wingood, a professor of behavioral sciences and health education at the Rollins School of Public Health, were told from the outset that approval for a local site was an uphill battle, but they persisted because both he and Wingood had spent much of their careers working with HIV-infected women like Taylor.

“We were convinced there were no others like us,” Ofotokun said. “This was our life, and we felt there was no better place for this work than Atlanta, where the epidemic just happens to be raging. We have the largest number of AIDS cases in the southeast.”

There are an estimated 14,000 women living with HIV/AIDS in Georgia. Fifty-six percent of those live in Atlanta.

“What is scary is these are women of child bearing age, and they can transmit the disease to their offspring,” Wingood said

Under Ofotokun’s and Wingood’s guidance, researchers will conduct detailed clinical, neurocognitive, behavioral and genetic assessments in hopes of understanding HIV progression in women and what specific factors, such as biology, stigma, medical distrust and social behavior, increase women’s vulnerability to infection.

“Women are more likely to become infected compared to men,” Wingood said. “The question I ask myself as a scientist is what makes them more susceptible?”

Taylor, 45, of Decatur, has been under Ofotokun’s care since learning of her diagnosis three years ago.

“It was Dec. 14, 2010,” she said. “I got in my car and I cried and screamed and cursed for about 15 minutes. Then I just absolutely engorged myself with information about the disease.”

It was the same way, Taylor said, when she learned about WIHS.

“I’m a paralegal by trade, so naturally I started doing some research,” she said. “I was really excited to find out that the study was backed by the NIH and the focus was how the virus affects women.”

One of the strengths of the Atlanta site, Ofotokun said, is the relationship it has forged with its community partners, SisterLove, AidAtlanta, the Center for Black Women’s Wellness and others.

“They have been part of helping us develop operations, how to recruit women, in every decision we make,” he said.

Dazon Dixon Diallo, president and CEO of SisterLove, said the local non-profit decided years ago to become more directly involved in institution-based research.

“We wanted to be a local leader on that, and so we were very intentional about working with Emory researchers and other local institution,” she said. “We started out just being a partner in community education, educating people about clinical trials and what works, what trials are available, then built our own capacity to conduct research, which elevated us to become a partner in the research itself.”

Diallo said the agency encouraged Emory to apply for the NIH funds — $12 million over 5 years — and assisted with writing and submission. The study is being conducted at the Grady Infectious Diseases Program Clinic (The Ponce Clinic) and the Woodruff Extension Building at Grady Emory Campus.

“What really drove us is the concentration of women with HIV in the south,” she said. “For many women in the study, it will be a lifetime of state-of-the-art health care, the Cadillac of every thing you will need living with HIV but don’t have the means to pay for health insurance. As part of the research protocol, they will be evaluated twice a year and may be screened for cancer, hypertension, cardiovascular disease and even violence from their entry into the study until they die. That’s what makes this so powerful.”

Diallo said that, for a lot of women in the study, participating will be a chance to feel like they are part of the solution to ending the epidemic.

Taylor said she intends to be completely involved in as many aspects of the study as she can and hopes people who may be at risk of the disease, or naïve about how it’s transmitted, will begin to protect themselves.

“I have a 20-year-old daughter and since HIV has been renamed a chronic condition instead of a death sentence, I feel like her generation, in particularly, no longer takes it seriously,” she said. “This is not like a cold. It does not go away, so why gamble? Every time you have unprotected sex, you are playing Russian roulette with your life.”

Taylor and researchers say WIHS holds much promise for women, if for no other reason that it will inform U.S. policy on HIV/AIDS.

“We can win the fight against AIDS, and this study will give us the tools to begin to understand the factors that will eventually help us,” Ofotokun said.

Additional information about the Atlanta WIHS, contact the project director, Sara Sanford, at sesanfo@emory.edu, or call SisterLove at 404-254-4734.

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By PR Newswire for The Albany Business Review

NEW YORK, Feb. 3, 2014 /PRNewswire/ — The Elton John AIDS Foundation (EJAF) announced an educational grant to The American Fertility Association (AFA), for the purpose of increasing awareness of family-building options for HIV-positive men and women. This work was initiated in 2012 with the assistance of Growing Generations and International Fertility Law Group.

In an effort to increase awareness of the medical strides that currently allow HIV-positive individuals to safely have biologically-linked offspring, EJAF and The AFA have joined forces to implement a grass-roots educational campaign specifically targeting HIV-positive individuals, the physicians who serve them, reproductive endocrinologists (fertility specialists), and community-based organizations.

The campaign will focus on two underserved locations in the Southern United States and will utilize a social media campaign and a web-based, individualized pathway to parenthood for HIV-positive individuals, to be hosted on The AFA’s website, including resources for both men and women with HIV considering pregnancy. The campaign will also feature a seminar for professionals on HIV family-building options to educate the medical community on the science and issues involved. In every stage, collaboration with local agencies will be at the forefront.

“We’re honored to have support from Elton John AIDS Foundation to help bring hope and awareness to those living with HIV and desiring to safely have biologically-related children,” said Ken Mosesian, Executive Director of The American Fertility Association. Mosesian continued, “This work will also give us the platform from which to speak about the continued need for HIV prevention, including condom use.”

“Over the years, advancements in drug therapy and treatment have changed the lives of many people living with HIV/AIDS, making it possible for them to live longer, fuller, healthier lives,” said EJAF Executive Director Scott Campbell. “HIV-positive people are entitled to be a vital part of our society, just like everyone else. Thanks to groundbreaking advancements in fertility science, there is no reason that children shouldn’t be part of that equation. EJAF is proud to join with The AFA in championing the human rights of people with HIV, including their right to have families of their own.”

About The American Fertility Association:

The American Fertility Association (The AFA) is an inclusive organization committed to helping people create their unique path to parenthood by providing leading-edge outreach programs and timely educational information. The scope of our work encompasses reproductive and sexual health, infertility prevention and treatment, and family-building options including adoption and third party solutions. The AFA is a national, not-for-profit 501© (3) charitable organization headquartered in New York City.

About The Elton John AIDS Foundation:

At the Elton John AIDS Foundation (EJAF), we believe that AIDS can be beaten. We act on that belief by raising funds for effective programs and policies, and also by speaking out with honesty and compassion about the realities of people’s lives. Sir Elton John created EJAF over twenty years ago, first in the United States in 1992 and then in the United Kingdom in 1993. Through hard work and with the help of our network of kind, amazing, creative, and generous friends and supporters, the two foundations together have raised more than $300 million over the past two decades to combat stigma, prevent infections, provide treatment and services, and motivate governments to end AIDS. The U.S. foundation focuses its efforts on programs in the United States, the Americas, and the Caribbean, while the U.K. foundation funds HIV-related work in Europe, Asia, and Africa. Join us in speaking out, taking action, and contributing to our efforts to achieve a world without AIDS. For more information, please visit www.ejaf.org.

Contact:
Corey Whelan
Program Director
Email
(718) 853-1411

Read more news from The American Fertility Association.

SOURCE The American Fertility Association

The information on this page is provided by PR Newswire. All rights reserved. Reproduction or redistribution of this content without prior written consent from PR Newswire is strictly prohibited. Albany Business Review is not responsible for this content. Learn more about this service.

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By Hope Gillette for The Huffington Post

It has long been noted medical treatment and patient education varies depending on an individual’s race or ethnicity, and this health disparity is only becoming more evident. According to new research from Brown University, the gap is now clearly visible in when it comes to communication about HIV medication adherence.

In an investigation involving the doctor-patient dialogue about HIV drug adherence, data revealed there were several specific differences in doctor conversation based on a patient’s race or ethnicity. These disparities were classified based on speech patters called “utterances,” or patterns of dialogue related to asking questions, giving information, giving instructions, making requests, or expressing desires.

Researchers found these utterances were directly related to the discussions doctors had with patients regarding HIV medication adherence, and while physicians did well in some areas such as discussing adherence more with minorities compared to non-Hispanics whites, at the same time such discussions lacked other important qualities, like humor and open-ended questions.

Breaking barriers to medication adherence in HIV

Non-Hispanic black patients fared the worst when it came to participating in HIV medication adherence conversations; the data indicated Non-Hispanic black individuals, due to different speech patterns, were less likely to contribute to a conversation, and therefore HIV medication adherence discussions were dominated by the physician. Non-Hispanic black individuals were also less likely to discuss goals and values than other races and ethnicities.

For Hispanic patients, doctor discussions were lengthier than those for non-Hispanic whites; however, in those conversations there were fewer open-ended questions, a lack of humor, and a lack of problem-solving discussions. In fact, though the conversations were lengthy, Hispanics received the same amount of problem-solving discussion as did non-Hispanic whites. Instead, doctors focused on provider directives, direct statements like “Take your medicine or you’ll get sick.”

Part of the reason utterances are different for minorities, speculate researchers in the press release, is because so much emphasis is placed on physicians to spend adequate time with minority patients; it has nothing to do with the fact that minorities need more time. Experts argue that if the conversations were the same, minorities would likely need a similar amount of time compared to non-Hispanic whites, but cultural differences and language barriers can contribute to how an HIV medication conversation goes.

The possibility that seems most compelling to me is the doctors don’t trust their black and Hispanic patients as much to be adherent,” said lead author M. Barton Laws, assistant professor (research) of health services policy and practice in the Brown University School of Public Health.

“It has been epidemiologically observed that they do tend to be less adherent, but it’s not because they are black or Hispanic.”

The findings indicate underlying reasons why minority patients may be less adherent with drug protocols. Those groups who experienced physician discussions based on directive rather than problem-solving had a much lower rate of HIV medication adherence. While the research did not prove a cause and effect scenario, Law and his team indicate the next step will be to determine if changing communication patterns for minorities does or does not affect drug prescribing outcomes.

Originally published on VOXXI as HIV medication discussions vary based on race and ethnicity, says study

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By Keith Alcorn for nam – aidsmap

A switch to a cheaper injectable illicit drug led to a major outbreak of HIV infection in Tel Aviv, Israel, and should serve as a warning signal for other cities with apparently stable HIV epidemics among people who inject drugs, Israeli researchers warned last week at the 14th European AIDS Conference.

Professor Michel Kazatchkine, the UN Secretary General’s Special Envoy on HIV in eastern Europe and central Asia, also warned the conference of the potential for new epidemics of HIV in people who inject drugs, following recent HIV outbreaks in Romania and Greece driven by the availability of new substances.

HIV prevalence among people who inject drugs in Israel has been stable for the past decade, as a result of government-funded needle and syringe exchange programmes, and opioid substitution therapy. Crusaid Kobler AIDS Center, Tel Aviv Sourafsky Medical Center, had observed no cases of primary HIV infection in people who inject drugs among 130 cases of primary infection diagnosed by the clinic.

Yet in June 2012, Tel Aviv Medical Center Laboratory noticed a disturbing phenomenon. Five primary HIV infections had been diagnosed in people who inject drugs in two months, and over the following year a further 40 cases were identified. The majority of these cases were diagnosed following admission to hospital with severe bacterial infections – bacteraemia, pneumonia or endocarditis – and every person diagnosed with HIV was also found to have hepatitis C.

In every case the patient was a long-term heroin injector who had been using the needle and syringe exchange on a regular basis.

But in early 2012, a large number of heroin injectors began switching to a cheaper injectable substance, known as ‘hagitat’ in Israel, a cathinone derivative also known as ‘bath salts’, injected in combination with the opioid substitute buprenorphine. Cathinone derivatives include mephedrone, a popular ‘club drug’. Many synthetic cathinones are not controlled substances under drug enforcement legislation, and new variants are emerging all the time.

Everyone who became infected with HIV during the 2012-13 outbreak had switched to injecting ‘hagitat’.

In contrast, none of the stable drug users who continued to inject heroin became infected with HIV.

Cathinone derivatives are synthetic amphetamine-like stimulants that induce euphoria, increased sex drive and sociability, as well as delirium and violent, erratic behaviour. They can also cause cardiac arrhythmias, hyperthermia, rhabdomylosis or death, and are associated with a high frequency of severe bacterial infections if injected.

Cathinone derivatives were adopted rapidly by drug users in Tel Aviv because they are cheap in comparison to heroin, but the drug effect is short, requiring up to 30 injections each day. Whereas heroin injecting is a relatively private activity (needle sharing takes place with only one or two people in most cases), cathinone injecting tends to be highly social. Furthermore, whereas heroin injecting requires the drug to be heated in a cup or spoon before being drawn up into the syringe, cathinone derivatives must be dissolved in cold water to avoid inactivating the drug. The lack of heating is likely to remove any sterilising effect that heating might have during heroin injecting, said Dr Eugene Katchman of Tel Aviv Sourafsky Medical Center. A very high rate of syringe re-use and needle sharing occurs as a result of the high injecting frequency, Dr Katchman added.

Phylogenetic analysis of 30 outbreak isolates revealed that all drug users had been infected with HIV-1 subtype A/CRF01 AE, and suggested that all infections were linked to one originating isolate.

In an effort to limit the further spread of HIV, doctors from Tel Aviv Sourafsky Medical Center educated needle and syringe exchange programme staff and volunteers on the outbreak, and instituted an active screening programme among drug injectors who used the needle and syringe exchange.

Needle and syringe exchange staff launched an education programme among drug users, and also increased the supply of needles, syringes and sterile cups.

Everyone who tested positive for HIV was offered immediate antiretroviral treatment in order to reduce viral load and limit onward spread of HIV. Viral loads at diagnosis were high (a median of 181,000 copies/ml) and the median CD4 cell count was 560 cells/mm3.

A rapid, multidisciplinary response is required when shifts in drug use trigger a new outbreak of HIV among people who inject drugs, Dr Katchman told the conference.

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By Robert Herriman for The Global Dispatch

A recently published study in the American Journal of Public Health shows that HIV-infected women transitioning from jail experience greater comorbidity and worse HIV treatment outcomes than their male counterparts.

I had the opportunity to learn more about this research during an interview with the lead author of the study, Jaimie P. Meyer, MD, Yale University School of Medicine, Section of Infectious Diseases, AIDS Program on Tuesday (Listen below).

Why is HIV so prevalent in people of both sexes in the prison system? Dr. Meyers says one sixth of all people living with HIV/AIDS transition through jail or prison annually. “Part of the reason for this is the same types of risk behaviors that go along with HIV are the same kind of risk behaviors that go along with incarceration”, she notes. These include injection drug use, commercial sex work and factors like severe mental illness.

We then went into discussing the specifics of the study. Dr. Meyer said they did a multisite study looking at the individuals “engagement of care”. This includes do they have an HIV provider, taking antiretroviral treatment and adhering to it to get their viral loads low.

“What we found that prior to coming to jail, women did worse than men on every marker. And six months after leaving jail, women were a lot less likely than men to have an HIV provider, to be taking meds, to be adhering to their meds and having success with treating their HIV”, according to Meyer. “Women are about half as likely as men to have success in treating their HIV six months after being released from jail”.

This of course led to the obvious question, why?

Meyer listed some factors that are contributing to this–women are more likely to be homeless, ongoing cocaine use, and ongoing depression.

This unfortunately leads to greater risk of HIV associated disease, non HIV associated diseases but also to transmitting HIV to others.

So what can be done to reverse these results?

“What this study suggests is that we need specific approaches geared to women with HIV who are leaving prison or jail and transitioning into the community , intervention and programs directed to their specific needs.”

Dr. Meyer closes with, “It’s a population that deserves special attention.”

Robert Herriman – Writer, Co-Founder and Executive Editor of The Global Dispatch. Robert has been covering news in the areas of health, world news and politics for a variety of online news sources. He regularly writes about infectious disease news for Examiner.com and administers the Outbreak News section of The Global Dispatch.

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Spring forward with fashion, furniture, and artwork finds at the Housing Works bi-annual Best of Spring sales event! We have re-stocked our shops with top-quality seasonal merchandise for a fraction of the retail price. This year THIRTEEN is your lucky number with sales in bloom at all of our shops and online at shophousingworks.org!

BONUS! All shoppers who share their best thrifted finds with us on Instagram could win one of 5 $100 Housing Works gift cards. To enter:

1. Follow @housingworks on instagram
2. Upload a photograph or a video showing us your best thrifted find
3. Include the hashtag #thriftandshout

No purchase necessary to enter. Entries must be received by March 31 to qualify. View the complete rules online: housingworks.org/thriftandshout

Spring 2014 featured goodies up for grabs include:

Chloe Platform Slingbacks
Retail $750 Best of $165

Caterina Lucchi Lage Pleat Carry all
Retail $388 Best of $100

Comme des Garcons Leather baseball jacket
Retail $1425 Best of $275

Suno Zebra Print Blazer
Retail $450 Best of $110

Guava Contrast Sandal
Retail $235 Best of $70 Available Online Starting March 12

COST OF ENTRY: Entry to each sale is FREE; however, Housing Works Supporter level members get one hour early access. Advocate level and above get in 30 minutes early. Join today, or become a member at a Housing Works Thrift Shop location the same day of a Best of sale and still get in free!

WHEN AND WHERE

Soho, 130 Crosby St.
Saturday, March 1, 12-8pm

Upper East, 202 East 77th St.
Tuesday, March 4, 5pm to 8pm

Chelsea, 143 West 17th St.
Thursday, March 6, 5pm to 8pm

Yorkville, 1730 2nd Ave.
Saturday, March 8, 12am to 8pm

Columbus & 74th, 306 Columbus Ave.
Tuesday, March 11, 5pm to 8pm

Gramercy, Thursday, 157 East 23rd St.
Thursday, March 13, 5pm to 8pm

West Village, 245 West 10th St.
Saturday, March 15, 12am to 8pm

Hell’s Kitchen, 730-732 9th ave.
Tuesday, March 18, 5-8pm

Tribeca, 119 Chambers St.
Thursday, March 20, 5pm to 8pm

Brooklyn Heights, 122 Montague St.
Saturday, March 22, 12pm to 8pm

96th and Broadway, 2569 Broadway
Tuesday, March 25, 5pm-8pm

Park Slope, 266 5th avenue
Saturday, March 29, 12pm-8pm

shophousingworks.org
Wednesday, March 12th- the goods are gone!

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Image: Full Circle Animation video

From Room for Debate, in The Opinion Pages of The New York Times

In the war on H.I.V., we have seen successes in some African nations and stubborn patterns of new infection in developed nations like the U.S.

Around the world, there are obstacles to prevention and treatment. How will they be overcome?

Read the Discussion.

“Every Nation Needs Affordable Drugs” ~~ Michael Sidibe, Executive Director, UN AIDS

“Stigma Is the Common Denominator” ~~ Elton John, Author, “Love is the Cure”

“India Has the Tools; Will It Use Them?” ~~ Kartik Venkatesh, Massachusetts General Hospital

“Research Shows the Path to Zero” ~~ Myron S. Cohen, Professor of Epidemiology

“We Can End AIDS Even Without a Cure” ~~ Phill Wilson, Black AIDS Institute

“The Role of Sex Trafficking” ~~ Kathleen Wirth, Botswana Harvard AIDS Institute Partnership

“For Some, H.I.V. Is Embraced, Not Avoided” ~~ Tim Dean, Author, “Unlimited Intimacy: Reflections on the Subculture of Barebacking”

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Join the fight! Join the Campaign to End AIDS today!

From our friends at HealthGAP

It’s the time of year again when elected leaders in Washington decide on funding for federal programs. Time and time again, it falls to us to remind them that the decisions they make on funding for global AIDS programs are more than just line-items on a spreadsheet. These decisions decide the fate of millions of people.

Yesterday, Health GAP’s Senior Policy Analyst Matthew Kavanagh and our colleague Chris Collins wrote an article in Health Affairs that shows the devastating effect that flat-funding of PEPFAR (the President’s Emergency Plan for AIDS Relief) will have on the number of people on U.S. supported HIV treatment. Budget cuts to PEPFAR that have flat-lined the program for the past few years will begin to take a serious toll on the program’s ability to continue it’s upward trajectory in HIV treatment access in the coming year.

The research presented in this article is going to be crucial in convincing the U.S. government to increase funding levels for PEPFAR in order to save lives and continue on a trajectory to end AIDS. Please consider making a donation to Health GAP today to support in-depth policy analysis like this.

The article has been published at the same time as the White House and the State Department are drafting the President’s Budget Request for FY 2015. They are considering whether to flat-fund PEPFAR for a third year in a row. As shown in Matt’s article above, flat-funding PEPFAR in FY’15 will have drastic effects on the scale-up of HIV treatment in the coming year. We need your help to stop these budget cuts!

*Here are three quick and easy actions to take IMMEDIATELY: *

1. Register for the Student Global AIDS Campaign Thunderclap before 12 NOON on Thursday. We need 100 people to sign up via your twitter, Facebook or Tumblr accounts, so that our message to Secretary Kerry and the White House will be blasted into the social media world at one time to catch the attention of our targets.

https://www.thunderclap.it/projects/8434-don-t-pull-back-on-ending-aids

2. Today: Send the following tweet before the President’s State of the Union address (happening this evening!):

.@WhiteHouse: no more #SOTU broken promises! Restore deadly @PEPFAR cuts to create an #AIDSFreeGen http://ow.ly/t0HYa

3. Today and tomorrow: Send the following tweet from your twitter accounts:

.@StateDept #SecKerry restore PEPFAR from deadly cuts, demand big increase in #budget from WhiteHouse to #endAIDS http://ow.ly/t0HYa

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By Mark Hicks for The Detroit News

A Detroit woman is suing the city of Dearborn over how a police officer treated her during a 2012 traffic stop once he learned she was HIV-positive.

Shalandra Jones alleges her constitutional right to privacy and rights under the Americans with Disabilities Act were violated when, “demonstrating his own prejudices,” the officer revealed her condition to others, “berated and humiliated” her for not saying she has HIV before a search and then “unreasonably and discriminatorily detained and charged” her “solely on the basis of her HIV positive status,” according to the lawsuit filed Monday in U.S. District Court.

The suit, which also names the officer, seeks unspecified damages as well as a permanent injunction requiring Dearborn to develop and adopt policies for hiring, supervising and training its police officers.

The aim is to prevent officers from discriminating against others who have HIV or AIDS, said attorney Joshua Moore, president of Detroit Legal Services, which is representing Jones. “We really want the problem fixed,” he said. “It cannot be happening.”

Neither Dearborn Police Chief Ronald Haddad nor Dearborn city officials returned calls seeking comment Monday.

Jones’ vehicle, driven by a companion, was stopped Aug. 3, 2012, reportedly for a broken tail light and she ultimately was ticketed for marijuana possession. The police officer said he spelled marijuana; Jones, an authorized medical marijuana patient, told him she had the drug, according to the suit. The officer began searching the vehicle and Jones’ belongings when he found the driver did not have a license, the document said.

When Jones told him pills in her purse were for her illness, the officer responded: “You just made me mad!”

Police dashboard video from the stop was obtained by the American Independent, a national news network, and posted on YouTube.

In the video clip, the officer repeatedly mentioned his fear of being exposed to HIV, at one point saying: “I don’t want to catch something … I don’t want that (expletive). I got a family.”

The lawsuit also quotes the officer as saying: “Dearborn does not have that many people living with HIV, and the police do not like people with HIV.”

According to the Centers for Disease Control and Prevention, HIV is not transmitted through casual contact.

On the video, the officer is recorded telling Jones she was ticketed because he was “aggravated” she hadn’t disclosed her HIV-positive status before the search.

The officer’s statements were “cruel, discriminatory as to her disability, and did cause emotional harm and embarrassment,” according to the lawsuit.

In September, Dearborn dismissed a misdemeanor marijuana charge against Jones, her attorneys said.

Soon after the incident gained national attention in 2012, Haddad told The Detroit News the department would undergo training to improve interactions with people with HIV or AIDS.

Moore said he met with Haddad and referred him to a local group willing to coordinate the training. But as of this month, no plans had been pursued, he said, and it was unclear if any ever were.

“We realized they were not serious about correcting any situation,” Moore said.

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Join the Campaign to End AIDS today!

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By Kellee Terrell for BET Health News

Recently, news broke that an HIV-positive 22-year-old former college student in Missouri was accused of exposing others to HIV and allegedly taping his sexual encounters without their knowledge.

The police found more than 30 tapes in Michael Johnson’s home of partners he met mostly online and at his school, Lindenwood University, CBS.com reported. Since his October arrest, five people have come forward claiming they had unprotected sex with Johnson and were unaware of his status. One man claims that he tested positive and Johnson was the source of his infection.

It’s unknown how many people he had sex with asked him if he was HIV-positive, but according to Buzzfeed, two of his partners did, and Johnson said he was not. If found guilty, Johnson could be sentenced to life in prison.

Clearly this has sparked some heated online debates — just read the online comments to any story written about this case.

Now, I have always believed that anyone with an STD has a moral and ethical obligation to disclose his or her status to his or her partner(s). I do not condone what Johnson is being accused of, but should the act of not disclosing be a crime?

No.

But in many states it is. And what’s worrisome is that these laws don’t really protect HIV-negative folks. Instead they continue to stigmatize the HIV community, deter people from getting tested and unfairly prosecute innocent people living with HIV/AIDS. Remember, cases like Johnson’s may get the most media coverage, but they are the exception, not the rule. There are people being thrown in jail for biting or spitting at someone, when saliva isn’t how HIV is transmitted. Or being arrested because a scorned ex is trying to seek revenge by claiming they were unaware of their HIV status.

Not to mention, how if at all do these laws address the reality that for some living with HIV/AIDS, disclosing their status could mean they are attacked and even murdered?

But what’s really worrisome are the messages these laws send to HIV-negative folks like myself. They tell us that we are not responsible for our own health, which couldn’t be further from the truth.

If you want to remain HIV-negative, you have to make a conscious effort to do so.

Yes, some can control their situation better than others. For those in violent relationships, demanding condoms is not going to happen given that comes with dire consequences. Or I think about folks in marriages or long-term relationships who test positive not even thinking they were at risk because their relationship wasn’t as monogamous as they thought. Or people who have to use sex as a means to survive.

But let’s be clear, that was not the case with Johnson’s “victims.”

These people willingly had unprotected sex with Johnson. And this isn’t a judgment about having casual sex, because knowing someone doesn’t protect you from HIV/AIDS either. Only condoms do. And given the higher rates of HIV in the Black community, we really cannot afford to slip up given that we are more likely to encounter HIV when dating within our community.

Real talk: This isn’t new information.

And it’s frustrating because we are a generation of not knowing a world without AIDS and yet our cluelessness and the lack of responsibility blows my mind. Basic HIV 101: You cannot tell if someone has HIV, attractive people can have HIV and tops can be positive, too. And while talking about our statuses is important when entering sexual relationships, that doesn’t mean you take someone’s word as fact. People are not always truthful and in many cases people are not even aware that they are positive.

In the end, if anything tangible can be taken away from Johnson’s HIV exposure case, it is that you have be the one in charge of your health if you plan on remaining HIV-negative. The “burden” is on you, as it should be given that it’s your life and not anyone else’s.

Follow Kellee Terrell on Twitter

The opinions expressed here do not necessarily reflect those of BET Networks.

BET Health News – We go beyond the music and entertainment world to bring you important medical information and health-related tips of special relevance to Blacks in the U.S. and around the world. Click here to subscribe to our newsletter.

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By Perry N. Halkitis, Ph.D., M.P.H. for HuffPost

For almost 10 years, I have traveled with a group of graduate students to London, England each January. During the two weeks we spend together, we enact a course of study that examines the HIV epidemic, particularly the medical, behavioral, and social issues that have shaped our battle against HIV/AIDS for the last 30 years, and examine the responses to the epidemic in the United States as compared to the United Kingdom. The UK provides an excellent contrast to the US with its provision of healthcare under the National Health Service, a single-payer system which is entirely funded through central taxation. Despite the radically different approaches to healthcare funding, there are many similarities with regard to the course of the AIDS epidemic in the two countries, including but not limited to the perpetuation of the epidemic in gay and black populations.

Every year, one theme seems to most dominate the course of our studies. This year, much of our discussion and study focused on the emergence and implementation of biomedical technologies to combat the spread of AIDS, namely treatment as prevention and Pre Exposure Prophylaxis (PrEP). It is the former that provided the most lively and heated discussions for the group and for me provided another perspective on the problems associated with this particular approach.

The concept of treatment as prevention is a logical one. Effectively treat those living with HIV, thus reducing viremia and in turn rendering HIV-positive individuals as less infectious. The Swiss Statement clearly supports this idea, and numerous studies including HPTN052, have demonstrated the effectiveness of this HIV prevention approach. As a result, nowadays, HIV-positive individuals in the US are encouraged to begin and antiviral regimen upon diagnosis. Seems simple enough.

Yet there is a flaw in this strategy that has sat uncomfortably with me for the last few years. Data from across our country indicate that on average only 28% of Americans living with HIV effectively suppress their viral load. The treatment cascade posits that for every 100 American living with HIV, 80 are aware of living with HIV, 62 are linked to care, 41 are retained in care, and only 28 achieve viral suppression due to treatment. How then is it possible that treatment as prevention will actually work? There is an inherent flaw in the thinking around HIV prevention in light of this reality.

Our colleagues in UK are also skeptical about treatment as prevention watching us closely as we roll out this system. In fact, the British HIV Association does not recommend treatment upon HIV diagnosis; their guidelines prescribe that antiviral treatment (ART) not be initiated until markers such as CD4 count reach 350. More recently this figure has been reconsidered and ART is often initiated when CD4 counts reach 500. Our colleagues from across the pond and across professions—physicians, nurses, psychologists, advocates, and leaders of community agencies— all support this approach to care, arguing that there is no definitive evidence that initiating ART earlier is ultimately more beneficial than waiting. In fact, they believe that there is no no need to add undue burden on the HIV-positive individual, and ultimately there is no information about what a lifetime of administering antivirals will have on the health of HIV-positive individuals. While I respect this opinion, I am of the mind that one should suppress viral replication immediately and preserve those mature CD4 cells before they are destroyed. Also, one could argue that the Brits, under the NHS, are reluctant to begin antiviral therapy immediately upon diagnoses because of the cost implications. The latter, of course, is a hypothesis.

Still one argument that resounded loudly and clearly with me was raised by my colleague, HIV-positive activist, Silvia Petretti, the Deputy CEO of one of the UK’s most well established service organizations, Positively UK. Silvia powerfully and emotionally suggested that treatment as prevention is just another approach, which places the responsibility of the HIV epidemic on the shoulders of HIV-positive people. This can be viewed as another in the long line of HIV prevention strategies that places the burden on the HIV-positive, just like expectations that infected individuals always disclose, use a condom every time, and ultimately protect the well being of the HIV-negative. The long terms survivors whom I interviewed for my new book, The AIDS Generation: Stories of Survival and Resilience, raised similar concerns about the lack of shared responsibility.

I had never thought of treatment as prevention in this manner and never considered that this approach was just another that placed the responsibility of the epidemic on me and my fellow HIV-positive men and women. I wonder then how many of us are being bullied by the medical establishment and our health policy leaders to initiate treatment simply to curtail the spread of HIV without any regard to how these treatments affect us both in the short and long term, physically, emotionally, and socially. And I will think twice moving forward when I counsel those newly infected who seek my advice.

I would like to think that those advocating treatment as prevention ultimately have the health of HIV-positive individuals in mind first and foremost. But my immersion into the UK system this last month has led me to wonder about the motivation that underlies this approach. It is my hope that decisions about my health, and the health of all HIV-positive individuals, are not being made with the perspective that we are vessels of transmission that need to be contained. Coupled with the dismal statistics from the treatment cascade, one is left to wonder if treatment as prevention is serving anyone effectively. Perhaps it is time to refocus and replace our energies in treatment as care, helping HIV-positive individuals maintain their overall well being in every aspect of their lives, and ultimately sharing the responsibility for the containment of this epidemic with those who are HIV-negative.

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By Casey Quinlan for City Limits

Some advocates hope that Andrew Cuomo, who has supported Medicaid reform, gay marriage and gun control laws, will be willing to stake political capital on the effort to end new HIV infections.

Advocates will be listening closely to the governor’s budget address to see if the administration responds to their push for a comprehensive effort to effectively end new infections.

Last Spring, some New York politicians and advocacy groups began pushing what they call “an initiative to end AIDS,” or end new HIV infections, in the state. They are hopeful that Governor Cuomo and Mayor Bill de Blasio will take up the cause.

According to the New York State Department of Health, new diagnoses for HIV fell 37 percent, with diagnoses falling in all risk groups from 2002 to 2010. From 2003 to 2010, there was a 96 percent increase in the annual number of newly reported HIV infections in young men who have sex with men of color, the same report reads.

HIV is still an epidemic in neighborhoods in parts of the Bronx, including Tremont and parts of Claremont, Belmont and Crotona. And, says Daniel Tietz, executive director of AIDS Community Research Initiative of America [ACRIA,], which provides HIV/AIDS education and consulting and studies the needs of at-risk populations, “When only about 40 percent of New Yorkers with HIV are virally suppressed, meaning they are consistently engaged in care and on effective treatment, it is clear we’ve not solved this or ended the epidemic.”

The initiative is a combination of policies, some health-related and some focused on quality of life in general, such as better housing and primary care. It’s what Housing Works CEO Charles King calls a “thatch roof” of a plan because all of the parts are needed in order to strengthen its efficacy.

Multifaceted plan

Housing Works, Treatment Action Group and ACRIA organized engagement with state senators, assembly members, state and city agencies and the governor’s office to gain funding for the AIDS Institute, which recently avoided $40 million in cuts, not to mention talk of closure.

An essential part of the plan is making sure young people of color get access to fourth-generation testing, which simultaneously detects both antigen and antibodies for HIV s and can alert newly infected people much faster.

“There is a big spike in virus in the blood soon after infection, but often before an HIV antibody test would pick-up an infection. This is when folks may pose the greatest risk to others, usually unknowingly,” Tietz says. “The typical mouth swab or home test kit is not testing for the virus itself, but rather the body’s antibody response, which may take six to eight weeks after infection to develop. If someone had unprotected sex a few days ago and decided to take an HIV, the current antibody testing couldn’t tell you whether you were infected.”

A “30 percent rent cap,” or a making sure that New York City residents with HIV/AIDS living in subsidized housing have their rent capped at 30 percent of their income, is also important to the initiative, and one Housing Works has long fought for. The 30 percent rent cap bill passed both houses but stopped at Governor David Paterson’s veto in 2010.

The plan would also improve access to nPEP (non-occupational Post-exposure Prophylaxis) and PrEP (Pre-exposure Prophylaxis). The former medication would prevent HIV inflection after exposure to the virus and the latter pills would reduce their risk of becoming infected. King says he would like to do fewer testing sessions in clubs and instead focus on getting men who have sex with men primary care where they can be regularly screened for HIV, which he says will enable physicians to catch infections earlier.

“A testing session in a club can’t provide someone with a script for PrEP, and few actually have the time or inclination to discuss PrEP or PEP with people who are negative,” he saus. “We are going to catch far more people early in their infection and they will already be linked to care.”

Tietz says that the 30 percent rent cap would be key to the initiative as it would prevent homelessness for thousands of low-income New Yorkers who are permanently disabled by HIV/AIDS and would permit 1,000 of them to move out of the shelter system.

“These folks could then focus on their HIV treatment and not live in constant worry and fear of losing everything. People face lots of other barriers and challenges that we need to address, such as continuing stigma and discrimination, and mental health and substance use issues,” Tietz says.

Several agencies involved

A lot of coordination is required across state and city health agencies to make the plan effective.

The initiative would require significant involvement from New York City health officials, and Tietz says that Mayor Bill de Blasio’s appointment of Lilliam Barrios-Paoli as deputy mayor of health and human services is an encouraging signal.

The mayor has also expressed support for the 30 percent rent cap, which he supported in the past as a public advocate and throughout his mayoral campaign. Although de Blasio’s platform did not outright acknowledge AIDS prevention, his interests and political affiliations suggest he is much more willing to work with stakeholders on the issue than Mayor Michael Bloomberg, who was often at odds with the HIV advocacy community.

Speaker of the Assembly Sheldon Silver and Senate Majority Leader Dean Skelos did not return requests for comment on the initiative.

New York State Senator Brad Hoylman, a Democrat who represents District 27 in Manhattan, is supporting the initiative and says that although he is not blindly optimistic, he has seen strong signals in discussions with the governor’s team that they are interested in pushing the initiative forward. Hoylman argues that although the plan can be argued on the merits of its cost efficiency, his primary argument is a moral one.

“The issue is a tremendous one for low-income people, for the most vulnerable people in our society. One reason for the misunderstanding is that people think the crisis is over,” Hoylman said in a phone interview.

Benefits and costs

Each infection averted could save the state as much as $379,668 per person (in 2010 dollars) in lifetime medical costs according to the Center for Disease Control.

As for the initiative’s costs, PreExposure Prophylaxis (PrEP) treatment, or Truvada, the only FDA-approved drug, costs between $600 and $1,000 per month, according to John Emery, spokesman for the New York State Department of Health. It consists of two medications taken daily as long as the risk of HIV is high. It could cost up to $14,000 a year.

For non-Occupational Post Exposure Prophylaxis (nPEP), the treatment, a combination of three medications, lasts 28 days. Its costs range from $600 to $1200, Emery says. Both treatments are covered under Medicaid.

King says this is the right time for an initiative to end AIDs, for a variety of reasons. The city has gained a new mayor, the Affordable Care Act came to fruition and the Medicaid Global Spending Cap Fund freed up additional money. Since April 2011, enrollment in the Medicaid program increased by over 390,000 but remained $2 million under the $15.9 billion target, according to the state’s March 2013 Global Spending Cap report.

“We found that sweet spot, where the political stars were aligned and science was saying what we’d known for a while,” King says.

Will Cuomo act?

One of the key parts of the puzzle is having a governor willing to support ideas that aren’t always popular or easy and King says Andrew Cuomo, who has supported Medicaid reform, gay marriage and gun control laws, fits the bill.

“Cuomo has proven his willingness to champion bold ideas that aren’t always popular politically,” King says. “He did that with Medicaid reform in an inclusive and participatory way. He cut the right deals that predecessors had not.”

Advocates were disappointed that the governor did not mention the possibility of a task force in his annual State of the State address, but hope that he will mention it in his budget speech on January 21.

King says he doubts it will be mentioned, despite a “good faith effort on the part of the governor’s staff.”

“There is probably not enough time to get a deal with [anti-HIV drugmakers] that would make everyone comfortable with the costs. I also believe we will see a fairly strong effort by the Department of Health to advance the initiative even if the Governor doesn’t act at all,” King says.

Tietz is more hopeful on the matter, and echoes the sentiment that New York State Health Commissioner Nirav Shah’s support is key to advancing a task force on ending AIDS.

“I think the near-term issues are entirely about the timeline, including the pace of ongoing price negotiations with key anti-HIV drugs makers, and whether such discussions will be far enough along to permit an announcement at next week’s release by the Governor of his 2014-15 executive budget,” Tietz said in statement.

In the meantime, advocates like Tietz are doing their best to carve out funding before late March when the budget is finalized. Tietz said he will raise the issue again on February 3 at joint legislative budget hearings on the Health/Medicaid budget, but he said he believes the governor’s key staff understands the urgency of making a decision.

Tietz wrote the governor a letter on January 14, requesting that he mention the initiative in his budget speech and give the initiative the public push it needs, which read, “If the task force is promptly named and convened by you it could complete its recommendations on a plan to end the epidemic, the outline for which has already been developed by the AIDS Institute, for inclusion in the 30-day budget amendments.”

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By Rachel Swan for SF Weekly

A contentious anti-trust trial over pricing for HIV medications will have to start all over again, after the Ninth Circuit Court of Appeals ruled that the defendant, Abbott Laboratories, couldn’t reject a juror based on his sexual orientation.
Plaintiff GlaxoSmithKline PLC had already clinched a $3.5 million verdict and prevailed on several claims that Abbott violated antitrust laws by jacking up the price of its HIV cocktail drug — right after it licensed the medication to GSK. But the case really hinged on a brazen move that Abbott’s lawyers made during jury selection, nixing a juror who self-identified as gay.

Joseph Saveri, a lawyer for one of the plaintiffs suing alongside GSK, balked at the ouster.

“The problem here, of course, Your Honor, is the litigation involves AIDS medication,” Saveri told the court. “Incidents of AIDS in the homosexual community [are] well known, particularly [among] gay men. So…it looks like Abbott wants to exclude from the pool anyone who is gay.”

In their appeal to the Ninth Circuit, lawyers for GSK argued that, in light of the Supreme Court’s June decision to strike down the Defense of Marriage Act, “Juror B” — as he’s dubbed in court documents — should belong to a protected class.

Abbott’s peremptory strike against the juror is not only discriminatory, but unfounded, GSK’s counsel continued. During the selection process, defense attorneys asked five questions about his knowledge of HIV drugs, but didn’t broach the issue of whether he’d be a biased juror by virtue of having a male partner.

The appeals court sided with GSK, ultimately turning a business lawsuit into a civil rights case. The trial, which lasted four weeks and put millions of dollars at stake, will have to start anew.

You can read the Ninth Circuit’s opinion here:

Ninth Circuit Ruling GSK v. Abbott by Leah Rachel Swan

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By Mathew Rodriguez for TheBody.com

Eighteen months after the approval of Truvada (tenofovir/FTC) by the U.S. Food and Drug Administration as a pre-exposure prophylaxis (PrEP) regimen to prevent HIV transmission, the New York state AIDS Institute has released guidelines for health care professionals as to how to approach prescribing PrEP to people who wish to use the drug. Truvada is currently a part of many medication regimens for HIV-positive people, and is among the drugs used as post-exposure prophylaxis (PEP) for those who have had a potential exposure to HIV.

The guidance states that it was released after “studies evaluating the efficacy of PrEP have shown promising results.” With the U.S. Centers for Disease Control and Prevention issuing only interim guidance on PrEP for specific populations, New York’s guidelines are a welcome sign that adoption of PrEP may finally ramp up across the U.S.

The guidance includes methodology behind PrEP, what medicines are candidates for PrEP (currently only Gilead-produced Truvada), contraindications and considerations, notes on how to do assessments, education, laboratory tests, parameters for follow-up and monitoring and the proper course for discontinuation of a PrEP regimen.

Several key principles in the PrEP guidance include: PrEP as part of a full comprehensive prevention plan; PrEP as a tool for people in serodiscordant relationships; the importance of adherence; and advice on those who use PrEP and choose not to use condoms. On the topic of condom use, the guidance says, “Although consistent condom use is a critical part of a prevention plan, lack of use of barrier protection is not a contraindication to PrEP.” Concern about sexual risk and PrEP is a common theme in many discussions around the regimen.

Andy Velez, member of the AIDS Coalition to Unleash Power (ACT UP), which has been calling for the release of these guidelines for some time, said, “It’s good that the New York State guidelines have finally been released. But finally is not good enough. This kind of bureaucratic delay has meant that many who could have been prevented from being HIV infected have ended up seroconverting. We are living through the worst new infection numbers among men who have sex with men since the early years of HIV/AIDS. Business as usual on the part of bureaucrats, pharma and service providers is not acceptable. Urgency is the word.” ACT UP has begun extensive work around PrEP advocacy as it turns its focus toward HIV prevention as a cornerstone of its agenda.

The Guidance for the Use of Pre-Exposure Prophylaxis (PrEP) to Prevent HIV Transmission is written by the New York state AIDS Institute.

Mathew Rodriguez is the editorial project manager for TheBody.com and TheBodyPRO.com. Follow Mathew on Twitter.

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Image: Brendan Hoffman

By Simeon Bennett for Bloomberg

Yekaterinburg, the Siberian city where drug users used to be handcuffed to their beds to help them quit, exemplifies Russia’s efforts to stamp out the habit in a nation that has the most HIV-infected addicts.

The practice was stopped by local police in 2005, though going cold turkey still prevails, said Kiril Petrov, a coordinator with City Without Drugs, the organization whose centers used handcuffing but have abandoned that method. Users are expected to quit without the aid of addiction-easing medicines such as methadone, which is banned in Russia.

While its neighbors China and Ukraine are seeing the benefits of methadone and other ways of preventing HIV transmission such as clean needles, Russia is instead fighting drugs and the virus with a patchwork of home-grown strategies that emphasize willpower, personal discipline and healthy lifestyles. The approach reflects a culture that idolizes strong men such as President Vladimir Putin and is common in Russia, with hundreds of similar centers around the country, said Sasha Lesnevskiy, a psychologist at an HIV clinic in Yekaterinburg.

“It’s a kind of military idealism,” Lesnevskiy said. “I don’t understand as a psychologist why a person who comes out of one of these rehabilitation centers would quit drugs.”

There’s been a 10-fold drop in drug-related deaths since City Without Drugs started, Yevgeny Roizman, the group’s founder, said in a telephone interview.

Cheap Heroin

Still, the cold-turkey push isn’t stemming HIV: as of Dec. 25, the Sverdlovsk region, of which Yekaterinburg, with 1.4 million people, is the capital, had 1,494 cases of HIV per 100,000 people, the third-highest rate in Russia and twice the national average, according to the region’s state-run Center for Prevention of AIDS and Infectious Diseases. Almost 66,000 people have been infected with HIV in Sverdlovsk, making it the region with the most cumulative infections.

The City Without Drugs concept remains popular in Yekaterinburg. In September, Roizman was elected mayor of Russia’s fourth-biggest city in a surprise victory over a candidate from Putin’s United Russia Party.

City Without Drugs was started during the 1990s, when cheap, high-quality heroin flooded into Yekaterinburg from Afghanistan following the collapse of the Soviet Union.

“It was cheaper than vodka,” Petrov said. “It was even sold to school children.”

Handcuffs Helped

Petrov said he’s living proof the approach works. The enforced cold-turkey method — Petrov was handcuffed — helped him break his heroin habit and realize he didn’t need drugs.

“We have to put a drug user in such a condition where he has no access to drugs, and he himself can see that he can live and survive without drugs,” he said. “In the future, he himself has to decide whether he needs drugs or not. There is no other solution.”

About 5,000 people have been through the group’s centers, Petrov said, though the organization doesn’t keep figures on how many have remained drug-free.

No one is forced to stay, though drug users who try to leave will be urged to complete the process, Petrov said. A qualified psychologist helps the addicts, he said. Patients are asked to pay 8,000 rubles ($240) a month to cover the cost of food. Those who can’t pay are still accepted, he said.

Quarantine Room

At one of the group’s centers on the city’s outskirts, a locked iron gate, a security guard and a dog help ensure no one gets in or out unnoticed. The slogan “Strength in Truth” is stenciled in blue and red letters above the door of a run-down house. Addicts in the initial stages of recovery spend three weeks in a so-called quarantine room jammed with bunk beds and are under constant video surveillance.

Osman Osmanov, 40, said he checked in to break a three-year habit of injecting heroin as many as 10 times a day.

“When I saw the room with the bars on the windows it gave me adrenaline to overcome this,” Osmanov said. “This center is the only thing that helped me get out of the swamp. I was at other centers but they were hopeless.”

While the program may help a few patients, Lesnevskiy said he refers drug users to centers operated by churches, Narcotics Anonymous, or a newly-opened state-run center.

Pavel Shalginsky, a 32-year-old drug user, said he declined an opportunity to attend a City Without Drugs center.

“I said I’d rather go to prison,” Shalginsky said.

Infections Rise

Roizman rejects such criticisms.

“I’m not interested in these talks,” he said. “I gave my blood and my soul. I invested my money and 15 years of my life in this.”

Meanwhile, new HIV infections in Russia jumped 13 percent to 70,453 in 2012. Vadim Pokrovsky, director of the country’s Federal AIDS Center in Moscow, said he “can’t find a sane explanation” for why his superiors in the Kremlin continue to prohibit methadone.

“The people who are prevailing now are the supporters of force used in order to combat drug use,” Pokrovsky said. “The question of how to stop the epidemic of HIV among drug users is still not solved.”

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By Ellie Feinglass for The New York Times

One afternoon last spring I met a farmer named Salomão in a rural community in Southern Mozambique. Salomão was in his late 30s, living with both HIV and tuberculosis, and very poor, with few possessions aside from the clothing on his back, some cooking pots, and his hoe. In late March, he walked without shoes for eight hours in the pouring rain so that he could pick up his month’s supply of drugs. When he got to the health center, he was tired and weak. He was then humiliated and turned away because his health card was wet. And in the process, Salomão’s HIV status – something that should be held in complete confidentiality – was disclosed to everyone who happened to be in the crowded waiting area at the outpatient clinic. Upon returning to his village, Salomão was shunned by his family and many of his neighbors. Without his medicine, his health deteriorated rapidly. By May, he had developed several abscesses on his leg. He resisted returning to the health facility. Within a few weeks Salomão died at home, alone, and in silence.

This story repeats itself in towns and villages across the globe. A mother takes her three year-old daughter to the hospital, where she is diagnosed with malaria. The girl dies several days later because the medicine she needs is out of stock. A son carries his ailing father 12 kilometers to the nearest health center, only to find that it is closed. A young woman dies in labor because she does not pay a bribe. Entire communities accept lack of access to basic but life-saving services as an inexorable reality. Countless people suffer from conditions that are preventable and treatable.

The culture of silence runs deep and is often grounded in the belief that any provision of health care is a gift bestowed upon the patient and his or her family. It stems from both the absence of functional systems of grievance redress and the very real fear of retribution when patients do voice complaints, as well as from power inequalities around gender, class, and educational level, among others.

While at the turn of the millennium, access to affordable HIV treatment in low and middle-income countries was virtually nonexistent, at the end of 2012 there were 9.7 million people receiving lifesaving therapy. Thanks to this rapid scale-up, as well as to groundbreaking scientific evidence that early treatment can reduce transmission of disease, we are now at a critical juncture; for the first time, the end of the AIDS epidemic is conceivable.

While we have made tremendous strides, the challenges that remain are vast. Most people living with or at risk of HIV still do not have access to prevention, care and treatment. The epidemic continues to ravage families, communities and entire nations. This is particularly true in sub-Saharan Africa, which bears the burden of disease in disproportionate measure, and where HIV/AIDS is the leading cause of death in adults.

We must acknowledge that medicines and technology alone are not enough. The solution will never be a purely biomedical one. Our strategy, if it is to be successful, must recognize that achieving universal access to care and treatment necessarily means addressing human rights barriers to health services. This will require confronting not only the challenges of physical distance and availability of diagnostics and drugs, but also of stigma, discrimination and quality of care.

So how do we take health and human rights ideology from the theoretical to the tangible in order to have real impact on the lives of marginalized populations?

Accountability of public health services to individuals and communities will be essential in achieving and sustaining gains in access to and quality of health services.

We need to focus on increasing civic engagement by developing capacity directly among the poor to pursue their entitlements and engage in governance of the health sector. For this to happen, laws and health policies must be accessible to everyone, both physically and linguistically. This requires translation into local languages and use of both written and spoken means of communication that are more inclusive of those with limited or no literacy.

Civil society has a central role to play in efforts to achieve justice in the health sector. Yet participation of civil society is too often nominal and is undermined by the narrow political space in which these groups operate and by their limited financial and technical capacities.

When people do have the courage to complain, they need somewhere to go. We must work with governments to establish mechanisms for transparency and grievance redress that are both inclusive and responsive.

And we need to build a culture of solidarity between patients and providers and to better support health workers, many of whom themselves are struggling to survive and are victims of unjust systems in which they do not have the tools and information they need to perform their duties.

As we push forward in the struggle to achieve the universal right to health care, we must call on governments, donors, and the NGO community to place real investment in the legal empowerment of the poor and to recognize this piece not as an add-on, but instead as vital as the medicine itself.

Ellie Feinglass is Namati’s Health Advisor and Co-Director of the Right to Health Program in Mozambique.

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Image: AP Photo/Joseph F. Major

By Reuters; published by The Washington Post

Scientists seeking a cure for AIDS say they have been inspired, not crushed, by a major setback in which two HIV-positive patients believed to have been cured found the virus re-invading their bodies.

True, the news hit hard last month that the so-called “Boston patients” — two men who received bone marrow transplants that appeared to rid them completely of the AIDS-causing virus — had relapsed and gone back onto antiretroviral treatment.

But experts say the disappointment could lay the basis for important leaps forward in the search for a cure.

“It’s a setback for the patients, of course, but .?.?. the field has now gained a lot more knowledge,” said Steven Deeks, a professor and HIV expert at the University of California at San Francisco.

He and other experts say the primary practical message is that current tests designed to detect even very low levels of HIV in the body are simply not sensitive enough.

As well as having the human immunodeficiency virus (HIV), the Boston patients both also had a type of blood cancer called lymphoma, for which they had bone marrow transplants — one man in 2008 and the other in 2010.

They continued taking antiretroviral AIDS drugs, but eight months after each patient’s transplant, doctors could not detect any sign of HIV in their blood.

In the early part of 2013, both patients decided to stop taking their AIDS drugs and both appeared to remain HIV-free, prompting their doctors at Boston’s Brigham and Women’s Hospital to announce that they may have been cured.

Yet in December came news that one of the men had begun to show signs of an HIV rebound by August, while the second patient had a relapse in November.

One of the doctors, Timothy Henrich, said the virus’s comeback underlined how ingenious HIV can be in finding hiding places in the body to evade attack efforts by the immune system and by drug treatment.

He said both patients were “currently in good health” and back on antiretroviral therapy.

Barely a decade ago, few HIV scientists would have dared put the words “HIV” and “cure” in the same sentence. Yet some recent cases are intriguing.

First was the now famous case of Timothy Ray Brown, the so-called “Berlin patient,” whose HIV was eradicated during treatment for leukemia in 2007 after he received a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection.

Such an expensive and life-threatening procedure could never be used as a broad-spectrum approach for the world’s 34 million HIV patients. But the results focused scientific attention on a genetic mutation known as CCR5 delta 32 as a target for possible gene therapy treatment.

Last March, French scientists reported on 14 HIV-positive people who had been treated very swiftly with HIV drugs but then taken off them. The researchers said that seven years later, the patients were showing no signs of a virus rebound.

Just weeks before that, doctors reported that an HIV-positive baby in Mississippi given antiretroviral treatment for 18 months from the day she was born seemed to have achieved a “functional cure.”

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Road Map for Implementing and Monitoring Policy and Advocacy Interventions by the Health Policy Project

Author(s): Nicole R. Judice, Jeffrey Lane, Aaron Katz, Ron MacInnis, Mai Hijazi, Andre Verani, Amy Hagopian, Michelle Wu Yoon, Erin K. Hurley, Sallie Thieme Sanford

Abstract

This suite of tools, developed by HPP, the University of Washington, USAID, and the U.S. Centers for Disease Control and Prevention, was designed to strengthen the capacity of key stakeholders to engage in and monitor health policy development and advocacy interventions.

The Road Map consists of eight different tools that can be used separately or together to help stakeholders systematically review the policy process and take steps toward full implementation. Each tool is meant for a different stage of the policy process and helps users fully view the different actions necessary to move the policy process forward from development to implementation and evaluation.

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Read on for more details about the following three reports released earlier this month by the Kaiser Family Foundation.

Kaiser Releases Fifty State Reports On the Impact of the ACA on Coverage In Every State

New Analysis Estimates the Number of People with HIV Who Could Gain New Coverage Under the ACA

Analysis Examines Health and Access for LGBT Individuals

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Kaiser Releases Fifty State Reports On the Impact of the ACA on Coverage In Every State

New reports for each of the fifty states from the Kaiser Family Foundation show how the Affordable Care Act (ACA) changes insurance coverage in each state. The state-level reports serve as a guide to the potential impact of the ACA in each state and the District of Columbia as legislatures begin to convene and governors prepare their budget proposals and state-of-the-state addresses.

Based on analysis by Kaiser researchers, each state report provides a breakdown of how many uninsured people are eligible for Medicaid or for financial assistance to help them buy private insurance in the new Marketplace, and how many may gain new coverage but will not receive any financial assistance. Each report also details the income levels at which people in each state are eligible for Medicaid or financial assistance in the Marketplace. For states not expanding Medicaid, each report quantifies how many uninsured people with incomes below the poverty level fall into the “coverage gap” and will be ineligible for financial assistance in the Marketplace or for Medicaid in their state. In larger states the reports also estimate how many uninsured residents are undocumented immigrants and therefore are ineligible for any coverage under the ACA. The reports can be viewed online as well as printed out and taken with you.

The state reports complement an online infographic released last month featuring an interactive map that allows users to click on each state to obtain key data about how the uninsured are expected to fare under the ACA in that state, and to compare the law’s impact in different states.

KFF previously released detailed analyses of those eligible for tax credits in the marketplaces and those who fall into the coverage gap, as well as briefs that examine the characteristics of people in the coverage gap and the impact of the gap by race and ethnicity in states that are not moving forward with the Medicaid expansion. Also available is a brief that takes a closer look at the uninsured who will be eligible for Medicaid. For more information about the uninsured and the health reform law, visit www.kff.org.

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New Analysis Estimates the Number of People with HIV Who Could Gain New Coverage Under the ACA

A new analysis by the Kaiser Family Foundation in conjunction with researchers at the Centers for Disease Control and Prevention (CDC) provides the first national estimates of the expected impact of the Affordable Care Act’s coverage expansions on people with HIV.

The brief finds that close to 70,000 uninsured people with HIV who are in care could gain new coverage. This group includes almost 47,000 who could gain coverage through Medicaid if all states were to expand under the law and almost 23,000 who could gain coverage through the health insurance marketplaces, most of whom would get financial assistance.

Currently, 25 states are not planning to expand their Medicaid programs under the law, reducing the number of people with HIV who could gain Medicaid coverage. The analysis estimates that state decisions not to expand Medicaid would reduce the number eligible for Medicaid by more than 15,000, leaving them without affordable insurance.

For individuals left out of coverage expansions, the Ryan White HIV/AIDS Program will continue to be a critical source of support. The program will also likely continue to remain critical in helping wrap around insurance coverage for many insured people with HIV, as it does today.

The full analysis is available online. The Foundation has also updated The Uninsured: An Interactive Tool to highlight people with HIV who are uninsured, why they are uninsured and how the ACA could impact them.

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Analysis Examines Health and Access for LGBT Individuals

Several recent policy changes, notably the implementation of the Affordable Care Act (ACA) and the Supreme Court’s overturning of a major portion of the Defense of Marriage Act (DOMA), are reshaping the health care and coverage landscape for lesbian, gay, bisexual, and transgender (LGBT) individuals and their families.

A new issue brief from the Kaiser Family Foundation examines what is known about LGBT health status in the U.S., with a focus on concerns such as the HIV/AIDS epidemic, mental health and violence. It also discusses the impact of the ACA and the Supreme Court’s DOMA ruling on health care coverage and access for LGBT individuals.

“Health and Access to Care and Coverage for Lesbian, Gay, Bisexual and Transgender Individuals in the U.S.” is available online.

—-

The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people. The Foundation is a non-profit private operating foundation, based in Menlo Park, California.

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Please take a moment to act on this important alert from our friends at the Drug Policy Alliance

Help Save Lives!

Tell Your Member of Congress to Lift the Federal Funding Ban on Syringe Access Now!

Congress is drafting the annual federal spending bill as we speak. Buried deep in this bill is a senseless ban on federal funding for syringe access programs. The ban means that states cannot use federal dollars for syringe access programs, even though they save lives by reducing the spread of HIV/AIDS.

Over the next two weeks, eight members of Congress will decide the fate of this harmful ban! Tell your member of Congress to save lives by lifting the syringe access funding ban now!

Syringe access programs are proven to prevent illness and death, by providing sterile syringes to people who inject drugs and minimizing the transmission of HIV and hepatitis C. These programs also benefit people who don’t use drugs but could still be protected from disease and death. But even though syringe access programs save lives, federal funding for them is banned by Congress because of the misguided war on drugs!

This harmful ban has resulted in hundreds of thousands of people contracting preventable diseases. Medical professionals across the country are being denied one of the most useful tools to fight the spread of HIV/AIDS and hepatitis C.

Congress doesn’t draft a budget very often. The last time it happened was two years ago, when the syringe access ban was sneakily inserted in this dense legislation. Lifting the ban will save lives and taxpayer dollars at no additional cost to the federal government.

Today, you have a chance to make sure the ban is finally lifted. But our window of opportunity won’t last long and lives are hanging in the balance. That’s why your member of Congress needs to hear from you right now: Urge them to end the syringe access funding ban today.

~ ~ ~ ~ ~

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By Guy Gugliotta (12/04/13) for Kaiser Health News, in collaboration with The Washington Post

ADRIAN, Mich.—When Medicaid expands next year under the federal health law to include all adults living close to the poverty line, one group of eligible beneficiaries will be several million men and women who have spent time in state and federal prisons and jails.

The Department of Justice estimates former inmates and detainees will comprise about 35 percent of the people who will qualify for Medicaid coverage in the states expanding their programs to anyone earning less than 138 percent of the federal poverty level, or about $15,000 for an individual in 2013. The Congressional Budget Office estimated earlier this year that 9 million people will get that new coverage next year.

In addition, the expansion could help states cover the medical costs of some current inmates who need hospitalization or other expensive specialized care outside of prison.

Michigan, which has long been recognized as an innovator in inmate health care, is expanding its Medicaid program. Officials here say that funding could help cover the needs of some seriously ill inmates as well as provide new coverage for released offenders, which could be a valuable tool in curbing recidivism.

“A significant number have never prepared their own meals. They don’t know how to shop, or how to budget,” said Tammy Meek, prisoner re-entry coordinator for the Gus Harrison Correctional Facility in this small city in southern Michigan. “Some can’t even write their name in cursive. Health care is critical in protecting the public and giving the client [former inmate] the tools he needs to succeed.”

GOP Lawmakers’ Concerns

But the Medicaid coverage for former offenders has stoked the interest of some powerful GOP members of Congress, including one from Michigan, House Energy and Commerce Committee Chairman Fred Upton. He and Health Subcommittee Chairman Joe Pitts of Pennsylvania last month asked the Government Accountability Office to review the effect of the health law’s Medicaid provisions on former offenders. “We must better understand the true costs of expanding the program to any new population and weigh such costs with the competing interests of our nation’s most vulnerable law-abiding citizens,” they wrote.

A Republican committee source said Upton and Pitts simply wanted “updated data” from GAO on “how Medicaid interacts with the criminal justice system” because they were “committed to understanding how every Medicaid dollar” will be spent under the new health law.

A Democratic committee source, however, dismissed the Upton initiative as “a complete red herring” prompted by Republicans’ search “for another way to come up with something that will ding the Affordable Care Act.”

The congressmen’s request notes that some researchers have suggested that large numbers of people added to the Medicaid rolls in an expansion could be prisoners. But ordinary, in-prison health care is not covered by Medicaid. The Medicaid law, passed in 1965, denies federal matching funds for convicted prisoners—about 1.5 million adults nationwide—and for 750,000 unconvicted detainees held for trial or petty crimes and misdemeanors in county and city jails on any given day. Each state, county or city must pay for the medical needs of all detainees from its general funds. The Affordable Care Act does not change this law.

However, since 1997, the federal government has allowed matching Medicaid funds to pay for specialized hospital care for 24 hours or more outside the prison system for inmates who were enrolled in or eligible for Medicaid before their incarcerations. Since most states narrowly draw the eligibility rules for adults, this funding generally covered people such as the frail elderly, patients suffering from serious disabilities and chronic diseases and pregnant women.

Michigan received $8 million in matching funds for that program during the year ending Sept. 30, state Department of Corrections spokesman Russ Marlan said. Next year, when about half the states have agreed to expand their Medicaid programs, the number of these patients should rise dramatically as will the federal matching funds. Marlan said Michigan could receive $20 million in Medicaid funding from the federal government in 2014 to help pay for such specialized treatment of prisoners, “but it’s probably too early to know for sure.”

Potentially far more important for the state’s bottom line, Medicaid expansion will also cover low-income inmates leaving prison.

“Having access to health care and mental health care contributes to their success in staying out of prison,” noted Heidi E. Washington, warden at the Charles E. Egeler correction facility in Jackson, Mich.

Lowering Recidivism

Helping former inmates adjust to the outside world has been shown in many studies to curb recidivism. Michigan, which has used state funds for reentry programs that include health care for nearly a decade, has seen its prison population drop in the past five years from 51,554 to 43,636. For released offenders with special needs—mostly mental disorders—recidivism rates plummeted from 50 percent in 1998 to 22.5 percent in 2012. Michigan spends $35,000 each year for every imprisoned inmate.

But curbing recidivism doesn’t just hinge on having funding from programs like Medicaid, noted Ira Burnim, legal director of the Bazelon Center for Mental Health Law. “These folks have to have services, and when they have access to housing and local support, they do very, very well.”

Michigan in 2005 hired a private company, Professional Consulting Services, to coordinate individual release plans for special needs inmates, serving as an intermediary between the Department of Corrections, state Medicaid officials and outside housing and service providers.

Chief Operating Officer Betsy Hardwick said PCS handles about 1,200 cases at any one time, preparing individual support plans and monitoring inmates for their first nine months on the outside. Hardwick said that 28 percent of the special needs inmates had Medicaid on release, but by the end of their first year in the community, “anecdotally we think between 60 percent and 70 percent are being approved.”

The effort appears to be a critical confidence builder for Martin Baker, 61, a repeat offender for breaking and entering who earlier this month was getting ready for parole at Adrian’s Gus Harrison prison and had been notified that he will have Medicaid upon release.

“I’ve got a bad liver from hepatitis C, and I couldn’t afford any medications on my own,” said Baker, a small but fit gray-haired man who also suffers from bipolar disorder and battled drug issues in the past. “My primary goal is to get my medical situation stabilized and get into a solid recovery program.”

Without insurance, he said, “you feel sick, and it causes you to get depressed and not care, so you say, ‘okay, I’m going out and get a pack of heroin.’ I don’t want that to happen.

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By Lisa De Bode for Al Jazeera

Tela Love, a 36-year-old transgender woman who used to work the streets of New Orleans’ French Quarter as a prostitute, has been HIV-positive for nearly 10 years. When she started exchanging sex for money and occasionally drugs, she said, local police arrested her after finding condoms in her bag. She was subsequently incarcerated at Orleans Parish Prison, where another inmate forced her to have unprotected sex with him. She later heard he was HIV-positive, she told Al Jazeera.

Love’s experiences with police harassment and sexual violence in prison partly explain why Louisiana’s death rate from AIDS is nearly double the national average and the New Orleans metropolitan area has the second-highest rate of new HIV infections in the United States, according to Human Rights Watch (HRW).

Megan McLemore, a senior health research director at HRW, told Al Jazeera that Louisiana is not doing enough to curb the spread of the disease. “It is actually undermining the effort to control HIV by its own law and policies,” she said. In a report published Wednesday, she says officials prohibit access to sterile syringes and criminalize sex work, which “contribute to an uncontrolled HIV epidemic and an extremely high AIDS death rate.”

Around one-third of surveyed participants — who all admitted to exchanging sex for food, drugs or money — said police harassment and a subsequent fear of carrying condoms has resulted in unprotected sex. “(Police) are associating condoms with criminality and then using it as a threat of arrest,” McLemore said.

As a result, prostitutes hide condoms under their wigs or between their legs to try to prevent them from being seized, Love said. Another transgender woman told HRW, “I’ve seen other girls being harassed, and I learn to be cautious. I hide (condoms) under my wigs.”

But some individuals report having to resort to more drastic measures to stay out of trouble, such as performing sexual favors in exchange for avoiding jail. Love said she was forced to have sex “with no condom” with an officer.

Another sex worker in the French Quarter told HRW that a police officer took advantage of her vulnerable position: “He went through my purse and found the condoms, then he started asking me how much I charge for a blow job. He said if I wanted to go free I had to give him a blow job, because the condoms were reason enough to bring me in. So I did it and he let me go.”

McLemore said other police departments have already stopped the harmful practice of seizing condoms and have understood their potential to help prevent the spread of HIV and other sexually transmitted diseases. The Metropolitan Police Department (MPD) in Washington, D.C., now distributes leaflets or “condom awareness cards” to community workers and transgender advocacy groups to raise awareness about rights.

“Individuals are allowed to carry as many condoms as they want,” the card reads. “There is no ‘three condom rule.’ MPD officers cannot conduct a stop or conduct a search of a person or premises based on whether or not that person possesses condoms.”

Remi Braden, public affairs officer at the New Orleans Police Department, told Al Jazeera the NOPD has not received any record of the allegations in the HRW report. The department is “committed to investigating any and all complaints filed against our officers,” she said.

“The NOPD takes such allegations very seriously, and conducts thorough investigations into accused officers. Officers found to have violated departmental policy or law are disciplined and, in some cases, suspended or terminated,” she added.

Wesley Ware, director of BreakOUT!, an advocacy group against discriminatory policing and profiling of LGBT women of color in particular, told Al Jazeera the issue is “an ongoing problem.” In May, the group successfully campaigned for the adoption of an NOPD policy against gender profiling, he said. “However,” Ware noted, “the implementation of that is a different story. We’re still continuing to hear reports of people being stopped, profiled without any reasonable suspicion or probable cause.”

‘A deadly vicious cycle’

Incarceration is another major influence on Louisiana’s high HIV rate, the HRW report found. Even though Orleans Parish Prison provides testing for every inmate staying for more than one week, it is under federal oversight for failing to protect its inmates against sexual assaults and other forms of harm, the report said.

“People use bread bags or rubber gloves (for protection), but it’s rare that people actually even use them,” Love said. “It’s very dangerous. It makes you bleed worse. The likelihood of that being a good barrier is none.”

Love said a social stigma on taking medication against HIV also increases the risk of infection while in prison.

“The staff are very unprofessional,” she said. “They broadcast your business.” When prisoners are queuing at the doctor’s office for pills, she said, the staff tells everyone, “They got HIV. Better watch that punk.”

And once an inmate is released, the fear of police harassment for carrying condoms exacerbates the problem.

Someone can enter jail HIV-free, Love said, but “when she comes out of jail she probably won’t be. There’s a very good chance. And then she’s intimidated and afraid to use condoms.”

“It’s a deadly vicious cycle.”

Another factor fueling New Orleans’ HIV epidemic is the dearth of public syringe-exchange programs, which in New York have effectively lowered the number of new HIV infections from 12 percent to 4 percent, the report said. Syringes are classified as drug paraphernalia in New Orleans, McLemore explained; their receipt is illegal, but their distribution is not.

The only functioning clinic in the city opens for two hours on Friday afternoon and fails to adequately serve the needs of drug users, according to the HRW report. Elizabeth Jones, who once directed the Drop-In Center’s syringe exchange, told HRW: “As a medical facility, the law protects us but not our clients. They can still be charged with possession of a syringe.”

Poverty further complicates the problem in New Orleans. In the wake of Hurricane Katrina, nearly one in four residents lives in poverty. But for Love, who was forcibly displaced after the storm, the move offered a way out of a life mired in drugs and prostitution. At her temporary home in Atlanta, she came in contact with other transgender women who served as role models and ultimately inspired her to found New Legacy Ministries, a nonprofit organization that aims to provide support for transgender individuals, she said.

It’s time to take the initiative to “SAVE OUR SELVES!” she wrote on her website.

The New Orleans Public Health Department wasn’t available for comment at the time of publication.

~ ~ ~ ~ ~

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Washington, DC—A letter released today by over 70 Maryland-based doctors, nurses, and professors representing esteemed leaders in the medical field urges immediate action by Congress to lift the ban on federal funding for Syringe Services Programs (SSPs), calling on Maryland Senator Barbara Mikulski to push her colleagues on the issue.

As the Senate Appropriations Chair, Sen. Mikulski is in a unique position to lift the ban — an action that “would not involve the appropriation of a single additional federal dollar; the change would simply allow local and state medical authorities to spend federal dollars they are given as they see fit.” Further, in a political climate where healthcare cost-savings in particular are paramount, “for every dollar spent on SSPs, an estimated $3-$7 are saved in HIV treatment costs.”

“The federal ban has been in place since December 2011, after language was inserted into Appropriations legislation, and it has been detrimental to the health of Americans and the fight against HIV/AIDS ever since, especially those in your home state of Maryland,” the signatories highlight for Sen. Mikulski. It notes the many benefits of SSPs include cost-savings, increased linkage to drug addiction treatment, and support from law enforcement.

“Ending AIDS in the United States means basing our policy on science rather than ideology, and SSPs are critical, proven interventions in our fight against HIV/AIDS and hepatitis C. Our community considers having Senator Mikulski as Chair of the Appropriations committee a boon, given her history of supporting effective public health policy, including lifting this highly detrimental syringe funding ban,” says Christine Campbell, Vice President of National Advocacy & Organizing at Housing Works. “If Congress passes the current budget deal, it is critical that Sen. Mikulski prioritizes lifting the ban in Senate negotiations and galvanizes her House colleagues as well, both for her constituents and the nation.”

Assuming the recent budget deal is adopted by Congress, the Appropriations committee will draft an omnibus bill to fund non-defense discretionary programs of the government, including health-related programs. This process offers the opportunity to replace language enacting the ban such that local and state authorities have full control over their funds.

As the letter’s signatories emphasize, “there are few occasions when members of the medical community can unite and advocate for a public health program that costs nothing, saves taxpayer dollars, and saves lives. This is one of those occasions.” On the heels of World AIDS Day, with the 2013 theme “Shared Responsibility: Strengthening Results for an AIDS-free Generation,” Congress should remember – actions speak louder than words.

Read the full letter here.

Press Contact:
Christine Campbell
202-408-0305
campbell@housingworks.org

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OVER 70 MARYLAND MEDICAL & PUBLIC HEALTH PROFESSIONALS URGE CONGRESS TO LIFT FEDERAL BAN ON SYRINGE FUNDING
Johns Hopkins University and University of Maryland doctors send Sen. Barbara Mikulski (D-MD) letter calling for action in the wake of budget agreement.

FOR IMMEDIATE RELEASE:
12 December 2013

Contact: Christine Campbell
202-408-0305
campbell@housingworks.org

Washington, DC—A letter released today by over 70 Maryland-based doctors, nurses, and professors representing esteemed leaders in the medical field urges immediate action by Congress to lift the ban on federal funding for Syringe Services Programs (SSPs), calling on Maryland Senator Barbara Mikulski to push her colleagues on the issue.

As the Senate Appropriations Chair, Sen. Mikulski is in a unique position to lift the ban — an action that “would not involve the appropriation of a single additional federal dollar; the change would simply allow local and state medical authorities to spend federal dollars they are given as they see fit.” Further, in a political climate where healthcare cost-savings in particular are paramount, “for every dollar spent on SSPs, an estimated $3-$7 are saved in HIV treatment costs.”

“The federal ban has been in place since December 2011, after language was inserted into Appropriations legislation, and it has been detrimental to the health of Americans and the fight against HIV/AIDS ever since, especially those in your home state of Maryland,” the signatories highlight for Sen. Mikulski. It notes the many benefits of SSPs include cost-savings, increased linkage to drug addiction treatment, and support from law enforcement.

“Ending AIDS in the United States means basing our policy on science rather than ideology, and SSPs are critical, proven interventions in our fight against HIV/AIDS and hepatitis C. Our community considers having Senator Mikulski as Chair of the Appropriations committee a boon, given her history of supporting effective public health policy, including lifting this highly detrimental syringe funding ban,” says Christine Campbell, Vice President of National Advocacy & Organizing at Housing Works. “If Congress passes the current budget deal, it is critical that Sen. Mikulski prioritizes lifting the ban in Senate negotiations and galvanizes her House colleagues as well, both for her constituents and the nation.”

Assuming the recent budget deal is adopted by Congress, the Appropriations committee will draft an omnibus bill to fund non-defense discretionary programs of the government, including health-related programs. This process offers the opportunity to replace language enacting the ban such that local and state authorities have full control over their funds.

As the letter’s signatories emphasize, “there are few occasions when members of the medical community can unite and advocate for a public health program that costs nothing, saves taxpayer dollars, and saves lives. This is one of those occasions.” On the heels of World AIDS Day, with the 2013 theme “Shared Responsibility: Strengthening Results for an AIDS-free Generation,” Congress should remember – actions speak louder than words.

Read the full letter here.

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Housing Works is a healing community of people living with and affected by HIV/AIDS. Our mission is to end the dual crises of homelessness and AIDS through relentless advocacy, the provision of lifesaving services, and entrepreneurial businesses that sustain our efforts.

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By Bethany Young Holt & Manjula Lusti-Narasimhan for SFGate

President Obama’s significant commitment of $100 million in funding for HIV/AIDS treatment research will surely bring us closer to a cure. But hand in hand with even the best treatment should be better prevention.

High HIV infection rates among women around the world point to an urgent demand for new prevention methods that specifically address women’s health needs. Every minute, a young woman is infected with HIV. Married women, or those in committed relationships, are at particular risk of infection because only 8 percent of couples around the world use condoms.

It is time to turn our collective will toward finding methods that protect women from HIV and other sexually transmitted infections at the same time as preventing unplanned pregnancy. Multipurpose prevention technologies are a new class of products in development that do just that. What stands in the way of advancing the field may be how women’s health issues are funded.

Sexual and reproductive health is generally understood as a subdiscipline of women’s health care, but HIV and reproductive health research operate with separate funding streams and discrete research disciplines that tend not to cross-pollinate ideas, share findings or collaborate. The Initiative for Multipurpose Prevention Technologies is an international collaboration that bridges this gap by bringing together researchers, funders, developers and women’s health advocates across disciplines. These medications and devices are designed specifically to be female initiated and to offer women more choices to address their interlinked health needs.

For example, the sexual and reproductive health risks Priscilla and Clara face are multiple and interconnected.

Priscilla is 26. She lives in Cape Town, South Africa. She is married with two young children. She would like more children, but not immediately. Her husband works in a different city and is away for many weeks at a time. She worries about acquiring HIV. Priscilla would like to use condoms to protect herself and prevent an unplanned pregnancy, but her husband refuses.

Clara is 19. She lives in San Francisco and works part time and is in college. She used condoms intermittently with her first boyfriend, but worried about having an unplanned pregnancy. She went on the pill with her next boyfriend and used condoms for sexual diseases prevention, including for HIV, but the longer they were together, the less frequently they used them. She contracted chlamydia, increasing her chances of HIV infection.

The field needs more collaboration. Funding agencies, investors and product developers who are focused on interventions for women should take a more comprehensive approach to reproductive health. Investing in multipurpose technology development and strengthening linkages between research fields will advance the sexual and reproductive health needs of women everywhere – and help stop the spread of HIV.

Women’s health concerns worldwide, by the numbers

87 million
Unintended pregnancies a year

54
Percentage of adults living with HIV who are women

1 million
Number of people who acquire a sexually transmitted infection every day. Without treatment, some sexually transmitted infections increase women’s risk for infertility and cancer and increase their susceptibility to HIV infection threefold or more.

Source: World Health Organization; UNAIDS

Bethany Young Holt is the executive director of the Coalition Advancing Multipurpose Innovations, a project of the Public Health Institute; Manjula Lusti-Narasimhan is a scientist with the World Health Organization. Both writers are with the Initiative for Multipurpose Prevention Technologies.

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Image: AP

By Erika L. Sanchez for Al Jazeera

Chicago, United States – Maria Mejia grew up in an abusive household, so at the age of 13 she ran away from home and joined a gang in search of a sense of family. Soon after, she began dating the leader of the gang, a drug user, who infected her with HIV.

Mejia estimates she was infected between 1988 or 1989, when she was about 15 or 16 years old. She says she was diagnosed by sheer coincidence. Tired of the gang life, she decided to move back home and then joined the Job Corps in Kentucky, which required routine medical tests. A week before her 18th birthday, a doctor incorrectly informed that she had AIDS when she was, in fact, HIV-positive.

Distraught and confused, Mejia says she moved back home to Miami to die. Her mother, whom she describes as an “ultraconservative Catholic Latina”, told her, “We’re going to put this in God’s hands”, and asked her not to tell anyone in the family. Even though her mother’s shame was hurtful, Mejia said she was only trying to protect her.

In 2000, Hispanics became the largest minority group in the US, and they currently account for 16 percent of the population.

According to the Centers for Disease Control, Hispanics account for an estimated 19 percent of people living with HIV (220,400 persons) and an estimated 21 percent of new infections (9,800) in the United States each year. About one in 50 Hispanics will be diagnosed with HIV during their lifetime.

The rate of new HIV infections among Hispanic men is almost three times higher than that among white men, and the rate of new HIV infections among Hispanic women is more than four times that of Caucasian women.

Cultural stigma

Though many cultures stigmatise HIV, some say that attitudes towards HIV in the Hispanic community are deeply rooted in beliefs about sex.

“Sex stigma in our community is at the root of HIV stigma. Those values are still embedded in our psyche,” says Lorenzo Herrera y Lozano, a writer and HIV prevention volunteer who was diagnosed with HIV when he was 21 years old. “For me, it’s a reminder of how I violated the social contract of being a Mexican man.”

Herrera y Lozano says the shame surrounding HIV and sex stems from Catholicism, which holds that the primary purpose of sex is to procreate. “How do we hold our culture close to our heart, and how do we hold it to the light?” he asks. “As we continue to push against conservative norms, we will see more advances.”

According to the CDC, the stigma associated with HIV and homosexuality can contribute to the spread of HIV in Latino communities. Machismo attitudes, for instance, can keep some men from acknowledging risky behaviours, such as male-to-male sexual contact.

Before he informed his mother of his diagnosis, Herrera y Lozano says he first had to tell her he was gay. He says she was more concerned about his sexuality and asked whether he could also be treated for being gay. His father, who is older and a conservative Mexican man, still doesn’t know about his son’s HIV status. Herrera y Lozano says he believes it’s easier for both of them to keep it this way. “All he had was the information that the media provided,” he says.

Viviana Maldonado has experienced HIV stigma second-hand. When she was 14 years old, her father tested positive for HIV. He was married, had three children, and was a well-respected pastor in a rural Nebraskan community. She says he contracted the disease in the 1980s, but was not diagnosed until 1995 because of shame, guilt, and denial. To this day, she and her family still don’t know how he contracted it.

Though her father’s family and community were supportive throughout the entire experience, Maldonado says her father never talked about the origins of the disease.

“My mom asked him, but he would not budge. Deep down he had that Catholic mentality,” she says. Maldonado says she continues to grapple with the aftermath more than a decade after her father’s death. “I struggle with it more now as an adult. I feel like I’m not allowed to talk about it,” she says.

Socio-economic barriers

“To truly turn the tide on HIV in the Latino community, we must also confront the harsh social and economic realities that place some Latinos at greater risk for HIV,” Janet Cleveland, a deputy director of HIV/AIDS Prevention, told Al Jazeera in an email.

Cleveland points out that – in addition to the fear of stigma – access to healthcare, language barriers, and concerns about immigration status are significant factors contributing to HIV rates.

According to Planned Parenthood, Latinos are the least likely of all ethnic groups in the United States to be insured. More than a quarter of Latinos also live in poverty, which can prevent them from accessing sexual and reproductive healthcare. Consequently, Latinos experience higher rates of sexually transmitted infections than most other groups of people in the US.

Low-income immigrant women have even higher rates of uninsurance: 60 percent of low-income, non-citizen immigrant women lack health insurance, which is nearly twice the proportion of low-income women born in the US.

Cultural outreach

Lillian Tamayo, president and CEO of Planned Parenthood of South Florida, says her organisation partners with Latino organisations all over the country to tailor their programmes for the Latino community. In addition to providing sex education, HIV testing, access to contraception, and helping patients who need additional care, Planned Parenthood also offers workshops, training, and events to help parents talk to young people about sex.

“We’re not having these conversations with these young people about their bodies. Because of that, we’re putting these young people at risk,” she says.

Meanwhile, Maria Mejia has used her experience with HIV to become an educator and international social media activist. She is especially passionate about educating young people because she believes many of them “are not respecting the virus anymore”.

Mejia says they need to see someone who looks like them and speaks their language in order for the outreach to be powerful. “You can have all the experts you want, but at the end of the day, they still think it’s not going to happen to them,” she says.

Planned Parenthood also uses a “Promotores” model to more effectively reach Latinos. The programme trains people in the community to share their sexual and reproductive health knowledge through group presentations, house parties, and one-on-one outreach.

Tamayo says this can break down barriers since there are many areas traditionally off-limits in Hispanic culture. Women, for example, are often embarrassed to talk about their bodies. Because the model is informal, it can make people feel more comfortable sharing their experiences.

“By telling our stories, we humanise the condition,” Mejia says. “I wanted to create spaces that didn’t exist when I tested positive.”

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By Edgar Walters, Texas Tribune, in partnership with Kaiser Health News

When Dena Hughes learned about the Affordable Care Act’s passage, she rejoiced.

Hughes, who is HIV positive, has struggled to find insurance coverage, because HIV is considered a pre-existing condition. But even under the new law, Hughes said her care providers had advised her not to enroll in the federal health care exchange yet. It is unclear, they said, how the law will affect HIV care when marketplace coverage begins Jan. 1.

“Right now we get good care, and I’m not interested in having my stuff all shifted around,” she said from her Houston home.

Hughes and her husband, Daniel, also HIV positive, receive some health coverage under the Ryan White Care Act, a federal health care program for HIV and AIDS patients. Community advocates expected the Affordable Care Act to provide nearly universal health coverage for HIV patients, freeing up funding from the Ryan White program to cover services beyond primary care.

But many HIV patients in Texas live below the poverty line and are therefore ineligible for subsidies on the exchange. Add Texas’ decision not to expand Medicaid to cover poor adults, and the bulk of low-income HIV patients are missing out on expanded health coverage.

Dena and Daniel Hughes, who have four dependent children, recently started a home repair business and do not know how much they will earn next year.

The stakes are high. If their income is below $31,590 — the requirement for a family of six to receive tax subsidies on the federal exchange — they will rank among the thousands of HIV-positive Texans whose incomes are too low for subsidized private insurance but too high for Medicaid. Roughly 14,000 Texans with HIV used assistance from the Ryan White program to pay for antiretroviral medication in 2011, while nearly 19,000 were not receiving any HIV-related medical care, according to the Department of State Health Services.

Daniel Hughes receives medical care at Legacy Community Health Services, a federally qualified health center in Houston. Katy Caldwell, its executive director, said she had struggled to advise HIV patients about the marketplace with certainty that their health plans would cover all their medications. “You’ve got people on some complicated drug regimens that you want to make sure people stay on, and it’s not as easy as it sounds,” she said.

Referring to patients living below the poverty line, she added, “One of the hard things to explain to people is you’re actually too poor to get help.” At Legacy, 58 percent of patients are uninsured.

Texas’ Medicaid eligibility requirements are among the country’s strictest. For a family of six, adults without a disability must earn less than $4,608 per year to qualify for coverage.

But Gov. Rick Perry has adamantly opposed Medicaid expansion, citing worries about the program’s efficiency.

“The fact is that Medicaid is a broken system in need of fundamental reform,” Lucy Nashed, a spokeswoman Perry, said in an email. She added that “Texas has a proven history of providing services and effective HIV medications to HIV-positive Texans through the HIV-STD Program and the Texas HIV Medication Program.”

Katherine Record, a senior fellow at Harvard Law School’s Center for Health Law and Policy Innovation, directed a project that modeled how health reform would affect HIV patients in Texas. She found that roughly 65 percent of Texans who received assistance from the AIDS Drug Assistance Program, a Ryan White program, would be eligible for Medicaid under the expansion.

By comparison, “Pre-ACA, you could only qualify for Medicaid if you proved you were disabled, which pretty much meant having your HIV progress to full-blown AIDS,” she said.

For Santiago Estrada, a 53-year-old patient in Abilene, AIDS allowed him to enroll in Medicare, which covers his antiretroviral medication. He said the drugs alone would have cost him $2,000 per month out of pocket.

Estrada visits the Big Country AIDS Resources center in Abilene for care. He says the “wraparound” services the center provides with Ryan White funding, like assistance with nutrition and transportation, are paramount for his well-being.

Betty Sims, the center’s executive director, says the Affordable Care Act could mean big changes for many of her clients’ access to coverage. But for the 48 percent of her clients who live below the federal poverty line, most have never qualified for Medicaid “and are really left out in the cold,” she said.

Advocates say demand for transportation services ranks highly among the wraparound benefits that Ryan White money could assist with, if more HIV patients had primary care coverage under the Affordable Care Act. For Sims’ clinic and others that serve large rural populations, patients’ lack of access to a vehicle is a significant obstacle to HIV care. “There’s only one infectious disease specialist in the 19 counties we serve,” Sims said. The center has partnered with infectious disease physicians at Texas Tech University to consult with patients electronically.

“The Ryan White services that we provide are going to continue to be needed here no matter whether people have access to insurance or not,” Sims said.

One way states have sought to make the most of their Ryan White money under the new health law is to use the AIDS Drug Assistance Program funds to pay for HIV patients’ insurance premiums, rather than purchasing expensive drugs directly. Because the Affordable Care Act requires insurers to cover pre-existing conditions like HIV, “in almost every case now it will be cost-effective” to spend the money on HIV patients’ insurance premiums, even if they do not qualify for subsidies, said Ann Lefert, director of policy and health care access at the National Alliance of State and Territorial AIDS Directors.

Christine Mann, a spokeswoman for the Texas Department of State Health Services, said the agency was looking into such a measure.

Many advocates expect Texas to expand its Medicaid program eventually. But in the meantime, Ryan White funding will continue to shoulder primary care costs for the majority of impoverished Texans with HIV.

“They call it payer of last resort,” Dena Hughes said of that coverage. “But for some people, it’s the payer of first hope.”

Texas Tribune donors or members may be quoted or mentioned in our stories, or may be the subject of them. For a complete list of contributors, click here.

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Image: Gallery — Body Counts; “This was right after the police forced us (the TAG Seven) to deflate the giant condom we had put over the home of notorious homophobe U.S. Senator Jesse Helms in September of 1991. That’s me on the upper right, wearing my Silence = Death t-shirt.”

By Sean Strub on his site — www.seanstrub.com

In my new memoir Body Counts, I write about the People With AIDS Coalition in New York. They and other early networks of people with HIV played an incredibly important role helping newly-diagnosed people cope. They supported me after I was diagnosed in the mid-1980s. PWAC and similar groups gave us strength to disclose our HIV status to others. They helped us deal with hostile or frightened families, friends and employers. They helped us survive life in an indifferent society and an apathetic or aggressive political structure. These networks were a manifestation of the people with HIV empowerment movement as envisioned in the 1983 Denver Principles manifesto.

But as time passed, support for those networks diminished. Many of them went away. The empowerment movement for people with HIV, initially modeled after the women’s health movement, changed and became more focused on ACT UP-style political protests and street demonstrations. Ultimately, “treatment activism” supplanted the empowerment movement as personified by Michael Callen, Amy Sloan and others in the early years.

Treatment activism has expedited access to the drugs that saved many of us, myself included. But the human rights approach to the epidemic—protecting confidentiality, patient autonomy, combating stigma—were suddenly no longer priorities. The consequences of this shift are numerous. HIV criminalization cases, for example, have increased dramatically.

But there is hope: more recently, recognition has taken root for issues of legal barriers and stigma. And, to my great delight, the networks of people with HIV are on a rebound, once again asserting our right to a voice in the policy and decision-making that profoundly affects our lives.

One great development is the creation of the U.S. People Living with HIV Caucus. This is a constructive, efficient and respectful collaboration between national and local networks of people with HIV. I am proud to be a part of it.

Our 15-member steering committee includes representation from the five national networks of people with HIV in the U.S. (Positive Women’s Network/USA, International Community of Women with HIV/NA, Campaign to End AIDS, Global Network of People with HIV/NA and Sero Project), as well as ten other members representing prominent local networks or individual advocates.

The mission of the caucus is a simple one: speak with a unified voice for people with HIV in the U.S. When that voice was muffled in the past, we suffered. But the establishment of this caucus places us on a great track for the future. I’m so proud of everyone involved with the caucus, especially Executive Committee members Cecilia Chung, Naina Khanna, Barb Cardell, Vanessa Johnson and Andrew Spieldenner. They’ve invested a lot of energy and expertise to make this happen.

To support this Caucus, we ask that you support or engage in a network of people living with HIV, either locally or nationally. They are the Caucus.

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Image: National Domestic Workers Alliance / Flickr

By Amy B. Dean for YES! Magazine (9 October 2013)

Domestic workers have had some breakthrough wins over the past two weeks. Up until then, these workers were excluded from protections such as a guaranteed minimum wage, paid breaks, and overtime pay. On September 17, the Obama administration announced new rules extending the Fair Labor Standards Act to include the 800,000 to 2 million home health workers—who help seniors and others with self-care tasks like taking medications, bathing, and shopping—under the federal government’s wage and hour protections.

Next, California governor Jerry Brown signed into law the Domestic Workers’ Bill of Rights on September 26, allowing the full spectrum of domestic workers—including live-in nannies and housekeepers—to benefit from the same gains as the home health workers.

For the first time ever, these employees will be guaranteed the federal minimum wage and will earn overtime pay. And their victories have implications for a much larger portion of the workforce, including independent contractors, nontraditional employees, and those on temporary assignments. The domestic employees’ wins are helping to chart a path forward for the growing number of employees who work outside conventional office settings.

Much of the credit for these historic wins is due to the tenacious organizing of the National Domestic Workers Alliance, a group of workers in this field who advocate for their own rights. Led since 2010 by the dynamic young organizer Ai-Jen Poo, the NDWA has grown from a single chapter in New York City to a nationwide organization with campaigns for domestic workers’ rights in 19 cities and 11 states.

Here are five lessons that the wider progressive community can draw from the victories.

1. Local struggles can have national impact.

Before the creation of the National Domestic Workers Alliance, the New York-based organization Domestic Workers United started by organizing locally. After winning passage of the Domestic Workers’ Bill of Rights in New York state, the group took their campaign on the road. The alliance won a second state-level victory in Hawaii, and then began organizing nationally with the message that those who care for elders and people with disabilities deserve respect. (It helped that this message was already reverberating across the globe after the International Labor Organization ratified its Convention on Domestic Workers in 2011.)

Having campaigns at the local, state, and national levels gave the NDWA the flexibility to focus where victory was most likely. Massachusetts is likely to be their next state-level target, Poo told Nation columnist and YES! Magazine Local Economies Reporting Fellow Laura Flanders.

2. Crunch your own numbers.

Rather than defensively responding to reports by business groups and state agencies, the NDWA created its own, from-the-ground-up reports and analyses on the working conditions domestic employees face in America.

Developing the capacity to contribute to the research around domestic work allowed the alliance to set the terms of debate. Other groups can use the same technique to frame the public agenda—whether around city planning, state budget priorities, or federal reforms.

3. Put working people front and center.

The NDWA used Caring Across Generations to shine the spotlight on caregivers—who are often only seen publicly pushing a client in a wheelchair—and to show how much they do for their clients.

When Ai-Jen Poo appeared in cable news shows and magazine articles, she constantly pointed to the stories of domestic employees and thus kept the spotlight fixed on them. Putting real people’s stories forward as the basis for the campaign’s argument created public sympathy and understanding.

4. Find allies beyond the usual ones.

Although groups that hire home care employees could be seen as “the enemy,” the NDWA partnered enthusiastically with them. In New York and California, for instance, the alliance worked with Hand in Hand, a national association of caregiver employers who were willing to take a stand on behalf of their employees’ right to fair pay and labor conditions. Hand in Hand’s website even offers a toolkit for employers, with guidance on how to become a better employer.

Employers like Hand in Hand join the campaign not out of an impulse to charity, but because they know that fair national standards for home-care employees helps ensure better care for their loved ones. As Ai-Jen Poo said recently in a video for the PBS series Makers: “When it comes to human dignity, there is no such thing as an unlikely ally.”

Another way that the NDWA cultivated alliances was through the careful coalition-building that went into forming Caring Across Generations, a campaign that seeks to ensure that seniors receive the heath care they need from workers who receive a living wage. Launched in 2011, the coalition’s unusually broad range of member groups includes organized labor, seniors, faith-based groups, women’s rights organizations, and anti-poverty groups.

The different members have come together around a unifying vision for improving the lives of those who serve our youth and our elders. By joining across different organizing traditions and constituencies, they created a far-reaching effort that goes beyond the typical single-issue campaign.

5. Victory begets more victory.

Small victories can be an effective motivator on the road to bigger ones. By stringing together a series of international, national, and local victories—none of them complete in themselves—the NDWA showed that change is possible and created momentum for ever-greater wins. And the NDWA’s campaign for a Domestic Workers’ Bill of Rights is still moving forward, with active drives in Massachusetts, Connecticut, Washington, Illinois, and Oregon.

The NDWA’s record of steadily organizing with their eyes on a clear prize of policy solutions, recognition, and respect should serve as an inspiration. The movement’s relevance isn’t just the fact that they are winning; how they fight matters, too. Any movement that can transform adversarial employee-employer relations into a unified force for public policy change is worth learning from.

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Amy B. Dean wrote this article for YES! Magazine, a national, nonprofit media project that fuses powerful ideas and practical actions. Amy is a fellow of The Century Foundation and principal of ABD Ventures, an organizational development consulting firm that works to develop new and innovative organizing strategies for social change organizations. Dean is co-author, with David Reynolds, of A New New Deal: How Regional Activism Will Reshape the American Labor Movement. You can follow Amy on twitter @amybdean, or she can be reached via www.amybdean.com.

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New York, NY (December 2013)—Housing Works is pleased to announce the opening of 874 Jefferson Avenue, a 12-unit residence in the Bedford Stuyvesant neighborhood of Brooklyn. Several years in the making, the Jefferson Avenue residence consists of the gut renovation of a vacant row house, into a beautiful facility for 12 homeless individuals living with AIDS. A ribbon-cutting ceremony attended by the first tenants to occupy the building will be held this Friday, December 13th at 10:30am.

The $3M project received capital funding from the New York State Homeless Housing and Assistance Program, the United States Department of Housing and Urban Development Supportive Housing Program, the Federal Home Loan Bank Affordable Housing Program, and the NYC Department of Housing Preservation and Development Neighborhood Stabilization Program. Operating funding at 874 Jefferson will be provided by the NYC Department of Health and Mental Hygiene and the United States Department of Housing and Urban Development Supportive Housing Program.

Supportive services will be available to residents on or off site through Housing Works. These services will include case management, independent living skills training, health care, mental health care, harm reduction services, and eligibility to enroll in the Housing Works Job Training Program.

The population for 874 Jefferson will reflect Housing Works’ overall client population, all of whom are low-income, 91% of whom are African-American, Latino, or other minority, and one-third of whom identify as gay, lesbian, bisexual, or transgender. Residents at 874 Jefferson will share extended histories of chronic homelessness, mental illness, and/or chemical dependence.

Client Debra Edwards is one of the 12 residents who will move into permanent housing at 874 Jefferson on Friday and receive its services. She has completed her GED and 19 college credits and is being supported by SSI and food stamps from HASA. She currently resides at WTHP (Housing Works, Women’s Transitional Housing) program. Her case management team is assisting her with permanent housing, mental health, sobriety and employment. After years of alcohol and cocaine abuse she has now achieved sobriety of for 96 days and completed a rehab program at Rhinebeck rehab (Upstate NY), September 27th.

“I’m starting a new journey in my life that Housing Works help me to achieve,” says Ms. Edwards. “I have been in the shelter system for 14 months and never want to experience that again. This place will give me a new home to go with my new life.”

Each unit at 874 Jefferson will contain a full kitchen that is separate from the living area; space for a kitchen table, coffee table, and lounge chair; and a full bathroom. The ground floor of the facility will include a lounge and space for support staff, office equipment, and a staff kitchen. All residents will have access to a rear yard and rooftop terrace. In addition, environmentally friendly features at the building include a green roof, flooring made from recycled material, LED lighting, and no-VOC paint.

Much of the additional funding raised for the Jefferson Avenue Residences was procured through Housing Works Annual Design on a Dime Benefit. The annual fundraiser celebrated it’s 10th anniversary and raised over one-million dollars to complete construction just last spring. This year’s event will continue to raise funds for the expansion of supportive housing and will be held on April 24th 2013.

NATIONAL HUD FUNDING CALL-IN DAY!

Today, Tuesday, December 3, is “National HUD Funding Call-In Day!” As early as next week, the conference committee tasked with coming up with a topline spending level for fiscal year (FY) 2014 is expected to come to some sort of deal that will set FY 2014 spending levels and may replace sequestration. The deal, and subsequent spending decisions over the next few weeks, could have a tremendous negative impact on funding for the Department of Housing and Urban Development (HUD). Join the Alliance and its partners across the country to call your Members of Congress TODAY to tell them the negative impacts further funding cuts would have on your communities and the need for more HUD funding!

We must make sure to impart to our Members the importance of housing and homelessness programs in our communities before a final deal is made. Call your Members of Congress TODAY as part of a National Call-In Day!

Here’s what you can do:

1. Call your Senators and Representative(s) TODAY and ask to speak to the person who handles housing issues. You can reach their offices by calling 866.898.2624.

2. Use these talking points to explain how cuts to HUD programs will negatively impact your community.

More Information

We must urge the conference committee to replace sequestration in order to protect HUD funding before the conference committee’s December 13 deadline to issue a report to Congress. Coming to agreement on an FY 2014 budget that cancels sequestration will allow appropriators to pass individual funding bills instead of a continuing resolution (a long-term stopgap funding measure at FY 2013 funding levels), which would harm housing and community development programs. Key HUD programs like the McKinney-Vento Homeless Assistance Grants will fare far better in an individual funding bill than a stopgap funding measure. Following the cuts in the FY 2013 NOFA (see below), we can’t afford further cuts!

We must seize this opportunity to impact the conference committee and work to make homelessness a thing of the past. Take this opportunity to call your Members’ offices and tell them how important these programs are to your community. A ten-minute call could have a tremendous impact on funding for people at risk of or experiencing homelessness.

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House Votes to Extend Federal AIDS Programs by Pete Kasperowicz for The Hill

The House on Tuesday quickly passed legislation that would extend for five years federal programs and funding aimed at combating HIV/AIDS around the globe.

Members passed S. 1545, the PEPFAR Stewardship and Oversight Act, in a voice vote. PEPFAR is the President’s Emergency Plan for AIDS Relief, the U.S. initiative to help with AIDS relief that was launched under the Bush administration in 2003.

The bill extends a requirement that the Department of State, Broadcasting Board of Governors, Department of Health and Human Services and U.S. Agency for International Development continue to work together on plans to combat global HIV/AIDS.

It also extends funding commitments to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Included in the bill is a requirement that U.S. contributions to the fund are capped at 33 percent, language that is seen as helping to encourage donations from other countries.

“This bill is time sensitive,” said House Foreign Affairs Committee Chairman Ed Royce (R-Calif.). “During the week of December 1st, the Global Fund will convene a donor’s conference.”

Minority Leader Nancy Pelosi (D-Calif.) thanked Republicans and Democrats for passing it quickly, and Rep. Jim McDermott (D-Wash.) called PEPFAR the “crowning achievement” of the Bush administration.

President is likely to be in a position to sign the bill into law as early as this week, as the Senate passed the same bill on Monday.

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HOPE Act Allows HIV-Positive to Donate Organs by Winnie McCroy for EDGE

AIDS service organizations are applauding the House of Representatives’ recent decision to allow people living with HIV to donate their organs to other people living with HIV. The passage of the HIV Organ Policy Equity (HOPE) Act, which is awaiting President Barack Obama’s signature, could save the lives of more than 1,000 PLWHAs with liver and kidney failure each year.

“Since the ban was implemented in 1988, the development of Highly Active Antiretroviral Therapy (HAART) has significantly improved the life expectancy of people living with HIV,” said Jason Cianciotto, GMHC’s Director of Public Policy. “As a result, the population living with HIV in need of organ transplantation has grown significantly. The HOPE Act is a critical step toward ensuring that people living with HIV can give and receive the gift of life. [It] is not only a scientifically sound public health policy, but also a great act of compassion.”

The HOPE Act would allow donated, HIV-positive organs to be used for transplants to other HIV-positive patients. For the past 25 years, federal law has prohibited this medical procedure. But the HOPE Act will now direct the Department of Health and Human Services and the Organ Procurement Transplant Network (OPTN) to develop standards for research on HIV-positive organs, and permits pos-to-pos transplants if research determines this is warranted. This research is expected to take about a year, according to Johns Hopkins University transplant surgeon Dorry Segev.

“Thanks to the HIV Medicine Association (HIVMA) and many other advocates for their tireless work in leading the passage of the HOPE Act though Congress. Lifting the ban will save many lives and reduce health care costs,” said Chris Collins, amfAR’s Vice President and Director of Public Policy.

OPTN must develop standards to ensure that these transplants do not impact the safety of the organ transplantation network. The legislation also amends federal criminal law regarding HIV transmission to clarify that these organ donations are not barred.

There are also some concerns about “superinfecting” another HIV-positive patient with a second strain of the virus through such a transplant. More research will be needed to determine how immune-boosting ARVs will interact with the transplant drugs that prevent rejection of donor organs. Some research has suggested that PLWHAs are more likely to reject organ transplants.

In addition to saving the lives of hundreds of PLWHAs, the HOPE Act will also make more organs available for transplant. There are currently more than 100,000 patients waiting for life-saving healthy organs, with 50,000 more added each year. Allowing PLWHAs to donate organs to other PLWHAs will take an estimated 600 of these patients off the list, shortening the general waiting list for uninfected people.

“By reforming outdated policies banning all HIV-positive organ donations, Congress has provided hope not only to the thousands of people living with HIV in desperate need of a transplant, but also HIV-negative individuals who will benefit from the decrease in demand for uninfected organs,” said National Minority AIDS Council (NMAC) Director of Legislative and Public Affairs Kali Lindsey.

Passage of the HOPE Act will save lives and help break down the stigma associated with HIV/AIDS, said amfAR’s CEO Kevin Frost, adding that, “This legislation makes federal organ donation regulations more reflective of the evidence and allows for critically important research to move forward.”

Senators Barbara Boxer, Tammy Baldwin, Tom Coburn and Rand Paul introduced the legislation in the Senate, with Rep. Lois Capps introducing it in the House. It passed unanimously in the Senate and House Committee on Energy and Commerce this summer, and on Nov. 12, it passed in the House, also by unanimous consent. It now awaits signature by the President.

NMAC applauds Congress for taking action on this important piece of legislation,” added Lindsey. “In particular, we thank Senators Barbara Boxer and Tom Coburn, as well as Representatives Michael Burgess, Lois Capps and Andy Harris, whose bipartisan leadership was critical to the law’s passage. Their efforts are a sign that Republicans and Democrats can still work together for the good of our nation and its citizens.”

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By Phil Galewitz, KHN Staff Writer, for Kaiser Health News

This KHN story was produced in collaboration with USA Today

Kelly Price knows too well the pain of infected teeth and how they become so sensitive it hurts to eat or drink. He has suffered with that in the past and still has several teeth that need to be extracted, but the 51-year-old unemployed machinist can’t afford to see a dentist.

That’s why on a morning last month he was helping out at the Food Bank of South Central Michigan filling bags for weekend meals for needy children with Special K cereal, cans of spaghetti and meatballs, green beans, and a juice drink.

The hours Price volunteers inside the sprawling warehouse in “cereal city” will help him get to see a dentist for free. “I would rather pay with cash, but if this is the only way I can do it [that’s] fine because I am helping someone else and it all works out,” he said.

Price is one of the more than 4,000 adults who since 2007 have received care under the Calhoun County Dentists’ Partnership — a privately financed program that requires patients to perform some volunteer work to qualify for the free dental services. The “pay it forward” model enables low-income, uninsured patients to earn their care by helping local nonprofits, including the local homeless shelter, Red Cross and Salvation Army.

The effort, being replicated in a dozen other communities such as Springfield, Mo., and South Bend, Ind., fills a crucial need because the federal health law, which expands insurance coverage to millions of people, does nothing to improve adults’ access to dental care. The law expands dental coverage only to children.

Kip Etheridge, a dentist who sees patients from the program in his office a few hours a month, said the volunteer work makes them more vested in their care and reduces the number of people who don’t show up for the program’s dental appointments.

“It’s not free care, they work for it and that aspect is what has encouraged dentists to participate,” Etheridge said.

The program has attracted attention from dentists across Michigan and federal health officials.

“The Calhoun County program epitomizes the best kind of private sector, community-based solution to access-to-care problems,” said Norm Palm, president of the Michigan Dental Association. “This program is organized in a way that everyone can win.”

Gap In Care

The use of dental services has declined significantly since 2007, with about 36 percent of U.S. residents seeing a dentist in 2011, according to the America Dental Association. Nationally, more than 73 percent of low-income adults under 65 lack dental coverage, according to a study by the Kaiser Family Foundation (KHN is an editorially independent program of the foundation).

But even that underestimates the problem, because Medicare, the federal program for the elderly and disabled, typically does not cover dental services. Even adults who qualify for Medicaid, the state-federal health insurance program for the poor, have no dental benefits in eight states and in 17 other states only have dental coverage for emergencies such as relief of pain and infection, according to a study commissioned this year by the American Dental Association.

Lacking coverage, many patients don’t seek help until the dental pain gets severe, and then they often head to hospital emergency rooms.

The number of dental visits to hospital ERs doubled from 1.1 million in 2000 to 2.1 million 2010, according to a recent study by the American Dental Association.

In 2006, at least three patients a day were showing up at Bronson Battle Creek Hospital complaining of dental pain, but the facility could offer them only pain pills or antibiotics and urge them to see a dentist. That’s when the hospital, local dentists and community health and business leaders conceived the volunteer model.

The partnership has cut by 70 percent the number of patients with dental pain showing up at the hospital ER, according to a study published in the journal Health Affairs in September.

Patients must volunteer four hours for every $100 worth of care. While some do the minimum, others accrue hundreds of hours so they can use them to obtain dental services for years. To be eligible, people must have incomes below 200 percent of the federal poverty level, or about $24,000 for an individual in 2013, and lack dental coverage.

Before they see a dentist, patients must also attend a two-hour oral health class and be seen by a hygienist, who reviews their health history and does a dental screening and cleaning. That shortens the time the dentists need to spend with the patients and determines which dentist will treat the patient. Dentists decide which services they prefer to offer.

More than 40 dentists participate — or nearly half of those in the county. Most of the dentists provide their services for free. The program offers a $1,000 annual bonus to the dentists, but very few have accepted that, program officials say.

Using money donated by the United Way and local foundations, the program spends $140,000 a year for the two part-time hygienists, a two-person staff to manage the program and dental supplies.

Michigan is one of about 30 states that allow hygienists to work under indirect supervision of a dentist, meaning the dentist does not have to be in the same location as the hygienist. Program officials say that’s been a key component because it makes it easier to schedule patients, keep costs down and reduce the time dentists need to spend with each patient.

‘An Awesome Program’

Ian Gallagher, 31, who has been unemployed since 2009, signed up for the program last month when his tooth started throbbing. He hasn’t seen a dentist since losing dental coverage in 2003. Before his screening exam, he volunteered at Battle Creek Pride, a gay and lesbian advocacy group. “This is an awesome program,” he said while meeting with the hygienist. He is scheduled to have the tooth extracted in November.

Samantha Pearl, executive director of Community HealthCare Connections that runs the partnership, said she estimates the partnership this year will generate about 16,000 hours of volunteer work— or the equivalent of nine full-time workers. “Every person has something that they are uniquely qualified to give and this works when we are all contributing,” she said.

In the past year, the program has expanded so four hours of volunteer service can buy six months of chiropractic treatment. A local orthodontist has offered to help people under age 23. A local lab also has donated its expertise to make dentures.

Pearl said the challenge is keeping up with demand. The dental program is working to lower wait times to see dentists from a few months to a few weeks. With more employers in Michigan dropping health and dental coverage, more people will need help, she said.

Charles Palumbo, a Battle Creek dentist who helped launch the program and has extracted hundreds of teeth from people who have come through it, said volunteering is important for the patients. “We want them to have a sense of dignity as opposed to an entitlement to what is happening,” he said. “We want them to feel like they are paying for services.”

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From our friends at HIV Health Reform, and written by Priti Bhattarai

Inadequate Marketplace Coverage Raises Concern among HIV Advocates

With the health insurance marketplace now open for enrollment, it is essential that all health plans offer adequate coverage and have transparent policies. However, preliminary findings show there is a critical need for easier access to qualified health plan data, and important HIV medications seem to be absent from drug formularies. Both issues demand immediate attention to better facilitate enrollment of people with HIV/AIDS into the Marketplace plans.

Based on a preliminary review conducted by the HIV Health Care Access Working Group (HHCAWG), a coalition of national HIV health policy advocates, several marketplace plan formularies seem to be missing one or more Single Tablet Regimens (STRs) and/or do not provide clear information on drug coverage.

The success of the ACA for people with HIV/AIDS will be determined by whether they have access to the latest treatment advances, one of which is the availability of combination antiretroviral medications, or single tablet regimens. STRs play a vital role in the management of HIV disease, as they significantly reduce daily pill burden, increase adherence and improve health outcomes.

According to HHCAWG, 23 insurance plans exclude STRs in several states, which is inconsistent with the current standard of care for HIV. A majority of public and private health insurance plans cover STRs, including the state benchmark plans that set the minimum standard for pharmaceutical coverage under the Affordable Care Act (ACA). It also appears that accurate information on antiretroviral coverage and in-network HIV providers, which is critical to selecting an appropriate insurance plan, is currently extremely difficult to obtain.

The steering committee of HHCAWG has written letters to express their concern to Secretary Kathleen Sebelius, Department of Health and Human Services (HHS) and Gary Cohen, the Director of Center for Consumer Information and Insurance Oversight (CCIIO). HHCAWG wrote to those insurance companies who have yet to provide appropriate coverage for STRs in Marketplace drug formularies.

The letters highlight the list of plans that exclude STRs in several states, the need to amend formularies to include all STRs allowing people with HIV access to these medications, the need to update plan profiles in marketplace, and the implications of failing to cover STRs, which may result in dangerous disruptions in treatment.

ACA allows many tens of thousands of individuals with HIV to have access to health insurance coverage. However, limiting access to STRs won’t allow HIV patients enrolled in plans to access the simplified drug regimens that promote treatment adherence, putting them at greater risk for developing more serious and costly complications.

Take Action!
Read the sample letter to the insurance companies and advocate for a better coverage by writing to the insurers at your state demanding for better access to care!

HIV Health Care Access group ARV Letter (PDF)
Letter to Center for Consumer Information and Insurance Oversight (PDF)
Letter to Department of Health and Human Services (PDF)
Sample Letter to insurance company (template)

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For Immediate Release

New York, NY (November 2013)— On November 20th, 2013, Housing Works will host and celebrate its 10th annual Fashion for Action benefit. Supported by 250 of the fashion industry’s most influential designers, the highly anticipated event will feature an exclusive sale to benefit and advocate New York’s HIV/AID and LGBT Community. Together, with the support of New York’s charitable and social scene, the benefit has raised almost $5 million towards the fight against HIV/AIDS.

As the benefit will take place on Transgender Remembrance Day, proceeds from this year’s event will be dedicated to Housing Works’ HIV-positive transgender clients. All funds raised will provide supportive services including transitional and permanent housing, group therapy, and legal services.

Housing Works will welcome back Oscar-nominated actress Patricia Clarkson as Co-Chair, along with Michael Carl of Vanity Fair, fashion consultant & casting agent, Natalie Joos and new to the event, cutting edge fashion designer Asher Levine.

Levine, known for his progressive style that pushes the boundaries of gender, will breathe new life into this year’s fundraiser. The young fashion maven first emerged into the industry in 2010 creating designs for Lady Gaga. Now just 25, his creative approach to fashion and leather work has been recognized by a number of high profile names, most recently adding Will.i.am to his client roster.

Although Asher’s work is currently available for private clients, guests of the event will be able to shop from his sought after designs in a specially curated shop for the event. “As long as Housing Works continues to spread awareness, HIV’s worst enemy, I will be there to support them with every stitch I can make,” Levine remarks about his involvement.

Opening Night will be held at The Altman Building, located at 135 West 18th Street (between 6th and 7th Ave.). The evening will kick off with a VIP Hour from 5:30 to 6:30 PM followed by the general event from 6:30 to 9:30 PM and will continue as a four-day public designer sale at Housing Works Thrift Shops.

For more information, please visit www.fashionforaction.org

PURCHASE TICKETS

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Written by Larry Bryant

In Dallas (TX) on Tuesday November 5, 2013, Larry Dunn was sentenced to 40 years for fatally stabbing Cicely Bolden in the neck with a steak knife. He did so, he says, because the mother of two revealed to him after having unprotected sex that she was living with HIV. A tragic situation and outcome all around especially for Ms. Bolden’s son and daughter, aged 7 and 9 respectively, who first discovered their mother after coming home from school.

Similar acts of violence fueled by ignorance and fear have dotted the map frequently in the past few years. It is fair to say that Ms. Bolden should have, could have, disclosed her HIV status before having unprotected sex. It’s also worth discussing safe sex options the couple could have chosen. The truth is probably closer to Ms. Bolden’s fear of disclosure at all based on the long and documented history of violence against women in her situation. This same fear more than likely prevented any discussion around safe sex options. Only those two know what prompted Cicely to disclose when she did. A fatal choice that perhaps she didn’t anticipate.

As an HIV positive man, I know men and women like Mr. Dunn. Men and women whose ignorance – sometimes selective and willful – left unchecked and fueled by fear and misinformation grow to divisive and sometimes deadly proportions. This case as much as any is the cry for help needed to ensure adequate and appropriate HIV education disseminated everywhere in generous doses. Arguably more important is the call for modern, accurate, and age appropriate sex and sexuality education given in any and all school aged settings – elementary to adult education.

As much as creating more of these spaces and opportunities for discussion, questions, answers, and sharing we lessen the fear attributed to the unknown and perhaps the conditions that led to a mother being stabbed to death in her own bed.

And then again, there’s Arkansas.

In September of this year, three Pea Ridge Arkansas children were banned from attending class or any school related activities because they may be living with HIV, a clear violation of an Americans with Disabilities Act tenet. Sadly, this too is not an isolated case. According a statement by the Disability Rights Center of Arkansas:

“[T}o provide documentation that children are HIV negative before entering school is unlawful and immoral. It stigmatizes individuals with disabilities — or their ‘perceived’ disabilities, as there is no indication these individuals have HIV. There is only an unlawful fear that they do.”

With pressure emerging from the media and community members the siblings were allowed to go to class. However, damage has been done.

Pea Ridge Superintendent Rick Neal and the Arkansas Board of Education have essentially committed State sponsored terror by calling HIV a ‘contagious disease’ and publicly outing the children and family by stripping any right of privacy and disclosure. By banning the students in the first place the decision makers in the Arkansas public school system have significantly lessened the probability that some other family will disclose their status — willingly or not. It has justified the irrational fear that exists on all sides regarding HIV infection and care. And of course this fear exists far beyond Arkansas classrooms.

This is the same irrational fear, anger, and ignorance that filled Larry Dunn.

We have to know that we can raise and educate our newest generation with the tools necessary to protect themselves from HIV infection and other health conditions. We have to believe that our children and grandchildren will have the vision and compassion to successfully address sexual and gender-based violence. With growing global diversity and increased cultural visibility and integration with social media, perhaps even racism, along with race-based violence and discrimination will cease to exist.

However, this distant utopia may not even be possible because we can’t seem to protect our children from ourselves.

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Image: Mark Wilson/Getty Images/File

New Web Portal Explains The Affordable Care Act — Obamacare — For People With HIV

MENLO PARK, Calif., Nov. 4, 2013—The Kaiser Family Foundation has produced a new consumer web portal to help people living with HIV navigate the Affordable Care Act (ACA). Specifically designed to address the needs of people with HIV, the Obamacare & You portal, funded by Gilead Sciences, Inc., is presented as part of Greater Than AIDS, a leading national public information initiative developed by the Kaiser Family Foundation together with the Black AIDS Institute.

It is estimated that about one in four people with HIV in care in the U.S. are currently uninsured and many more are underinsured. People with HIV could be among those who make the greatest gains in coverage from the ACA, and the portal was developed to help navigate the new healthcare environment.

Features of the Greater Than AIDS Obamacare and You portal include:

~~ A “Find Your Story” feature that explains how someone with HIV may be affected by the ACA based on their current insurance situation;

~~ A Frequently Asked Questions (FAQs) section that provides answers to more than fifty questions about the ACA as it affects people living with HIV, such as “Can I be denied health insurance because I have HIV?” and “If I receive services from the Ryan White HIV/AIDS Program or AIDS Drug Assistance Program (ADAP), do I still need insurance?”;

~~ State-specific information for all 50 states and the District of Columbia on health insurance marketplaces (including a list of available plans and information about financial assistance), Medicaid coverage options, Ryan White HIV/AIDS and AIDS Drug Assistance Programs, and other relevant HIV resources;

~~ A guide to the essential health benefits provided under the ACA with detail about relevance to people with HIV;

~~ A downloadable worksheet to help people applying for coverage gather relevant information necessary to enroll and make plan choices that best suit their HIV care needs;

~~ Other tools, including links to the Foundation’s animated video explaining how to get ready for Obamacare and its health reform subsidy calculator.

“Our new Obamacare & You web portal for people with HIV is part of a growing body of resources the Foundation is developing to help Americans understand the ACA and their choices under the law,” said Kaiser Family Foundation President & CEO Drew Altman. “It is especially important that people with HIV understand how potential changes in health insurance will affect their coverage status and access to care and medications that are vitally important to their health and continuing prevention efforts.”

Among the aspects of the ACA that have particular relevance for people with HIV seeking coverage in the private insurance market are reforms that preclude insurance companies from using pre-existing conditions as a cause for denying coverage. The removal of spending limits—both annual and lifetime—also have bearing given the high cost of ongoing HIV care. In addition, since HIV rates are disproportionately higher among those with lower incomes, it is also expected that many people living with HIV will seek coverage in expanded Medicaid programs in those states that opt to do so.

The Obamacare & You consumer web portal is part of the Foundation’s ongoing effort to help consumers understand the ACA and their choices under the law. The content is the sole product and responsibility of the Kaiser Family Foundation. Gilead Sciences, Inc. provided funding for its development. More of the Foundation’s consumer resources on the ACA can be found on www.kff.org/aca-consumer-resources/.

The Foundation also produces fact sheets and analyses on the topic of HIV/AIDS, including materials on how the ACA affects people living with HIV. This information is available at www.kff.org/hivaids/.

More information on Greater Than AIDS is available at www.greaterthan.org.

About the Kaiser Family Foundation
The Kaiser Family Foundation, a leader in health policy analysis, health journalism and communication, is dedicated to filling the need for trusted, independent information on the major health issues facing our nation and its people. The Foundation is a non-profit private operating foundation, based in Menlo Park, California.

About Greater Than AIDS
Greater Than AIDS is a leading national public information response focused on the U.S. domestic epidemic. Launched in 2009, it is supported by a broad coalition of public and private sector partners, including: major media and other business leaders; Federal, state and local health agencies and departments; national leadership groups; AIDS service and other community organizations; and foundations, among others.

Through targeted media messages and community outreach, Greater Than AIDS works to increase knowledge, reduce stigma and promote actions to stem the spread of the disease. While national in scope, Greater Than AIDS focuses on communities most affected.

The Kaiser Family Foundation provides strategic direction and day-to-day management, as well as oversees the production of the campaigns. The Black AIDS Institute — a think tank exclusively focused on AIDS in Black America — provides leadership and expert guidance and supports community engagement. Additional financial and substantive support is provided by the Elton John AIDS Foundation, Ford Foundation and MAC AIDS, among others.

About Gilead Sciences, Inc.
Gilead Sciences, Inc. is a biopharmaceutical company that discovers, develops and commercializes innovative therapeutics in areas of unmet medical need. The company’s mission is to advance the care of patients suffering from life-threatening diseases worldwide. Headquartered in Foster City, California, Gilead has operations in North and South America, Europe and Asia Pacific.

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By Dr. Todd Frederick for SFGate

Let me start with a sobering statistic: Hepatitis C is now killing more people in this country than HIV/AIDS and another form of hepatitis, hepatitis B – combined.

Hepatitis C, a chronic condition caused by infection with the hepatitis C virus, or HCV, is one of the leading causes of liver cancer in the United States and the No. 1 reason for needing a liver transplant – by far.

By conservative estimates, about 3.2 million people are infected with this virus in this country. Most experts believe the number to be closer to 5 million, compared with about 1.15 million with HIV. At least 12,000 people are estimated to be infected in San Francisco alone.

More alarming is the belief that between half and three-quarters of those with the virus do not know they have it.

Baby Boomers – those born between 1946 and 1964 – are disproportionately affected by this disease, and the Centers for Disease Control and Prevention recommends that Boomers get a one-time test for HCV regardless of whether they have any symptoms or risk factors.

Other groups with a disproportionate burden of disease include African Americans, those undergoing dialysis, hemophiliacs, the homeless, the incarcerated, those who received a blood transfusion before 1992 and those who use drugs.

Now for some good news: People infected with hepatitis C can be cured. Yes, cured, as in “virus gone for good.” There is, however, a but: The underlying damage caused by the virus, typically accumulated over years to decades, will not be immediately reversed by getting rid of HCV, though there is hope for improvement as the body breaks down and remodels the scar tissue over time.

We actually have had a cure for this virus since 1986 – interferon-alpha – even before we knew what hepatitis C was. Unfortunately, interferon treatment doesn’t work for everyone, about 75 percent of all cases, and it has a number of serious and difficult side effects.

But treatment is rapidly evolving, and the days of interferon use are numbered. We will soon be entering the “interferon-free” era of hepatitis C treatment, and this can’t come soon enough.

In May 2011, the Food and Drug Administration approved two oral medications, protease inhibitors, as add-ons to standard therapy, pegylated interferon and ribavirin, for the most common type of hepatitis C. These were the first new drugs approved for treatment of the virus in nearly 10 years.

The FDA is reviewing submissions for two more new oral medications with anticipated approval by the end of this calendar year, sofosbuvir, a polymerase inhibitor, and simeprevir, a protease inhibitor.

Many more drugs are racing through development in clinical trials, with success rates exceeding 90 percent for many. It is an unprecedented time for new developments in this field, and the light at the end of the tunnel for our patients with hepatitis C is growing ever brighter.

If you were born between 1946 and 1964 or have known risk factors for HCV, please see your doctor or clinic for testing. If you test positive, your doctor can recommend appropriate treatment.

Here’s hoping this information will result in the diagnosis of many hidden cases of hepatitis C among potentially tens of thousands of Bay Area residents.

Hepatitis C
The San Francisco Hepatitis C Task Force offers information about viral hepatitis, including where to go for testing at: www.hepcsf.org/uploads/SF_guide_english.pdf.

Dr. Todd Frederick is a gastroenterologist and liver disease specialist with Sutter Pacific Medical Foundation. He practices at California Pacific Medical Center, San Francisco.

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Remember when you were first diagnosed with HIV?

You may have felt frightened, scared, and unsure about the future. Now you have the opportunity to give hope and advice to those who’ve been diagnosed recently by telling them, “You’ve got this.”

Upload your video to YouTube and then fill out the fields below. We’ll review your submission and post it on Healthline.com to share with the community.

In addition to providing hope, participants should know that Healthline will donate $10 for every video created to the Timothy Ray Brown Foundation (TRBF) of the World AIDS Institute. TRBF is the first and only organization in the 31-year history of AIDS created with the sole mission of finding a cure. Its central tenets are HIV cure awareness, education, securing funding for a cure, and supporting cutting-edge therapies.

Learn more about video submission.

See more at: Healthline or on Facebook

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By Lydia O’Connor for The Huffington Post

A legal battle between two rival pharmaceutical companies may consequentially resolve another, bigger debate: whether gays and lesbians may be excluded from a jury based solely on their sexual orientation.

San Francisco’s Ninth Circuit Court of Appeals on Wednesday will revisit a 2011 antitrust case between Abbott Laboratories and GlaxoSmithKline. In the case, GSK argued that Abbott had unfairly upped the price of the HIV-fighting drug Norvir by 400 percent in order to boost sales of its other HIV drug, Kaletra. GSK claimed that Abbott did so in order to harm competitors — including GSK — whose drugs must be taken with Norvir.

While the price hikes sparked a backlash among AIDS advocates and the gay community, the court ultimately ruled in Abbott’s favor.

GSK is now appealing that decision, citing Abbot’s rejection of a gay man as a potential juror as a move that should have been blocked by Batson v. Kentucky, a 1986 case establishing that a person may not be excluded from a jury because of race. Whether Batson also applies to sexual orientation may be answered by the case.

In legal documents, GSK also points to a more recent court decision: United States v. Windsor, in which the Supreme Court overturned the Defense of Marriage Act in June, citing the Equal Protection Clause.

“Windsor compels the conclusion that if the Equal Protection Clause offers any meaningful protection to gays and lesbians, the Clause must guarantee them the right and duty to participate in our country’s jury process,” GSK’s legal team argued. “Batson prohibits striking jurors based on classifications that have historically perpetuated discrimination against minority groups.”

Abbott, however, dismissed the notion that Windsor established a precedent extending Batson to include sexual orientation, citing a 1997 holding that “homosexuals do not constitute a suspect or quasisuspect class entitled to greater than rational basis scrutiny,” meaning that a person’s sexual orientation can legally be considered when scrutinizing his or her eligibility to be on a jury.

Moreover, Abbott denies the bumped juror’s sexuality was even the reason for his removal in the first place. Rather, it was his previous employment at the court, knowledge of a drug at issue in the case and loss of a friend to AIDS that Abbott says necessitated his exclusion from the jury.

Twelve civil rights groups are joining GSK in its argument, the San Jose Mercury News reported.

“For a court to conclude it’s fine for someone to be excluded from jury service because someone didn’t want a gay person on the jury would send a bad message,” said Jon Davidson, legal director of Lambda Legal.

Abbot has argued in court documents that the case is an inappropriate forum for such a discussion. “It is well established that a federal court should avoid resolution of constitutional questions when the case may be decided on a narrower ground,” the documents read.

Legal experts say the case could ultimately reach the Supreme Court.

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From US News Health/HealthDay News

THURSDAY, Oct. 17 (HealthDay News) — HIV-negative heterosexuals who take drugs that protect them from contracting the AIDS virus from their HIV-positive partners don’t engage in more risky sexual behaviors, according to a new study.

Researchers from the University of Washington in Seattle found that knowing they are protected against HIV transmission doesn’t change how these people behave sexually or lead them to have sex without a condom more often.

The study is published in the Oct. 16 issue of the journal The Lancet Infectious Diseases.

“Evidence for the effectiveness of new HIV-prevention strategies, including pre-exposure prophylaxis, has spurred optimism that the global HIV epidemic might be reversed,” Dr. Jared Baeten said in a journal news release. “However, an important question is whether HIV-negative partners who know they’re protected by prophylaxis will compensate for this by increasing their sexual risk-taking, such as through increasing their levels of unprotected sex.”

In conducting the study, an international team of researchers led by Baeten examined findings from the 2011 Partners PrEP study, which revealed that a preventive drug regimen could protect HIV-negative men and women from contracting the virus from their HIV-positive partner.

The researchers examined information on more than 3,000 people for up to one year before and after taking drugs to prevent the transmission of HIV, the virus that causes AIDS. The participants were counseled on pregnancy testing and how to reduce their risk for sexually transmitted infections, such as gonorrhea, chlamydia, and trichomoniasis.

Even before the participants learned the results of the research, which established the protective effects of the drugs, they were engaging in unprotected sex less often, the study authors found. The researchers concluded that the risk counseling the participants had received may have been effective.

After the participants knew the drugs they were taking were shown to provide protection against HIV transmission, the investigators found no significant difference in the level of unprotected sex taking place between partners.

There was, however, a slight increase in the frequency of unprotected sex outside the relationship. The researchers said there was no increase in rates of sexually transmitted infections or pregnancy.

“The results provide encouraging evidence that behavioral changes as a result of pre-exposure prophylaxis might not undermine its strong HIV prevention and public-health benefits,” Baeten said.

More information

The U.S. Centers for Disease Control and Prevention has more about HIV transmission.

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By Christine Vestal, Staff Writer, for Stateline

For most uninsured Americans, the motivation for checking out the health insurance exchanges is simple – they could face stiff penalties if they don’t sign up. For Native Americans, the decision is more complicated.

Longstanding treaties with the federal government guarantee all Native Americans free health care. As a result, the Affordable Care Act exempts them from paying a penalty if they choose not to purchase insurance. More than 2 million Native Americans receive free health care at federally supported Indian health facilities. Many others receive care from tribal facilities and urban Indian organizations.

So why would an American Indian or Alaska Native sign up for reduced-rate insurance on the exchanges?

Indian health advocates said the benefits are many. “It’s an unprecedented opportunity,” said Roxane Spruce Bly, who is working with New Mexico’s health insurance exchange to provide outreach to Native Americans. “It’s the biggest thing to happen in Indian health in my lifetime. It solves so many problems for Indian people.”

Although tribal members are entitled to free health care, most Indian health facilities do not offer a full array of services. When patients need major surgery or cancer treatments, for example, they are referred to specialists outside of Indian lands. At least two-thirds of those referral claims are rejected, Bly said. That puts Indians at risk of either paying major medical bills themselves or doing without needed treatments. In addition, about half of Native Americans live in urban areas that are great distances from tribal health facilities.

As a group, the nation’s 5.2 million Native Americans have poorer health and less access to health care than the rest of the U.S. population. Their uninsured rate is nearly 30 percent, compared to 15 percent for the country as a whole. And nearly half of all Indians have incomes low enough to qualify for Medicaid in states that have chosen to expand coverage, according to the Center on Budget and Policy Priorities. More than 1 million Native Americans are already enrolled in Medicaid.

Still, Bly and others said the idea of purchasing health insurance, even if deeply discounted, is a foreign concept for most tribal members. Even optimistic advocates for Indian enrollment in the exchanges said convincing tribal leaders and individuals to sign up could take years. Bly’s goal is to sign up 10 percent of New Mexico’s eligible Native Americans by the end of 2014.

Special Advantages
The ACA includes provisions for American Indians and Native Alaskans that make purchasing insurance on the exchange an even better proposition than it is for everyone else. They can sign up at any time – there are no open enrollment deadlines. Tribal members with incomes below 300 percent of the federal poverty level ($34,470 for an individual) are exempt from paying deductibles and copays, so they can purchase the cheapest plans without worrying about out-of-pocket expenses. All tribal members, no matter what income level, are exempt from out-of-pocket payments if they receive services from Indian health facilities. And unlike employers, tribes can pay exchange premiums for their members without paying taxes.

In addition, a separate law that has governed Native American health care for decades – the Indian Health Care Improvement Act – was amended when the ACA was signed. New provisions make it easier for Indian health facilities to accept payments from other insurers, including Medicaid, Medicare and private insurance. The new law also expands the types of services the facilities can offer and requires inclusion of behavioral health and substance abuse treatments.

For Indians enrolled in Medicaid, Indian health providers receive a fee-for-service that is much higher than other providers receive. In addition, they can collect fees from private insurers if Native Americans take advantage of the exchanges.

The new income sources are expected to help Indian health facilities expand and improve their services. Some, for example, do not now include dentistry or deliver babies. Few offer preventive services. According to a 2011 Centers for Medicare and Medicaid (CMS) report, the Indian Health Service budget—$4.2 billion in 2010—“is only sufficient to provide about half the necessary health services required.”

Ed Fox, a member of a tribal advisory group to the CMS, estimates the ACA could result in as much as $4 billion in additional revenue for Indian health services. But that’s only if tribal leaders take advantage of it, he said.

A tribal member himself, Fox conducts outreach meetings with tribal leaders in Washington state. He said so far the leaders he’s talked with plan to wait and see what other tribes do about the health insurance exchanges before they make a decision.

“They haven’t had the greatest experience with government programs in the past,” Fox said. If he walks into a meeting and says, “I’m with the federal government and I’m here to help you,” most tribal leaders simply laugh.

Medicaid Expansion
In states that expand Medicaid in January, enrolling newly eligible Native Americans will be less of a challenge than selling the exchange concept. But it will still take substantial state and federal outreach and education, an effort that is required by the ACA.

According to a report from the Government Accountability Office, Native American enrollment in Medicaid could double under the expansion.

But the GAO said the CMS and the Indian Health Service are not doing enough to spread the word about health insurance exchanges and new Medicaid coverage. States are also responsible for getting the word out.

In New Mexico, Medicaid director Julie Weinberg said members of her staff have been crisscrossing the sparsely populated state since August and have visited more than 200 tribal locations. The agency has also purchased radio, print and television ads. “It ends up being fairly costly,” Weinberg said. “We’re digging way down deep into our administrative budget to do the outreach.”

Montana and California have received a federal Medicaid waiver to directly reimburse tribal leaders for Medicaid expansion outreach efforts. Alaska and Washington have pending waiver requests, and three other states are interested, according to the GAO report.

In general, the federal government will pay 100 percent of all costs for newly eligible Medicaid enrollees for the first three years. After that the federal share tapers to 90 percent. Traditionally, however, the federal government has paid 100 percent of all Medicaid costs for Native Americans.

“The most important thing for state administrators,” said Carolyn Ingram of the Center for Health Care Strategies, “is to talk to tribes early and often.” She and others agree that most individual Native Americans are not likely to take full advantage of the health law without the support of their tribal elders.

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Join the Campaign to End AIDS today!

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By Winnie McCroy for EDGE

On the heels of their successful Oct. 4 “Die-in” at the New York Public Library, ACT UP/New York is calling all digital activists to join a two-day Hackathon during National Coming Out Day weekend, Oct. 12-13. The AIDS activist group will challenge new generations of programmers, designers and volunteers to pioneer the group’s approach to HIV prevention and AIDS activism in the digital age.

“The war on HIV must now be fought in the palm of one’s hand,” said Mathew Rodriguez of ACT UP. “If our generation wishes to be intensely social while intensely anti-social, we have to tap into that. As cliché as it may sound, we’ve got to make an app for that.”

Organizers say that their ACT UP/Fight Back/HACK AIDS campaign will be focused on creating online tools for HIV/AIDS education and prevention. Participants do not need not understand code to join the event, as activists, designers, students, writers, engineers, librarians, doctors, students, lawyers, researchers, musicians and coders will be welcomed with open arms.

ACT UP’s past campaigns and protests have been immortalized in the Oscar-nominated documentary “How to Survive a Plague,” and via the New York Public Library exhibition, but activists insist that while it is necessary and respectful to remember the past, the LGBT community must focus its attention on the present fight.

Unless the community takes action now, more than half of today’s young gay men and transgender women may become HIV-positive by age 50, according to estimates based on current epidemiological data from the U.S. Centers for Disease Control and Prevention. ACT UP has called the rise in new infections a new wave HIV epidemic, or AIDS 2.0, to explain the dramatic effect it will have on an entire generation of young people.

“We desperately need more resources and new talent to engage in today’s fight against rising rates of incidence and the criminalization of HIV,” said Bacilio Mendez II, co-chair of the Queer Caucus of the National Lawyers Guild and the Chair of ACT UP/DAWG (the Digital Activism Working Group).

Mendez proposes that ACT UP and other organizations need to think inventively and radically about how to reach people via their screens, where they are most likely to be first exposed to information about HIV.

“We are creating a new movement to inspire the next generation to join ACT UP in the fight to end AIDS,” Mendez said.

The hackathon concept is gaining popularity as a form of political protest. In September, EDGE reported on Trans*H4CK, the world’s first transgender hackathon aimed to address issues specific to the transgender community.

To learn more about the ACT UP hackathon, visit http://bacil.io/hackAIDS2013

Winnie McCroy is the Women on the EDGE Editor, HIV/Health Editor, and Assistant Entertainment Editor for EDGE Media Network, handling all women’s news, HIV health stories and theater reviews throughout the U.S. She has contributed to other publications, including The Village Voice, Gay City News, Chelsea Now and The Advocate, and lives in Brooklyn, New York, where she writes about local restaurants in her food blog, http://brooklyniscookin.blogspot.com/

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From our friends at the Coalition on Human Needs

End the Shutdown – Stop the Meltdown!
An Urgent Call for Your Help

The federal government has been partly shut for more than a week. Federal workers are prevented from doing their jobs. People are not getting services: Head Start, youth programs, mental health, emergency food… Inspections of food imports are way down; public health risks are up. And the unthinkable is being threatened by the House leadership: federal default on its debts and obligations if they don’t get their way.

Your voice is needed NOW:

Call your Representative: Tell him/her to end the shutdown and stop an economic meltdown
Call toll-free: 1-888-659-9562 Wednesday – Friday, October 9 – 11

We really are heading towards a crisis – tell us you care, and will act.

Suggested message when you call:

As your constituent, I want you to act NOW to end the government shutdown and prevent the economic catastrophe of a government default, without conditions. Please vote to restore funding for all of the services that families count on and to protect Social Security, Medicare, Medicaid, and food stamps.

When you call, you’ll be asked your zip code, and you’ll be connected automatically to your Rep’s office – simple!

We are so grateful to the American Federation of State, County, and Municipal Employees (AFSCME) for making this toll-free number available!

Here is why your call is so important:

Public opinion polls show the public strongly opposes the government shutdown. So House members who have voted to shut down government by tying de-funding or delay of the health care law to a stopgap spending bill are worried. Calls from constituents like you will make them very worried. They will press their leadership to stop the shutdown.

The House leaders have been trying to divide and placate public concerns by passing a dozen bills that would fund popular programs. Representatives need to hear from constituents that this piecemeal approach is unacceptable. We need all of government working. A simple vote on a short-term spending bill with NO riders or conditions will do that. Show your Rep you want a real solution, not a PR offensive.

We are about 10 days away from catastrophe: the federal government prevented from paying its bills and debts. The Treasury Department and respected economists call that the road to economic catastrophe and deep, dark recession. So far, the government shutdown has not stopped payment of Social Security checks or Medicaid/Medicare/food stamp benefits. But if the federal government does not have enough money to pay its bills, no cuts are exempt. Your Rep has to hear how strongly you feel that default MUST be prevented – NOW, with no conditions.

Your call is needed no matter who your Rep. is. If your Rep. favors a clean funding bill without conditions, it helps them to be able to cite strong constituent support. If he/she voted for the shutdown, you need to hold them accountable. Your call reinforces the message coming from multiple polls that voters oppose these tactics.

How your rep voted: On the key vote tying a short-term extension of spending to de-funding of the Health Care Law, votes were mostly along party lines. All Republicans except Rigel (R-VA) voted for it (he opposes short-term spending bills); All Democrats except Matheson (D-NC) and Matheson (D-UT) voted against (they opposed the health care law).

How does the government shutdown affect Hill office’s phones? We’ve been making lots of calls and we mostly get through. It’s possible you’ll get voicemail. Leave a message. The alternative is silence – a bad choice.

Please forward the request to call widely. And please don’t forget – we need you to call.

Learn more:
CHN’s Federal Shutdown Impacts.
Government Shutdown Followed by Economic Meltdown? from CHN’s October 7 Human Needs Report.

Please forward this widely! Thanks!!

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By Hannah McCartney for CityBeat

The Ohio House yesterday offered overwhelming support for a bill that would authorize local health boards across the state to establish syringe-exchange programs with fewer roadblocks, which could pave the way for Cincinnati to establish myriad programs across its neighborhoods most afflicted by intravenous drug use and bloodborne pathogens.

House Bill 92, sponsored jointly by Rep. Nickie Antonio (D-Lakewood) and Rep. Barbara Sears (R-Sylvania), would remove a restriction that stipulates programs can only be implemented when a local health emergency has been declared and lays out mandates for programs to protect the rights and educate the intravenous drug users who take advantage of the programs.

Syringe exchange programs have been the privy to significant controversy; opposers say that offering addicts the tools they need to fuel drug habits ultimately fuels destructive habits and sends the wrong message to drug abusers.

What’s helped turn the issue non-partisan, however, is overwhelming data supporting claims that the program saves lives. In 2004, the World Health Organization published a study on the effectiveness of syringe programming in reducing HIV/AIDS that found a “compelling case that (needle-exchange programs) substantially and cost effectively reduce the spread of HIV among (injection drug users) and do so without evidence of exacerbating injecting drug use at either the individual or societal level.”

Adam Reilly, who is an HIV project manager for a local healthcare provider, says that a syringe exchange program is already in the works for Springdale; the location is expected to open in about a month. He says that project has been seven years in the making because of how entangled efforts to establish the program become in bureaucracy.

Establishing a program is particularly laborious, he explains, because it requires citywide cooperation — including law enforcement — which has proven to be a challenge for programs in other states, where police officers are prone to harass participants entering or leaving an exchange facility.
The current bill would essentially take the issue out of the political arena, Reilly says, and thrust the responsibility onto health departments. The city of Cincinnati in 2012 already declared a public health emergency following significant proof of a citywide HIV/Hepatitis C epidemic sourced primarily from heroin abuse.

Cincinnati’s now-defunct nonprofit agency STOP AIDS found through focus groups that the majority of intravenous drug users are Caucasian middle-aged males; 145 of 147 study subjects reported using ineffective methods to clean used equipment. Their data estimates that 4,000-6,000 people locally are currently living with HIV/AIDS.

STOP AIDS also estimated that spending $385,000 per year on a syringe exchange program has the potential to save nearly $50 million annually in health costs generated from contracting HIV or HCV infections.

To make the program as effective as possible, Reilly says other exchange programs offer participants assurance in writing that their identities will be protected; the House bill also says that future programs wold be required to encourage drug users to seek medical, mental health or social services, also offer counseling and other educational requirements.

The bill has been assigned to a Senate committee, where it will go through another vote and, if passed, will require Gov. John Kasich’s signature to become law.

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Join the Campaign to End AIDS today!!

Help for Housing in Atlanta!

Housing has consistently been identified as a priority need for PLWHAs, not only in Atlanta but all across the country. Waiting lists spiral out of control, people are placed in substandard housing that puts their health and lives at risk. Khafre Abif is just one example of a PLWHA trying to get housing who has been unsuccessful and is sleeping on a friend’s couch in an unsafe neighborhood. He has asked for our help in addressing this issue, not only for himself, but for others who are in the same position. *Call and/or email the decision makers in Atlanta at the bottom of this page, and advocate for them to work with the community to deliver the housing resources to the people that need it.* Feel free to use the script below!

Let us know about your calls/emails at info@campaigntoendaids.org!

—-

“My name is _____ and I am a member of the Campaign To END AIDS.

One of our demands is that our leaders understand the vital role safe and stable housing plays in prevention and treatment and incorporate housing as a structural intervention for both. Waiting lists and delayed application processes put people lives in danger.

I am calling not only to request that Khafre K. Abif’s application for the TBRA HOPWA program through AID Atlanta be approved, but that you also address the growing concern over the lack of affordable decent housing in your jurisdiction.

Khafre is a local and national activist that is in need of a stable and safe housing environment. I want to stress to you how important the provision of housing for him and others like him. Approval of these applications is a step they need to see continued improvement in their health and overall well-being.”

—-

Housing Coordinator — Theresha Compton; theresha.compton@aidatlanta.org; 404-870-7781

Director of Client Services — Nicole Roebuck; nicole.roebuck@aidatlanta.org; 404 870-7724

Case Manager — Neyamka Johnson; neyamka.johnson@aidatlanta.org

Finance HOPWA — Dawn Smith; dawn.smith@aidatlanta.org

Finance HOPWA — Solimar Vargus; solimar.vargus@aidatlanta.org

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Join the fight! Join the Campaign to End AIDS today!

New York, NY October 3rd 2013—Housing Works and HIV Law Project announced their official merger today. With the addition of five legal professionals, the combined entity is now the largest provider of legal services for people living with HIV/AIDS in New York.

The two organizations have an almost 20-year history of working together and share a common commitment to serving underserved populations, including women and their families; people of color; undocumented and recent immigrants; members of the LGBT community; and the homeless.

Housing Works’ legal department has taken the lead in fighting for clients wrestling with homelessness and HIV/AIDS, among other areas. Its recent focus includes combating landlords and brokers who systematically practice “source of income” discrimination in housing. The HIV Law Project has provided groundbreaking, client-focused legal services to affected communities in New York City since 1989.

Together, they will help Housing Works to secure and maintain affordable housing for clients, ensure basic human rights, and combat discrimination against those living with HIV/AIDS.

“I’m thrilled that HIV Law Project has found a new home in the Housing Works family”, said Eric Longo, former Board Chair of HIV Law Project. “Thanks to this transaction/merger, Housing Works will be able to continue serving the legal needs of many underserved and disenfranchised clients in New York City.”

The merger will also provide expanded services: HIV Law Project has dedicated staff focused on immigration law, which will allow Housing Works to offer direct representation on immigration matters.

Senior Staff Attorney Armen H. Merjian, one of the nation’s top HIV/AIDS and civil rights attorneys, will remain in his role at Housing Works and also serve as Executive Director for HIV Law Project. “I have worked with the HIV Law Project for decades,” said Merjian, “and I’m excited to bring their passion and expertise – so compatible with our own – into the Housing Works family.”

Robert F. Bacigalupi, the former governmental benefits coordinator at Legal Services of New York and former President of LeGAL, will assist Merjian in supervising the new unit. This includes twelve employees—eight lawyers, two paralegals, and two support staff. A leader in HIV/AIDS legal and advocacy services, HIV Law Project will retain its name and independent board of director.

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Written by Bryan Jones, C2EA Great Lakes Regional Co-Chair

Empowering people living with HIV/AIDS has been a platform of mine for a long time. That’s why I am very grateful for the opportunity granted to me by Ms. Christine Campbell of Housing Works and Mr. Kali Lindsay from the National Minority Aids Council. Presenting alongside them only reinforces what I’ve known in my heart to be true all along, that we as Positive People do matter and that we do have a voice that is just as important as statistics.

Presenting at the United States Conference on AIDS in New Orleans as well as the North American Housing and HIV/AIDS Research Summit in Montreal, Canada have been very inspiring and influential experiences in my advocacy. Christine and Kali have given me that extra boost to continue fighting by giving me these opportunities. This experience has made me realize that I’m definitely on the field playing the game, and not just in the bleachers watching.

In Ohio where I’m from, as well as other locations around the country I’ve been, PLWAs are often pushed aside and not utilized to their full capacity, nor are they added to the equation when it comes to prevention. I once heard someone say at a conference (and you know who you are), “THERE SHOULD BE NOTHING ABOUT US WITHOUT US,” and that message resonated to my very soul and began to be part of the foundation of my advocacy.

It’s funny that at the Housing Summit all the presentations were filled with statistical models, peppered with the latest buzz words, blah, blah, blah… Don’t get me wrong, the data and stats are very much needed to convince those naysayers that housing is prevention. But the piece that was missing from almost all the presentations except a few was the inclusion of actual people living with HIV/AIDS, their stories, their voices. That one element needed to take the stats and data off the page and make it real human.

One exception was the presentation on Mass Incarceration, Housing Instability and HIV/AIDS (of which yours truly was apart). After our presentation, many people came up to me and commented that to hear a real story integrated and supportive of the material was refreshing and more impactful than a lot of the data that was presented. They also felt that our (wow that feels good – “our”… let me say it a little louder – OUR!) presentation had the perfect balance of strong data, strong recommendations, and a very moving human element.

The message I send out to my peers is to start telling your story, because just like mine yours too can make a difference. Thanks to Christine and Kali who I saw firsthand are very committed to People Living with HIV/AIDS. It will go down in history (at least in my history) that at the North American Housing and HIV/AIDS Research Summit and the United States Conference on AIDS our PLWA voice was heard.

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Join the Campaign to End AIDS today!

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By Neil G. GiulianoCEO, San Francisco AIDS Foundation; former mayor of Tempe, Ariz. — for The Huffington Post

Millions of uninsured and underinsured Americans will have access to new health coverage options as open enrollment commences next week. This includes countless individuals whose HIV infection previously rendered them ineligible for health insurance, many of whom currently rely on AIDS Drug Assistance Programs and the “payer of last resort” Ryan White program to cover their medical care and daily HIV medications.

There is no doubt that new health coverage plans and programs under the Affordable Care Act can improve the lives of millions, and San Francisco AIDS Foundation and other organizations across the country are working to smooth the transition for people living with HIV. The foundation’s legislative advocacy team has been fully engaged and collaborating with other agencies to help clients and providers prepare, navigate the system, and get the most out of the changes ahead.

But let’s be clear: This stage of ACA implementation is just a step in the process toward the broader goals of improving health care access, engagement in care, and health outcomes for all.

While we use the term “health care reform” as a convenient catch-all to describe ACA implementation, what’s initially changing, starting Oct. 1, isn’t health care but who pays for health care. Will it get people closer to accessing diagnostic tests, preventive care, and medical treatment? Certainly. Will it end the HIV crisis in marginalized communities across the country? No, not on its own.

Today, of the estimated 1.1 million people in the U.S. who have HIV, only two thirds are aware of their infection and linked to HIV care. Half actually remain in care and are receiving HIV treatment, and just 25 percent have suppressed their viral load. That last statistic bears repeating: Only a quarter of Americans living with HIV have the medical care, treatment regimen, and medication adherence support they need to keep the virus in check; the other 75 percent are at risk for disease progression and for passing HIV on to others.

And in regions across the U.S., the most marginalized and stigmatized communities continue to be hit hardest by HIV/AIDS. They include men who have sex with men, transgender women, people of color, individuals who inject drugs, people who lack stable housing, sex workers, people facing language barriers and/or uncertain immigration status, and those living in poverty.

It’s because of these dire statistics and health inequities that San Francisco AIDS Foundation and other HIV/AIDS service organizations provide the services we do: HIV testing in safe, nonjudgmental settings; syringe exchange programs that offer medical care referrals (and compassion), not just clean needles; substance use and mental health treatment services that welcome all; housing support, so that folks have a place to store their meds and cook a meal to go with their pills; benefits counseling to help navigate complex medical and benefits systems (and now the transition to new payers under the ACA).

Access to new health care coverage options will be life-changing for countless people who have never before been able to afford decent medical treatment. Yet this facet of the ACA does not solve many of the problems that San Francisco AIDS Foundation and other organizations have been addressing for decades. For the most marginalized among us, stigma and discrimination bar the way to HIV testing, treatment, and care.

Ensuring access to culturally competent, high-quality health care for vulnerable populations is one of the ACA’s long-term goals — and one that San Francisco AIDS Foundation shares. Culturally competent care is not a luxury. It can mean the difference between life and death: Recent research links good patient-provider relationships and communication with fewer missed appointments (a key factor in mortality risk). It is crucial that community-based organizations be part of longer-term ACA implementation planning, to ensure that the definition of “culturally competent” meets the needs of all people living with and at risk for HIV.

We welcome the positive changes ahead, and we will prepare and assist our clients and the community we serve to navigate the complex transition to new health care plans and payers. The process will advance, we will be a part of it, and our work to bring about the end of HIV/AIDS once and for all will advance as well.

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Join the fight! Join the Campaign to End AIDS today!

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By Jodie Howerton for the Huffington Post

Several years ago, when my oldest was in 5th grade, I previewed the HIV/AIDS video that our local public school uses to fulfill state educational mandates. The video was produced in the 1980’s (might have had an update in the early 90’s), was incredibly fear based, and contained very outdated information about the virus.

I was stunned. In most other ways, I’ve been very impressed with the curriculum our school district utilizes. The video featured newspaper headlines that read “Thousands Die of AIDS,” and even spliced in a shot of the grim reaper at one point. To illustrate how HIV attacks the immune system, the video used abstract concepts related to baseball that even I, as an adult, was confused by. Then there was the personification of HIV as a red monster.

My 8-year-old son, Duzi, is HIV positive.

He is not scary and he is not contagious. He takes a regimen of anti-retroviral medication every day and has an undetectable viral load. He is not a threat to anyone.

The information in the video was scary. Those without additional information would be afraid of my son after watching it. Afraid of my adorable, smart, hilarious son who plays soccer and baseball, does karate, and is a talented hip-hop dancer.

The video perpetuated stigma.

When the video ended, my head was spinning, blood rushed to my face, and my hand shot up. Why, I demanded, was this video being shown at all? Wasn’t there something else produced in this century that we could show instead? The poor teacher showing the video was simply utilizing a resource that had been approved by our school district. I then complained to the principal and to the school nurse, who put me in contact with the Health Coordinator at the school district.

The health coordinator was incredibly kind and helpful. She admitted that the video was outdated and together, we searched for replacement videos — for an entire year. We found nothing appropriate for the public school setting. And I really mean nothing.

Don’t just criticize. Create.

So, I decided to make some new videos. With the collaboration of the Office of Superintendent of Public Instruction in Washington State, physicians from Seattle Children’s Hospital, and fundraising help from Seattle Children’s Hospital Foundation, I’m creating a series of four brand new video resources for 5th grade, 6th grade, middle school and high school students.

These videos will be available FREE OF CHARGE to any school district in the nation that wants them.

Utilizing a documentary format that features a “day in the life” of an HIV positive person, the videos will contain medically and scientifically accurate information and will focus on reducing the devastating social stigma still associated with the disease. Students will understand the truth about prevention and transmission, and will feel compassionate, not fearful.

Of course, given the nature of education budgets in states across our nation, there is not any funding available for these videos. We need to raise $150,000 to create all four videos. We’ve launched a fundraising campaign on Indiegogo to help us create the first video.

A Collective Family Decision to Disclose

Before you go to Indiegogo, I need you to know how much thought, discussion, and prayer went in to my family’s decision to disclose Duzi’s status so openly. Up until now, we have only disclosed his positive status on an individual basis. We have never believed that HIV is something to be ashamed of. We have never communicated to Duzi that he has something to hide or be embarrassed of. Never. We have so normalized HIV in our home, that we actually rarely discuss it any more. Every morning, Duzi takes his HIV meds, I take my thyroid meds, Caleb takes his acid reflux meds, and Alex takes her iron supplement. It’s no big deal.

We started to realize sometime in the middle of last school year that more people knew about Duzi’s HIV status than we thought. Unfortunately, even though HIV status is protected under federal privacy laws, moms at the bus stop, parents at athletic events, and well-meaning people in our church like to chat about “secret” things. We realized that we were not in charge of the information people were communicating to one another about our son’s health. People that knew about Duzi’s status didn’t know that we knew that they knew and so were not coming to us directly to ask questions. We had no idea what myths were being perpetuated.

We’ve decided, with Duzi’s input, with my older kids’ input, with perspective from our community of positive families, and with counsel from friends who know us well, to disclose openly.

Secrets have much more power than truth. We desperately want Duzi to live free of the burden of secrecy and shame; I have no doubt that open disclosure will have some consequences. I have no doubt that we will encounter ignorance and prejudice But, at least we will know about it.

And, I’m prepared to fight for my son’s right to live in the light.

We have 30 days to raise money for our “Redefine Positive” campaign on Indiegogo. Would you consider contributing?

Facebook Page

Twitter

Contact:
JodieH@sunbreakscommunications.com

You can read our official press release about the campaign here.

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Join the fight! Join the Campaign to End AIDS today!

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On behalf of our friends at amFAR; click here for this information and more on their website

PLEASE SIGN THIS PETITION TODAY! There is no deadline, and for every 250 signatures in a given district a Hill visit is triggered and those signed petitions are delivered directly to representatives in Washington, DC. Make sure your reps know where you stand on evidence-based, life-saving HIV and Hep C prevention! Sign as an individual and/or an organization. SHARE WIDELY!

According to an overwhelming body of evidence, needle and syringe services programs not only reduce the spread of HIV and other blood-borne diseases, but also save money, encourage the safe disposal of syringes, minimize the risk of needlestick injuries to law enforcement officials, and help give people who inject drugs access to vital drug treatment services.

In spite of the strong evidence in favor of these cost-effective public health programs, the use of federal funds to support syringe exchange programs is banned. Join us in urging lawmakers to end the ban.

Here’s what you can do:

Sign our petition.

View our short film, The Exchange, and share it with others.

Contact your members of Congress and tell them you believe the ban on federal funding for syringe exchange is anti-science and anti-public health, and needs to be removed.

Learn about this important issue:

~ Issue Brief: Federal Funding for Syringe Services Programs: Saving Money, Promoting Public Safety, and Improving Public Health (March 2013)

~ Fact Sheet: Public Safety, Law Enforcement, and Syringe Exchange (March 2013)

~ The Twin Epidemics of HIV and Drug Use: Innovative Strategies for Healthy Communities, co-produced with the International AIDS Society (December 2012)

~ Map of Syringe Exchange Programs in the U.S. (April 2012)

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By Max Brantley for the Arkansas Times

I wrote Rick Neal, superintendent of the Pea Ridge School District, for more information about the district’s decision to bar attendance of three students until they’d been tested for HIV. The decision has stirred up worldwide interest because most believed the Ryan White case and subsequent federal law made it impossible to bar students from public schools even if they are HIV positive. The three children are in foster care; two reportedly have disabilities.

I asked Neal for more information generally and also for copies of the correspondence with the district’s legal advisor, who reportedly said the district was within its rights in barring admission until an HIV test.

I got a brief note just now from Neal, that said in its entirety:

“I’m out of my office the [sic] late Thursday I will forward your request to my attorney. FYI , the students are back in school today. The issue has been resolved. I’ll be glad to send you what you need when I return.”

I’m trying to get more information.

The district had further muddied the waters yesterday with a prepared statement reported by the Daily Mail. The statement confirmed that it had required HIV testing of some students and continued:

‘This rare requirement is due to certain actions and behaviors that place students and staff at risk. The district respects the privacy and confidentiality of all students.

‘It is very unfortunate that information regarding this situation is being released by outside organizations.

‘Our goal is to provide the best education for every student, including those in questions, in a responsible, respectful and confidential manner.”

Tom Masseau of the Disability Rights Center, which has vigorously advocated the children’s right to attend school without need for testing, said he had learned the children were allowed to attend school today. Previously, the district had said the children couldn’t attend without providing results, But he said that didn’t end the center’s concerns.

He said there’s no need for testing because the children must be provided a free and appropriate education whether HIV positive or not. He said the center is concerned with singling out children for testing, particularly children with disabilities, and with the possibility the results could become public. He didn’t know if the return of the children meant they had provided test results. The school district letter did not say the students had to test negative for HIV to return, only that they had to be tested, but Masseau said that’s of no consquence.

“I want to know the real reason they were tested,” he said. He said districts sometimes raise the possibility of disruptive behavior — and the possibility that students could become scratched in a fight, for example — as a pretext to force students into homebound schooling. “To me it’s just mind-boggling that we’re going down this road.”

He said all districts have a range of precautionary responses for both teachers and students in all types of situations, including fights. To suggest these students should be tested is to suggest all students and teachers should be tested against the possibility they might get in a scrape. He said the science is well-known, in any case, that the chances of transmission of HIV is possible from such contact are extremely small.

Masseau said the center would remain involved because it doesn’t want to see children stigmatized, they challenge the legality of requiring testing and they want to be sure the children are receiving free and appropriate education.

I’ve tried to reach the district’s lawyer, Vicki Vasser with Matthews, Campbell, Rhoads, McClure and Thompson in Rogers, about the issue, but have so far been unsuccessful.

A variety of calls to people familiar with the issue adds to the shape of the story as hinted at in the school district statement yesterday. The essence is that some of the children have sometimes presented behavioral issues. When the district learned that the family included relatives with HIV, they wanted to know about the children to provide what they call “appropriate, individualized” education plans that also protect children and staff. The Department of Human Services, which has custody of the children, provided the requested information so the children could return to school. In theory, the results of their tests will be known only to the people who develop and deliver their education.

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Join the fight! Join the Campaign to End AIDS today!

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Rick Neal, superintendent of schools in Pea Ridge, Arkansas

By Tim Murphy for Housing Works & C2EA

Housing Works, the Campaign to End AIDS (C2EA), and HIV activists in northwest Arkansas urge you to contact Rick Neal, the superintendent of the Pea Ridge, Arkansas, school district and tell him not to ban from school kids who have HIV. Contrary to the school district’s thinking, HIV is not transmissible in a school environment!

Neal’s email is rneal@prs.k12.ar.us and his phone number is 479.451.8181. His mailing address is: Rick Neal, Pea Ridge School District, 781 West Pickens Rd., Pea Ridge, AR 72751. (See below for a sample message!)

According to news reports, the district has told the foster parents of three children, two of whom have disabilities, that the children may not come to school until the parents have produced documentation that the children are HIV-negative. The Americans with Disabilities Act (ADA) prohibits schools from banning children with HIV. Moreover, the school district’s own website says (at the bottom) that it “does not discriminate on the basis of race, color, sex, national origin or disability in any of its policies, practices or procedures.”

“I’ve been on my phone and social media nonstop protesting this,” says Kari Coffman, an openly HIV-positive member of C2EA who lives outside Ft. Smith, Arkansas. “I’ve gotten retweets from Hydeia Broadbent and Magic Johnson.”

The Disability Rights Center of Arkansas is on the case.

Housing Works will keep you posted on the story.

~ ~ ~ ~ ~

Ready to call, email, write, or all of the above but drawing a blank on what to say? Let this quick script help!

“Superintendent Rick Neal: HIV is NOT spread by casual contact so there is no reason to ban kids from school. Also, regardless of the status of the parents, kids cannot be required to provide evidence of being tested to be admitted to school. Keeping HIV-positive kids from school is ILLEGAL.”

Again, Rick Neal’s contact info is: rneal@prs.k12.ar.us // 479.451.8181 // Rick Neal, Pea Ridge School District, 781 West Pickens Rd., Pea Ridge, AR 72751

Let him know we’re watching!

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By Katie McDonough for Salon

It is illegal under federal law to prevent a student from attending school based on perceived HIV status, but an Arkansas school district has banned three students, all siblings, from returning to class until they submit to an HIV test, according to a local advocacy group.

The Disability Rights Center of Arkansas (DRCA) reports that the Pea Ridge School District found documentation suggesting the children’s birth mother, and one of the children in the school, may be HIV-positive. School administrators then sent a letter to the children’s foster family saying they would be prevented from attending classes until they submit to an HIV test.

The children returned to school anyway, and were made to wait in a separate room until their foster parents picked them up, according to local news station KFSM.

The DRCA is charging that the school district is illegally discriminating against the children, saying in a statement: “The fact that the foster families have to provide documentation that the children are HIV negative before entering the school is unlawful and immoral … It stigmatizes individuals with disabilities — or their ‘perceived’ disabilities, as there is no indication these individuals have HIV. There is only an unlawful fear that they do.”

The school responded in a Monday statement:

The Pea Ridge School District is dedicated to providing a safe environment for our students, teachers and staff.

As reported in the media, the district has recently required some students to provide test results regarding their HIV status in order to formulate a safe and appropriate education plan for those children. This rare requirement is due to certain actions and behaviors that place students and staff at risk. The district respects the privacy and confidentiality of all students. It’s is very unfortunate that information regarding this situation is being released by outside organizations.

Our goal is to provide the best education for every student, including those in questions, in a responsible, respectful and confidential manner.

More here:

Katie McDonough is an assistant editor for Salon, focusing on lifestyle. Follow her on Twitter [at]kmcdonovgh or email her at kmcdonough@salon.com.

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Disappointed? Frustrated? Angry?? For more info on how to get involved in local advocacy on this issue, contact C2EA Southeast Regional Co-Chair Kari C. at info@campaigntoendaids.org now!

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Check out the National Female Condom Coalition‘s site for organizing tools, fact sheets, reports, and ways to get involved in Global Female Condom Day today both in your community and over social media! Some highlights are below!

Global Female Condom Day

September 16, 2013 marks the second annual Global Female Condom Day-a day of education and advocacy to increase awareness, access, and use of female condoms. Take the pledge to take action along with female condom advocates around the world on Global Female Condom Day.

How can you participate in this global day of action?

Blog, Tweet, and Post about Female Condoms

Spread the word about female condoms through your personal social media networks as well as your organizational channels. Post about female condoms on your blogs, Twitter feed, and Facebook pages. Check out our organizing tools to get sample tweets and posts, Facebook pictures and the GFCD logo to help get the message out. But don’t stop there! Feel free to create your own unique messages and images as well! RSVP to our event on Facebook, and use the hashtags #GFCD and #femalecondoms on Twitter.

Talk About and Promote Female Condoms in Your Community

The female condom needs advocates like you to promote its benefits and answer questions. On September, 16 tell your sister, brother, niece, nephew, friend from church, school friend, colleague or client about female condoms – it will make a difference! You can go to our resources page to help explain and promote female condoms to your community. Check out our female condom talking points, too!

Advocate for Female Condom Access in Your Community

Help expand the number of places that make female condoms available. Make sure your organization makes female condoms visible, and that staff can answer questions about them. Create a pro-female condom culture at your organization by including female condoms in prevention discussions with colleagues, partners, and clients. Talk to city and state health departments and community clinics about distributing female condoms at their locations. Collaborate with local businesses to serve as education and distribution points for female condoms. Ask your pharmacist to stock female condoms at your local drugstore.

Host Your Own Mini Film Festival

Using the winners from this year’s international “Female Condoms Are _____” film contest organized by PATH in conjunction with CHANGE, AIDS Foundation of Chicago, and Universal Access to Female Condoms (UAFC), you can show your community entertaining, informative, and creative short films about female condoms to start a discussion about access and use in your community. Think about hosting a screening at your organization, youth club, local library, church, community center, or dorm. Check out the toolkit put together by PATH for everything you need to host your own screening.

Join the Global Female Condom Video Campaign

Tell the world why you support female condoms in a 10-second video. Check out our how-to guide for step-by-step instructions that make it easy for you to create your own video on your phone, computer, or video camera. Upload it to YouTube and share the link with us so we can make a Global Female Condom video playlist.

Help Pick the Fan Favorite in the “Female Condoms Are ______” Film Contest

Cast your favorite among the 12 finalists of the “Female Condoms Are____” film contest. Visit this site to watch the short videos on female condoms and then vote for the one you like best. Encourage others to do the same by posting the link through Facebook and Twitter. Sharing these films through social media is a great way to engage your community in conversations about female condoms.

Connect with Female Condom Advocates in Your Community

Female condom fever is spreading across the globe! More and more women and men are learning that female condoms are a powerful tool for sexual health, and they want access. To join a community of female condom advocates in the United States, explore this site to learn about the female condom movement and receive email updates. Connect with Universal Access to Female Condoms (UAFC) Joint Programme and learn about international female condom advocacy by visiting www.condoms4all.org and ZawadiSmartLove on Facebook and Twitter.

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Join other advocates in the fight to END HIV/AIDS! Join the Campaign to End AIDS today!

Sent on behalf of our friends at the National Alliance to End Homelessness

Congress is back today and that means that federal funding issues are back on the docket! Their return to DC offers us an opportunity this week to educate our Members of Congress on the importance of providing sufficient funding for HUD and its many low-income housing and homelessness programs before final agreements on FY 2014 funding are reached. This week is National Call-In Week! We need YOU to call your Members’ offices THIS WEEK to discuss the importance of these programs in your community and the need to provide MORE HUD FUNDING!

Here’s What You Can Do:

1. Call your Senators’ and Representative(s)’ offices THIS WEEK and ask to speak to the person who handles housing issues. You can find your Members’ numbers by calling the congressional switchboard at (202) 224-3121.

2. Use these talking points to discuss the need for increased funding for HUD programs, particularly the McKinney-Vento Homeless Assistance Grants.

3. Let me know which office(s) you contacted! Encourage others to make calls as well!

We’re setting a goal of generating at least 250 calls this week to all Members of Congress about the need for increased HUD funding in the final FY 2014 budget. Please make as many calls as you can and encourage your colleagues, Board members, clients, and anyone else who cares about HUD funding to make calls this week! It’s important that we keep track of how many calls we’ve made so we can be sure we’ve met our goal, so please let me know who you’ve called!!

In the next few weeks (or days), we anticipate that Congress will address FY 2014 funding through a short-term (30 or 60 days) stopgap funding measure to fund the government beyond the end of the fiscal year on September 30. After dealing with pressing international issues, they are likely to return to budget issues and finalize FY 2014 funding. If you weren’t able to join us last week for our HUD funding update webinar, you can access a recording of the webinar here for more information on possible funding scenarios.

At the moment, the timeline on Congress’ negotiations and decision making remains unclear; therefore, we must make as many calls as early in the process as possible – this week. We must work this week to ensure that those experiencing or at risk of homelessness receive the funds they deserve. Take this opportunity to reach out to your Members of Congress and remind them of the fantastic work your community is doing preventing and ending homelessness with these federal HUD programs.

Please let me know if you have any questions! I look forward to hearing from all of you about your calls!

Best,
Kate

Catherine (Kate) Seif
Policy Outreach Coordinator
National Alliance to End Homelessness
202.942.8256
cseif@naeh.org
www.endhomelessness.org

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By Grant Colfax, MD, Director, Office of National AIDS Policy & Lynn Rosenthal, White House Adviser on Violence Against Women for blog.AIDS.gov

Today we are proud to announce the release of the report by the President’s Working Group on the Intersection of HIV/AIDS, Violence against Women and Girls, and Gender-Related Health Disparities. We have had the honor of serving as co-chairs of the interagency Federal Working Group since March 2012, when President Obama issued a Presidential Memorandum to address two overlapping challenges to the health and wellbeing of communities across the United States: the effects of HIV/AIDS, and the alarming rate at which women and girls experience violence.

More than 1 in 3 women in the United States has experienced rape, physical violence, or stalking by an intimate partner in her lifetime; of these women, 69% report experiencing intimate partner violence at age 25 or younger, and 22% experience IPV for the first time as girls between the ages of 11 and 17 years. Furthermore, approximately 280,000 women in the United States were living with HIV in 2009, with an estimated 15% unaware of their status. Women account for 20% of new HIV infections in the United States, with over three-quarters of these new infections occurring among black and Latina women.

By themselves, these statistics represent a compelling call to action, but the particular prevalence of intimate partner violence among women living with HIV further reinforces the need to address the intersection of HIV/AIDS and violence against women and girls: 56% of women living with HIV, compared to the national prevalence of 36%, have experienced violence by an intimate partner.

Given these data, the Working Group established by the Presidential Memorandum was tasked with developing actions for evidence-based, culturally relevant steps for Federal agencies to address the barriers to care and prevention for both HIV and violence. The culminating report charts a path forward to improve collaboration among agencies by leveraging federal resources in support of the health and wellbeing of women and girls, particularly those living with or at high-risk for HIV/AIDS and violence. The report’s action steps include: a focus on research and data collection to evaluate existing programs; ideas to develop new strategies for intervention; and expanded efforts to empower women and girls, as well as engage men and boys, in the prevention of violence and HIV risk.

The release of this report comes at a particularly exciting time for women’s health, with open enrollment into the health insurance marketplace beginning October 1 under the Affordable Care Act. Built into the report are action steps to improve screening rates for both intimate partner violence and HIV for women; already as a result of the Affordable Care Act, new health plans provide coverage with no cost sharing for these services. Each of the report’s action steps will help meet the goals of the National HIV/AIDS Strategy and are synergistic with the Administration’s additional efforts to promote health and wellness among women and girls.

On Sunday, September 8, we will present the report at the United States Conference on HIV/AIDS, in New Orleans. We look forward to sharing the report with stakeholders, because a coordinated response to this complex issue is necessary to maximize impact. While the report identifies specific federal actions, its long-term success will depend on collaboration with partners in the private sector, faith communities, academia, and advocacy organizations. Our collective efforts will help us reach the goals of the National HIV/AIDS Strategy and reduce violence against women and girls.

Read the full report here.

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Join the Campaign to End AIDS today!

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By Abigail Wood for HIV Health Reform

Open enrollment begins October 1st and you might be wondering how you can get help enrolling people in new programs. You might also wonder what training is being provided to get enrollment assisters up to speed. Statereforum has crowd-sourced from advocates in all 50 states plus the District of Columbia this chart: State Approaches to Consumer Assistance Training. The chart details how each state will be conducting consumer assistance training for their navigators or in-person assisters. Just a few of the topics covered in this chart are the training format/curriculum being used by each state, the training model being used, and the evaluation process of participants in the training.

The chart also includes links to the agencies that were funded to provide enrollment assistance, if awards have been announced. Check the “awarded grants?” column to view the list.

Action step: Funded organizations are required to enroll a massive number of people, so they are actively seeking other organizations that can host regular or one-time enrollment events. Not sure how you will enroll all your clients? Reach out to funded organizations – they can help! Note that you may have to provide some HIV-specific benefits training. Your state public health department or legal services provider may be able to help.

Resources:

Statereforum: State Approaches to Consumer Assistance Training

NASTAD Brief on Outreach, Eligibility, and Enrollment (PDF)

Helping Consumers Apply & Enroll Through the Marketplace (PDF)

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Join the Campaign to End AIDS today!

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Image: CDC NPIN

By Amy Killelea, Senior Manager, Health Care Access for NASTAD

HIV/AIDS disproportionately impacts gay men and other men who have sex with men (MSM), particularly gay men/MSM of color, in the form of higher infection rates, less likelihood of timely linkage to care, and less likelihood of viral suppression. To make headway against the epidemic and to meet the goals of the National HIV/AIDS Strategy (NHAS), we need tools and strategies that are aimed at improving prevention, access to care, and retention in care for gay men/MSM.

Educating Gay Men about New Coverage and Enrollment Options

The Affordable Care Act (ACA) provides the tools to allow us to address the health care crisis among gay men/MSM; however it will take leadership and vision to ensure that we are using these tools to scale up HIV/AIDS prevention, care, and treatment for this population. The threshold question is: how do we ensure that gay men/MSM are aware of new coverage options through the ACA and apply for and enroll in coverage? The following provides a place to start:

1. Ensure that community organizations focused on gay men/MSM are part of ACA outreach and enrollment programs.

~ The ACA includes a number of programs and initiatives aimed at making sure that people know what coverage options are available and assisting them in applying for and enrolling in coverage. These programs include funded grant opportunities through the Marketplaces (e.g., Patient Navigators) as well as training and certification opportunities for outreach and enrollment workers (e.g., Certified Application Counselors).

~ Many AIDS Service Organizations and case managers are preparing to undergo ACA outreach and enrollment training to be able to help assist clients into new coverage options. In order to reach gay men/MSM – particularly young gay men/MSM – the community organizations that are already working closely with this population should access these training and funding opportunities.

~ In addition to accessing ACA training and certification programs, community organizations and linkage to care programs focused on gay men/MSM should think innovatively about how to incorporate education around ACA coverage options into their existing programs.

2. Develop tailored messages and scripts on what the ACA means for gay men/MSM.

Open enrollment through the Marketplaces begins October 1, 2013. In preparation for open enrollment, health departments, providers, and community organizations are working to develop messages and scripts to ensure that people living and at risk for HIV are aware of new coverage options and the benefits of applying and enrolling in Medicaid or Marketplace coverage. National organizations – such as Enroll America – are already developing templates that may serve as a framework for creating more targeted messages aimed at gay men/MSM.

3. Continue to address stigma in health care settings.

A closely related issue to education efforts around outreach and enrollment is whether the health care settings and providers that newly insured people will seek care will be equipped to offer culturally competent care. Providers must recognize the effect of racial bias and same-sex stigma on meaningful access to care and develop practices that address these structural barriers to care. NASTAD and the National Coalition of STD Directors (NCSD) have developed a series of tools to help address stigma and improve access to culturally appropriate care. Ensuring that broader health care systems and providers – including community health centers – are able to provide culturally competent care free of stigma is essential to make sure we are maximizing public and private insurance expansions available through the ACA. These tools and practices could be integrated into broader outreach and enrollment efforts as well, such as Patient Navigator and Certified Application Counselor training.

Without outreach and enrollment efforts that are tailored to reach gay men/MSM, we will have built a new system of care and treatment that remains foreclosed to populations who do not know how to enroll, do not know why they should enroll, and do not trust that the system is able to provide care and services that are free of racial bias and stigma. Over the coming weeks and months, new and innovative strategies that coordinate linkage to care efforts with ACA client education, outreach, and enrollment efforts will be necessary to ensure we are using the ACA to truly address health disparities.

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Join the Campaign to End AIDS today!

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By Naloxone Ninja for Open Society Voices

You may think that superheroes only fight crime, but they can also fight serious public health issues like drug overdose—a major and often overlooked cause of death among people who inject heroin or other opioids.

Armed with naloxone, the safe, effective, and easy-to-use antidote to opioid overdose, I travel the world fighting the overdose epidemic. And I’m not the only superhero with naloxone. Drug users, their families, outreach workers, and police around the globe have been trained to use naloxone to save lives.

You can help, too. In preparation for Overdose Awareness Day on August 31, here are the five main things you need to know about naloxone:

1. Naloxone saves lives and should be available at the scene of any overdose. A recent study shows that areas with programs that distribute the opioid overdose antidote to people who use drugs and their friends have lower rates of overdose deaths than nearby communities without the programs. Naloxone is extremely safe, cheap, and easy to use. And, with overdose as a leading cause of death for drug users around the world, making naloxone easily available to them and those around them is a no-brainer.

2. Naloxone is empowering. People who rescue friends using naloxone can feel an increased sense of self-efficacy and pride. One drug user who had saved a peer said, “I felt like a superhero or something, you know? You know how a superhero comes and saves the day? So you feel like you did something righteous and unselfish…. And that’s how you feel when you have to save somebody’s life and you’re able to do it, and utilize new techniques that you know. And a life is saved. It gives you a good feeling.” This increased sense of self-worth may translate into people taking better care of their own health. One study even found an increased rate of entry into drug treatment programs following overdose training.

3. Naloxone attracts participants to other life-saving public health services, including harm reduction programs. For many people who use drugs, overdose is a much more immediate problem than HIV or hepatitis. By offering drug users what they want—naloxone—programs find that they often are able to engage new people in their other services, like HIV testing and treatment. For example, a harm reduction program in Tomsk, Russia, increased their number of participants by 60 percent when they started distributing naloxone.

4. Advocates for HIV and hepatitis C prevention and treatment should be advocates for naloxone, too. People who use drugs have a 74 percent greater risk of overdose if they are HIV-positive. One Australian study found that 72 percent of deaths among subjects with hepatitis C were from drug overdose or suicide—not from advanced liver disease as a result of hepatitis. Naloxone is especially vital as a safety net for drug users living with these viruses.

5. You can start your own naloxone program. In fact, naloxone is probably already legal in your country, and used in most operating rooms and emergency departments. To learn more, and to get the tools you need to start distributing naloxone to drug users, visit naloxoneinfo.org.

This August 31, I’ll be at an Overdose Awareness Day event in Melbourne, Australia. To find out what events or memorials are taking place in your area, visit overdoseday.com.

Learn More from OSF:
Health, Harm Reduction

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Join the fight! Join the Campaign to End AIDS today!

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Image: Getty

By Titania Kumeh for The Los Angeles Times

The Ladies of Diversity in downtown Los Angeles works to give HIV-positive homeless women of color a reason to stay connected to medical services.

In the back of a skid row community health center, a woman with teardrop tattoos under her eyes begins to tell her story.

To a circle of other women, she says she ran away from home and joined a gang at 13. She started injecting PCP, and as a teen spent time in jail. By 22, she worked as a prostitute. At 37, she was diagnosed with HIV.

Now 50, the woman known as Hilda tells the circle that the only time she took her HIV medication was when she was in jail. “Why?” someone asks. “I wanted to die,” she answers.

Welcome to a weekly support session sponsored by the Ladies of Diversity, a federally funded program that works to give HIV-positive homeless women of color a reason to stay connected to medical services. Leaders allowed the Los Angeles Times to attend one gathering on the condition that clients be identified only by their first names.

The organization aims to better understand the challenges that keep infected black and Latina women from connecting to HIV care, said Tina Henderson, an HIV/AIDS researcher for 20 years and the program manager of the Ladies of Diversity.

California is one of eight states where such a project has been given money by the federal Health Resources and Services Administration.

Medications exist that can help people with HIV live longer, healthier lives. But more than a third of infected women are not in regular care and only a quarter have the virus under control, according to the Centers for Disease Control and Prevention. For women of color, this has had particularly deadly results, partly because this demographic is disproportionately infected.

Although black women make up 13% of the female population, they account for nearly 64% of all estimated new HIV infections compared with 18% of white women and 15% of Latinas.

CDC data also show that black Americans are least likely to be in ongoing care or have the virus under control once an HIV-positive status is known. As a result, black women accounted for 65% of all women who died from HIV in 2009 compared with 18% of white women and 14% of Latinas.

Ensuring that women of color get HIV treatment can prevent more deaths, Henderson said.

That’s where organizations like the Ladies of Diversity come in.

Every Monday morning, past sidewalks populated with skid row’s inhabitants, black and Latina women meet in the Center for Community Health on San Pedro Street and talk about God, addiction, sobriety, living on the streets and HIV.

Most say they waited for years after learning of their HIV status to take medication. When they did take the many pills needed to stay healthy, it was on and off.

“What saved my life was one, God,” Hilda said. But she also thanks a slew of treatment centers, support groups and case managers that helped her to stay sober for three years, that helped her get her first apartment, that helped her get her virus under control.

Women around her holler an affirmative “yes” after Hilda declares each of these victories.

Women of color, in general, face distinct obstacles to getting and sticking with medical treatments, said Kieta Mutepfa, an HIV/AIDS researcher at the UCLA CARE Center. Although HIV services are available, Mutepfa said, stigma prevents many women from seeking them.

Mutepfa also said she had worked with women who had told her that they dropped out of care because they didn’t like the way they were treated by physicians. “If providers are culturally incompetent, you’re not going to find a lot of people running to get treatment,” she said.

Add to that a lack of housing and the problems associated with poverty, Henderson said.

“When you’re homeless, you’re worried about survival and it’s not about HIV,” said 60-year-old Wanda, a Ladies of Diversity peer mentor. “You’re worried about where your clothes are because someone’s gonna take them.”

Medications are also prone to thievery on the street, she said. Then there’s the problem of storage. Some antiretroviral drugs need to be refrigerated, which is difficult for anyone who is homeless.

Wanda said she faced those obstacles when she was homeless in 2003. She was diagnosed with HIV in 1977, but didn’t start taking her meds until 10 years later. Wanda said she got HIV from her late husband, a former heroin addict. Her husband died in 1999, she said, a loss that triggered her downward spiral into drug addiction.

“I stopped caring,” she said.

Taking her medications regularly during her homelessness seemed like an impossible feat, she said, as equal doses of denial, depression and addiction kept her down. After years, she finally went into therapy. She got a case manager. She went to support groups.

She became one of the first peer mentors for the Ladies of Diversity, visiting missions and walking the streets of downtown Los Angeles with fliers in hand telling people about their meetings. “To sit someone down and say, ‘Take this medicine,’ that’s not good enough. We have people who don’t understand or have things going on with their life. Every day’s a struggle.”

Tonya Jessie said she saw the same thing as a peer support counselor at an HIV treatment center in South Los Angeles called SPECTRUM Community Services. She said she had worked with a lot of HIV-positive people who didn’t pick up and take their medications because they were embarrassed. “They don’t come because they don’t want anybody to see them coming. If someone see’s you in this place, it’s got something to do with AIDS.”

Jessie, 63, has had HIV for 20 years. She is not sure how she got it. It could have been from sharing needles or from not using condoms when she was supporting her drug habit through sex work, or from her husband, who died from AIDS-related illnesses in 2003. “When he came out of prison, he had only 20 T cells so he had had it for awhile,” she said.

Jessie says she’s been sober for 13 years. She’s in ongoing care. And she has her viral load under control.

“I take all my medications faithfully … and I take them as prescribed,” she said.

Jessie said she attended a support group for women at SPECTRUM every Thursday. It’s part of a regimen she recommends to everyone she works with. “Take your meds, eat right, go to support groups and find people who are living with this just like you. That’s what I had to do,” she said. “I still learn a lot.”

~ ~ ~ ~ ~

Join the fight! Join the Campaign to End AIDS today!

Letter Text Below

Dear Colleagues,

Please consider signing on to the attached letter to the Congressional Tri-Caucus in support of their leadership to eliminate racial and ethnic health disparities and efforts to reintroduce the Health Equity and Accountability Act, a bill to advance health equity. The bill contains a number of provisions to advance access to affordable, quality health care for immigrant communities and LEP individuals, in addition to accomplishing other important goals.

Rep. Lucille Roybal-Allard, Chair of the Healthcare Task Force of the Congressional Hispanic Caucus, with the support and sponsorship of the Congressional Tri-Caucus will be re-introducing the Health Equity and Accountability Act to the 113th Congress. In the 112th Congress, Representative Barbara Lee introduced H.R. 2954, the Health Equity and Accountability Act of 2011, which built upon the foundations of the Affordable Care Act to further eliminate health disparities for racial and ethnic minorities, and for the subpopulations that face additional barriers based on factors including, but not limited to, immigration status, age, disability, sexual orientation, gender identity, and limited English proficiency.

We hope your organization will support the reintroduction of this important legislation to advance the health of communities of color, including immigrant communities. The letter is below and attached. To sign-on, fill out the form here: https://docs.google.com/forms/d/1JCb-xkI0b9Y-zrsrE0rTAH8iqsIe1TXWtBIR-csaJRI/viewform

For more information about HEAA, please visit, http://www.apiahf.org/policy-and-advocacy/policy-priorities/health-equity/health-equity-and-accountability-act

Questions? Please contact Natalie D. Camastra with the National Latina Institute for Reproductive Health (NLIRH) at Natalie@LatinaInstitute.org or
Candace Gibson with NLIRH at Candace@LatinaInstitute.org.

——-

Sign-On Here: https://docs.google.com/forms/d/1JCb-xkI0b9Y-zrsrE0rTAH8iqsIe1TXWtBIR-csaJRI/viewform

[DATE]

The Honorable Lucille Roybal-Allard
Healthcare Task Force Chair
Congressional Hispanic Caucus
2330 Rayburn HOB
Washington, D.C. 20515

The Honorable Raul Ruiz, M.D.
Healthcare Task Force Vice-Chair
Congressional Hispanic Caucus
1319 Longworth HOB
Washington, D.C. 20515

The Honorable Donna Christensen, M.D.
Health Braintrust Chair
Congressional Black Caucus
1510 Longworth HOB
Washington, D.C. 20515

The Honorable Barbara Lee
Healthcare Task Force Co-Chair
Congressional Asian Pacific American Caucus
2267 Rayburn HOB
Washington, D.C. 20515

The Honorable Ami Bera, M.D.
Healthcare Task Force Co-Chair
Congressional Asian Pacific American Caucus
1408 Longworth HOB
Washington, D.C. 20515

Dear Representative Roybal-Allard, Representative Ruiz, M.D., Representative Christensen, M.D., Representative Lee, and Representative Bera, M.D.,

We write to thank you for your work and leadership to advance the health and well-being of communities of color in the United States and to eliminate racial and ethnic health disparities. During the debate on health reform in the 111th Congress, the Congressional Tri-Caucus ensured that the voices of our communities were included in the Affordable Care Act (ACA). We fully support the provisions in this law that expand access to affordable health insurance coverage for those who are uninsured and underinsured, ensure quality in the delivery of care, advance research, and promote disease prevention in our communities. These are all important steps towards eliminating racial and ethnic health disparities and achieving health equity.

We are thankful for your continued leadership and commitment to developing legislation that builds on these advancements. We support the efforts of the Congressional Tri-Caucus, under the leadership of the Congressional Hispanic Caucus Healthcare Task Force Chair Representative Lucille Roybal-Allard, to re-introduce the Health Equity and Accountability Act to the 113th Congress.

In the 112th Congress, Representative Barbara Lee introduced H.R. 2954, the Health Equity and Accountability Act of 2011, which built upon the foundations of the Affordable Care Act to further eliminate health disparities for racial and ethnic minorities, and for the subpopulations that face additional barriers based on factors including, but not limited to, immigration status, age, disability, sexual orientation, gender identity, and limited English proficiency by providing federal resources, policies, and infrastructure for health equity initiatives. H.R. 2954 established a principled, strategic, comprehensive vision for achieving health equity post-health reform, and has effectively complemented the U.S. Department of Health and Human Services’ (HHS) historic health equity initiatives. For example, in August 2012, HHS announced the Reducing Cancer Among Women of Color App Challenge, an initiative to combat and prevent cancer among women of color, which reflects a key provision of H.R. 2954.

The Health Equity and Accountability Act continues to achieve broad support among health equity advocates, professional associations, and other groups working directly with communities of color. This Act provides a comprehensive roadmap to address the reality that communities of color disproportionately face chronic and infectious diseases and other healthcare-associated issues including costly emergency room visits, loss of productivity and functional ability, and unnecessary institutionalization and premature death due to substantial cultural, social, and economic barriers to obtaining quality health care. As organizations committed to reducing racial and ethnic health disparities and promoting health equity, we are ready to support your work in this endeavor.

The undersigned [NUMBER] community organizations, national advocacy groups, professional organizations and research institutions, many of whom have supported this legislation in the past, are ready to offer our expertise and collaboration to advance the Health Equity and Accountability Act in the 113th Congress.

Thank you again for your leadership on these issues.

Sincerely,

LIST IN DEVELOPMENT

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Image: Gregory Bull/AP

By Kyle Cheney and Maggie Haberman for Politico

Gov. Rick Perry wants to kill Obamacare dead, but Texas health officials are in talks with the Obama administration about accepting an estimated $100 million available through the health law to care for the elderly and disabled, POLITICO has learned.

Perry health aides are negotiating with the Obama administration on the terms of an optional Obamacare program that would allow Texas to claim stepped-up Medicaid funding for the care of people with disabilities.

The so-called Community First Choice program aims to enhance the quality of services available to the disabled and elderly in their homes or communities. Similar approaches have had bipartisan support around the country. About 12,000 Texans are expected to benefit in the first year of the program.

One line of thinking as to why the Texas governor, who has honed his national image in no small measure by denouncing Obamacare, would make such a seemingly inconsistent move goes like this: Treating disabled and elderly people is less politically charged than a sweeping national law forcing people to buy health insurance. Perry recently decided against seeking reelection next year but is mulling a second presidential bid in 2016,

Perry spokesman Josh Havens said in a statement that the governor has long sought to help people with disabilities.

“Long before Obamacare was forced on the American people, Texas was implementing policies to provide those with intellectual disabilities more community options to enable them to live more independent lives, at a lower cost to taxpayers,” the statement read. “The Texas Health and Human Services Commission will continue to move forward with these policies because they are right for our citizens and our state, regardless of whatever funding schemes may be found in Obamacare.”

Still, the move comes as a surprise coming from a governor who has insisted he won’t implement the Obamacare reforms, and who slammed Health and Human Services Secretary Kathleen Sebelius for touting the law during a trip to the Lone Star State earlier this month.

“With due respect, the secretary and our president are missing the point: It’s not that Americans don’t understand Obamacare, it’s that we understand it all too well,” Perry said at the time. “In Texas, we’ve been fighting Obamacare from the beginning, refusing to expand a broken Medicaid system and declining to set up a state health insurance exchange.”

Perry’s anti-Obamacare purism has helped shape his national persona. He’s has called the law a “monstrosity” and taken steps to block Texas’s participation in some optional components. So his decision to embrace an element of the law, even though he has the support of his state’s Republican Legislature, could present a messaging challenge on a bigger stage.

Advocates for the disabled said the governor is doing the right thing.

“Adding CFC will mean that approximately 12,000 Texans with intellectual and developmental disabilities who have been waiting for comprehensive waiver services will be able to receive some of the basic supports they very much need now,” said Jessica Ramos, public policy director at the Texas Council for Developmental Disabilities. “For some, CFC will mean the difference between being able to live at home rather than having to move to a nursing home or other type of institution.”

The Texas Legislature approved the program earlier this year, and Perry signed it into law as part of a larger package of health reforms, as well as in the state budget. Now, his administration is working win approval from the Obama administration to fit the program into the state’s existing Medicaid framework.

“Efforts are under way to develop and submit an application to the Centers for Medicare and Medicaid Services for participation,” said a spokeswoman for the Texas Department of Aging and Disability Services. The goal is to implement the initiative by Sept. 1, 2014.

Supporters of home care contacted by POLITICO worried that even a news story about the connection between the Community First Choice program and Obamacare would spook the Perry administration from participating.

t would be worse than a shame if Texas’s moving ahead with CFC or BIP policies — both are from the ACA — was hurt as the result of scrutiny from a press inquiry,” said one Texas-based advocate.

Added another local advocate, “I would hate for the CFC to become a political football.”

An official with a prominent national advocacy group noted that Texas isn’t the only resistant state to quietly accept some lower-profile components of the health law. Louisiana, Mississippi, Georgia, Maine and others have already been approved for 2 percentage point increases in their Medicaid fund through a little-known provisions of the health law, the advocate said.

“I think some of those [provisions] are easier because they’re not as high profile and people don’t connect home and community services with Medicaid,” according to the advocate.

But everything’s bigger in Texas. And with the possible exception of Sens. Marco Rubio (R-Fla.) and Ted Cruz (R-Texas), few other politicians have made as big a stink about Obamacare as Perry has.

Several activists and Democrats accused the Republican governor of hypocrisy. Ginny Goldman, director of the Texas Organizing Project, called the move “shameful.”

“It’s simply a shame that Perry is willing to accept $100 million in Affordable Care Act dollars that would help some … but to at the same time reject $100 billion in federal funds turns his back on 1.5 million people” who would be eligible for Medicaid expansion, she said.

“Rick Perry has accepted federal funds in the past. He’s accepted federal funds on a regular basis when it suits his needs, whether it was using federal stimulus dollars to balance the state budget or accepting FEMA money. … Sadly, he is driven by his political interests above all else and when it comes to the Affordable Care Act, he’s willing to turn his back on 1.5 million people who need health care.”

One Democratic strategist said it illustrates “how impossible it is to be ideologically pure on this.”

Eddie Vale, spokesman for the pro-Obamacare group Protect Your Care, had a more positive spin.

“This is yet another sign that common-sense Republicans, and now even Rick Perry, are realizing that Obamacare will benefit millions of people in their states,” he said. “As people continue to work together in a bipartisan manner to implement Obamacare it will leave the extremist repealers like Cruz and DeMint increasingly isolated.”

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By Kate Zernike for The New York Times

BELLEVILLE, N.J. — Gov. Chris Christie signed a bill Monday outlawing therapy that aims to convert gay children to heterosexuals, making New Jersey the second state to ban the controversial practice.

Mr. Christie, a Republican, waited until the last possible minute to make his decision on the bill. If he had not signed or vetoed it by Monday, it would have gone into law automatically.

Before the Legislature approved the bill by a wide margin this summer, Mr. Christie had said he was “of two minds” on it: he believes that parents should be left alone to decide how to raise their children, but, as a spokesman later clarified, he does not believe in so-called conversion therapy, which claims to “cure” gays and lesbians, in some cases by forcing them to masturbate to images of the opposite sex.

The governor has all but declared his intention to run for president in 2016, and had to be mindful of conservative primary-state voters who would see the bill as government intrusion into child-rearing.

But the therapy has lost significant support in recent years, as leading scientific and medical groups have disputed the idea that sexual orientation can be changed, and argued that the therapy can cause, in the words of the American Psychiatric Association, “depression, anxiety and self-destructive behavior.” In June, Exodus International, a Christian group that was a leading proponent of conversion therapy, disbanded after 37 years, apologizing to gays and lesbians for the harm it had caused.

In a statement accompanying his signature on the bill, Mr. Christie said, “I still have those concerns” — about intruding onto parents’ rights.

“However,” he added, “I also believe that on issues of medical treatment for children we must look to experts in the field to determine the relative risks and rewards.”

Gay rights advocates said they hoped that signing the bill signaled an “evolution” for the governor, a Roman Catholic who last year vetoed legislation that would have allowed same-sex marriage.

“I hope that the governor, in saying that he believes that New Jersey’s youth deserve protection, means that he sees that the next step in that evolution is to allow those same youth the dignity of marriage in their future,” said Troy Stevenson, the executive director of Garden State Equality, the state’s leading gay rights group. “To say that someday they will be fully included in society instead of being relegated to second-class citizenship, as they are now.”

But the governor does not evolve easily. He has strongly counseled Republican legislators from supporting an attempt to override his veto on same-sex marriage. He has said that he would abide by the results of a referendum approving same-sex marriage, but advocates say putting the issue on the ballot would invite national groups to campaign against it — and defeat it, as they have in most states.

Mr. Christie was not eager to talk about the bill in an appearance with Hispanic business leaders here in northern New Jersey. As reporters asked him his plans for the bill, he ignored their questions, continuing to smile for snapshots with voters.

California banned conversion therapy for minors last year, though a legal challenge is pending, and the Massachusetts legislature is considering a similar ban.

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By Olivia Ford from TheBody.com

Hepatitis C (hep C, or HCV), a virus that affects the liver, is sometimes called a “twin epidemic” to HIV. At least a quarter of people living with HIV in the U.S. are coinfected with hepatitis C, which is also transmitted through contact with an infected person’s blood. As with HIV, African Americans are disproportionately affected — they are two to three times more likely than whites to have been exposed to hep C, and far less likely to be cured using current treatments. That’s where hep C differs from HIV: It can be cured — and when promising new treatments become available in the near future, it will be more curable, especially for African Americans.

Yet, of the estimated 5 million people living with hep C in the U.S., more than 70 percent are not aware they have it. The population most at risk is “baby boomers” — those born between 1945 and 1965 — but most people who’ve been exposed don’t even know they’ve been at risk. And in its silence, hep C kills more people in the U.S. per year than HIV.

So, how do you get baby boomers who may have tooted a little cocaine in their day to be tested for a disease commonly associated with injection drug use? How do you advocate for people who don’t know they need an advocate? The answers lie in some exciting sea changes in hep C screening and care — including a landmark New York state bill requiring health care providers to offer a hep C test to their baby boomer patients. Here to talk about these changes are Geraldine Joseph, a physician assistant with the Ryan Network and the St. Luke’s Medical Group in Harlem, where she coordinates the Hepatitis C Program; and Hadiyah Charles, hepatitis C advocacy manager at the Harm Reduction Coalition (HRC), a national advocacy organization based in New York City and Oakland, Calif.

Olivia Ford: Could you paint a picture of hepatitis C and its prevalence in the U.S.?

Geraldine Joseph: In general, hepatitis C is an infection that we see most often in baby boomers — people born between 1945 and 1965. The majority of these people, about 75 percent of them, have not been tested; and quite a few of them that have been tested have never been linked to care for hepatitis C. Because people may have hepatitis C and be asymptomatic (they have no symptoms), they unfortunately don’t see the importance of following up with their providers about it. The patients that I am seeing are people that have had hepatitis C quite some time, and their primary care provider has told them, but they’ve never followed up.

Olivia Ford: Why are baby boomers at particularly high risk for hepatitis C?

Geraldine Joseph: The period in which baby boomers were coming of age was a time where there was a lot of “free love,” and people used drugs casually. Even a person who used drugs once or twice could have been at risk for hepatitis C — I have patients that used drugs only once or twice; maybe they’d just done some cocaine with a group of friends.

Speaking of which: When people think of hepatitis C, they usually think of injection drug use. I do see quite a few patients with injection drug use histories that have hepatitis C; but I’ve also seen people that have never used injection drugs, but have snorted drugs. People have blood vessels in their noses, and when you share drug paraphernalia to snort drugs, there can be an exchange of blood, and you can get hep C.

Also, prior to 1992, blood and organ banks did not screen for hepatitis C, so people who had blood transfusions or organ transplants prior to 1992 would be at risk.

Olivia Ford: Why is hepatitis C screening of particular concern for African Americans?

Geraldine Joseph: Demographically speaking, African Americans are disproportionately affected by hepatitis C. We also see the lowest cure rates for hepatitis C among African Americans — and also people of Latino descent. That has to do with the IL28B gene, which has three subtypes (CC, CT and TT). We can do an IL28B genotype test to check a person’s subtype and see how likely that person is to respond to hepatitis C treatment. If you’re CC, you’re highly likely to be cured from hep C with the standard of care that we have available for genotype 1 patients, which would be triple therapy: injectable interferon plus oral ribavirin, combined with either of the protease inhibitors Incivek (telaprevir) or Victrelis (boceprevir).

If you’re CT: you’re pretty good, also.

But with TT, you’re really less likely to be cured of the disease. And, unfortunately, African Americans have higher rates of the TT subtype.

Even with the developments in hep C treatment over the past several years, and the triple therapy we now have for genotype 1 patients, cure rates are still not the same for African Americans as they are for whites or Latinos, because we still have to use interferon. I’m not seeing the 85 percent cure rates in my practice that we saw in the clinical trials. I’m definitely seeing higher rates of success; but unfortunately, a lot of patients discontinue treatment because of the side effects of interferon and ribavirin, whether they use telaprevir or boceprevir.

Olivia Ford: Is there hope, as far as cure rates for African Americans, with any new hep C meds coming down the pipeline?

Geraldine Joseph: We anticipate, in the next 18 months to two years, the approval of all-oral treatment for hep C with the nucleotide polymerase inhibitor sofosbuvir (GS-7977). We’re seeing, even in people of color, cure rates of 90 to 95 percent in some of these clinical trials. They’re looking really, really promising. Because you don’t have to use interferon — which we can’t use to treat patients that have mental illness that’s not stable, or that have any autoimmune disease, which quite a few of my patients do. And many other patients, who have heard about the side effects of interferon, or have been on it before in past treatment, don’t want to be on treatment because they don’t want to deal with it.

Hadiyah Charles: Another thing with interferon is that it’s administered through injections. For people who have a history of drug use, sometimes having to inject a medication triggers a difficult history.

Geraldine Joseph: There are a number of promising drugs in phase 3 trials that will definitely have interferon-sparing regimens, which will make a huge difference in one’s cure rate, because they’re tolerated better. To Hadiyah’s comment, even people who haven’t abused injection drugs may just not like giving themselves injections on a weekly basis.

Hadiyah Charles: The New York state hepatitis C screening legislation is particularly important for African Americans because, with the Affordable Care Act (ACA) coming down the pipeline, we’re anticipating that people who didn’t formerly have access to health care will now do so.

We’re still waiting on New York state Gov. Andrew Cuomo to sign the hepatitis C bill into law. Once the bill becomes the law, baby boomers should be offered a hepatitis C rapid test when they see their physician for their annual checkup. That’s an opportunity for them to be able to find out whether or not they have hepatitis C, and if they do have it, whether or not they’re chronically infected.

The biggest, most amazing thing about it is that, if they are chronically infected, the new medications coming down the pipeline offer an eight- to 12-week regimen, all oral, no interferon.

Olivia Ford: As far as advocacy is concerned: With HIV advocacy, we know that stigma can be a big stumbling block to increasing awareness. Is the same true for hep C? Is the stigma different? What are some of the unique challenges around hepatitis C advocacy?

Hadiyah Charles: There is stigma associated with hepatitis C; but what’s both fortunate and unfortunate is that most people do not know about the disease. And if they’re aware of it, most people think that there is a vaccine for it, which there is not.

The CDC issued guidelines in August 2012. In those guidelines, they basically said that every baby boomer, every person born between 1945 and 1965, should have, or at least be offered, a hepatitis C screening test at least once, the next time they interface with medical professionals. That guideline more or less framed the message for hepatitis C. I think it was strategically done, in that they weren’t necessarily targeting people that have a history of drug use. The difference between that and the framing of HIV is, because HIV is associated with sexuality and drug use, and has been framed as a “gay” message, many people weren’t interested in getting tested; they just did not want to know more about it.

With hepatitis C being framed as a disease that really affects baby boomers, it’s a little bit easier to introduce the conversation of how a person would contract hepatitis C.

When the coalition of advocates drafted the legislation, we thought long and hard about including injection drug use as a component of it. For HRC, that’s our core population. But we realized that a huge segment of our society would be left out if we’d added that one component. We ultimately decided against it.

In New York, we had a unique situation, in that Assemblyman Kenneth Zebrowski, who introduced the hepatitis C screening legislation, saw his father pass away from complications related to hepatitis C. His father was of the baby boomer generation, and had had a blood transfusion prior to the time when the blood supply began to be screened for hep C. Unfortunately, he had gotten blood that was tainted with hepatitis C. Because there were no screening laws in place, even though he had access to health care and to primary care physicians, no one ever tested him for hepatitis C. And so, when they finally realized that he had the virus, it was too late

For New York state, that one element in Albany, along with the fact that new medications have the potential to change the trajectory of the virus, and the fact that hepatitis C is killing more people now than HIV, the stars were really aligned for this legislation to pass in both the Assembly and Senate houses in New York. It was also a bipartisan bill; Senator Kemp Hannon, who introduced it on the Senate side, is a Republican, out of Long Island.

New York City and Long Island are the epicenters of hepatitis C in the nation. It’s really amazing the way that the New York state legislators came together to promote New York state as a patient-centered state.

There’s an entity called the United States Preventive Services Task Force (USPSTF) that informs what insurance companies will reimburse for. They’re the entity that kind of changed the recommendations for mammograms, in terms of how often you can get one and how insurers would reimburse for it.

Hepatitis C screening for the baby boomer cohort originally had a C grading from the USPSTF; and when something has a C grading by them, it’s going to be really hard for medical professionals to get reimbursed for giving a test to anybody born in that cohort. We developed our bill in order to codify the CDC guidelines; it passed the Senate and House on a Thursday. On the following Monday, the USPSTF changed their rating from a C to a B rating. And so now, you have the CDC and the USPSTF speaking in one voice in terms of the risk categories.

The USPSTF also acknowledged that injection drug users and people who had a history of drug abuse were high-risk populations. So now, if somebody presents to their physician as a baby boomer or a person who is actively using or had a history of using injection drugs, the hepatitis C screening test cost should be covered by health insurance.

Olivia Ford: This is a bit of a devil’s advocate question: Hadiyah, just now you mentioned that if physicians follow this law (once the bill is signed into law), this will provide an excellent opportunity for people who wouldn’t otherwise be screened for hep C to be screened. We know from the example of routine HIV screening that that’s a pretty big if. The CDC has been recommending that HIV testing be offered in primary care since 2006. That’s a CDC recommendation, not state legislation, of course; but the uptake has been fairly paltry.

What’s the difference here, with this law? Will there be consequences for not adhering to it?

Hadiyah Charles: The Medical Society of the State of New York was in full opposition of this legislation, because they don’t believe that you should legislate medical care. There’s not enough funding at the New York State Department of Health to really police physicians around this law. At most, what we can do at this point is to make sure that they’re properly educated and know that it will, in fact, be state law to offer the test.

In the screening bill, we added an amendment where New York State Department of Health has to evaluate the testing and linkage to care aspect of the law. That’s one tool that we implemented within this legislation to really get an idea of whether or not the law is being followed — and if it is, how well. There is a similar evaluation mandate with the HIV screening bill.

Olivia Ford: Do you have a sense of what hepatitis C advocacy and education look like in other states? What’s the potential impact for other states and their health departments, following New York state’s landmark bill?

Hadiyah Charles: New York is definitely the first domino that will trigger other states with high hepatitis C prevalence to follow suit. We’re currently working on developing a campaign tool kit that will be entitled something like “How to Pass the Hepatitis C Screening Law in Your State.” People are definitely reaching out to Harm Reduction Coalition to find ways to pass similar legislation in their state.

It’s an ideal situation, when a person finds out they have a condition or a disease, that there’d be good news at the end of that tunnel. Under the ACA, people will have access to medications that are offering an almost 100 percent cure rate. In terms of being promoted as a patient-centered state, I think that hepatitis C advocates across the country will be able to really push legislators in their states to do their part in changing the trajectory of the epidemic.

Olivia Ford: How can medical providers and other members of the community get involved in advocating for the passing of this bill into law, and the passage of similar legislation in other states?

Hadiyah Charles: The Harm Reduction Coalition, in partnership with the National Black Leadership Commission on AIDS (NBLCA), as well as the Coalition on Positive Health Empowerment (C.O.P.E.), launched an inaugural African American Hepatitis C Action Day. It happened last month, on July 25. We gave people the opportunity to learn about hepatitis C, how to prevent it, and the treatment and care options that are currently available. It’s specific to African Americans, because, again, we are disproportionately affected by hepatitis C.

We did a series of free testing events in Albany, N.Y.; Atlanta; Buffalo; Detroit; New York City (including East and Central Harlem, Brooklyn and the Bronx); and Rochester, N.Y. We offered educational resources as well. In the Bronx alone, C.O.P.E. tested 82 people, 21 of whom had a positive hepatitis C result.

Thanks to OraSure Technologies, Inc., we were able to leverage new rapid hepatitis C testing technology to ensure that those who tested positive for hepatitis C received their results and were immediately linked to care so that they may benefit from new therapies.

This Action Day was really just a kickoff to what we will be working on throughout the year, leading up to July 25, 2014. There’s now considerable hope with hepatitis C screening, care and treatment. We are committed to making sure that everyone, and particularly African Americans, know all that there is to know about hepatitis prevention, treatment and care.

For anybody who is interested in doing more, they could certainly contact the Harm Reduction Coalition, NBLCA, C.O.P.E., NATAP (National AIDS Treatment Advocacy Project), VOCAL-NY or the National Viral Hepatitis Roundtable. We’re really working together, along with our federal government partners at the CDC and Health and Human Services, to educate communities about hepatitis C.

Olivia Ford: Geraldine, what would you like to see happen, as far as education for your fellow medical providers about hep C and this new screening law?

Geraldine Joseph: I would like to see some forums focused on primary care providers, especially internists and family practice physicians. They are the ones that are actually seeing a lot of the patients early in their disease, with slightly elevated liver enzymes. A key point is getting people evaluated when they have early disease, and not late disease, where you run into complications like liver damage (cirrhosis), or even end-stage liver disease, which can cause death. When we see patients in more advanced stages of hep C, where it’s progressed as far as cirrhosis, it’s harder to cure the disease. It’ll be important for primary care providers to be educated properly on testing, and referral to the appropriate places for hepatitis C evaluation and treatment.

Hepatitis C is a curable disease. It’s not like diabetes or HIV or high blood pressure, where you’re going to be on medications for life. We can cure people of this, or even eradicate it. But people actually have to know about the disease.

This transcript has been edited for clarity.

Olivia Ford is the executive editor for TheBody.com and TheBodyPRO.com.

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Press Release from the Office of Senator Kirstin Gillibrand

Gillibrand, Rangel Introduce New Legislation to Combat HIV/Aids Among Minority Communities

Gillibrand-Rangel Bill Provides Grants to Community and Faith-Based Organizations
July 31, 2013

Washington, DC – U.S. Senator Kirsten Gillibrand and Congressman Charles Rangel today introduced federal legislation in both chambers of Congress that would help combat the dramatic increase of HIV/AIDS in minority communities. The Communities United with Religious Leaders for the Elimination of HIV/AIDS (CURE) Act of 2013 would authorize the U.S. Department of Health and Human Services and the National Institutes of Health to provide grants to health agencies, and community and faith-based organizations for education, outreach, research, and testing activities related to HIV/AIDS prevention.

“HIV/AIDS continues to have a devastating impact on communities of color,” *Senator Gillibrand *said. “This legislation provides federal investments in early prevention, education, and research that are needed to battle this horrible disease. By investing in these critical resources, we can help protect some of those most vulnerable and save lives.”

“It’s so important that community organizations and religious leaders join in partnership to find ‘on-the-ground’ solutions to the HIV/AIDS epidemic in communities of color,” *Congressman Rangel *said. “This bill will empower and strengthen these partnerships by providing much needed funding to help them find creative ways to break the silence and denial of this devastating disease.”

The CURE Act of 2013 would:

Strengthen HIV/AIDS education and counseling: The legislation provides health agencies as well as faith and community-based organizations with the resources to expand education and an understanding of disease prevention. The bill also provides for counseling and work with runaway and homeless youth.

Spread awareness to minority communities: The outreach effort will include communities at great risk of contracting HIV/AIDS through the Office of Minority Health, which collaborates with communities in the public and private sectors to increase awareness of the major health problems facing racial and ethnic minorities.

Develop research to find effective solutions: The bill provides the necessary funding to the Center of Disease Control for both behavioral research and testing.

Minorities are at a heightened risk of contracting HIV/AIDS. African Americans account for nearly half of all new HIV infection cases, while Hispanics account for one-fifth. Native Hawaiians and Pacific Islanders are less than 1 percent of the population, yet their AIDS case rate is twice that of the white population. American Indians/Alaska natives have a 30 percent higher rate of HIV/AIDS infection compared to the white population.

Under the bill, the Office of Minority Health, Center for Disease Control, Substance Abuse Mental Health Services Administration and more organizations would receive funding to conduct HIV/AIDS research as well as provide prevention and counseling for ethnic minorities.

This legislation is supported by national groups and leaders including the National Medical Association, National Conclave on HIV/AIDS Policy for Black Clergy, National Black Leadership Commission on AIDS, the Black AIDS Institute, the National Alliance of Hispanic Health, Esperanza Latino Health, Asian Pacific Islander American Wellness Center, National Caucus of Black State Legislators, Us Helping Us – People Into Living, Inc., Reverend Calvin O. Butts, Abyssinian Baptist Church, Reverend Samuel Nixon, Jr., and Alfred Street Baptist Church.

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Confused about health insurance marketplaces? Want to know how “Obamacare” will affect you, or what new health care coverage options are becoming available? The Centers for Medicare and Medicaid Services have updated and improved their website explaining all the upcoming changes ~~ HealthCare.gov

HealthCare.gov will answer questions like:

~ What is the Health Insurance Marketplace?

~ What is the Marketplace in my state?

~ What if my state is not expanding Medicaid?

~ How and why to use the marketplaces

~ and MORE!

You can also check out what the Kaiser Family Foundation’s YouToons have to say about getting ready for reforms below!

“The YouToons Get Ready for Obamacare,” The Henry J. Kaiser Family Foundation, accessed 8/9/13, http://kff.org/health-reform/video/youtoons-obamacare-video/

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Do-It-Yourself Legislative Visits With Your Members of Congress During the August Recess ~~ A new toolkit from our friends at AIDS United

The August recess is the perfect time for you and your organization to meet with your Members of Congress to remind them that HIV is an issue that impacts YOUR community! Beginning August 3, 2013, until September 8, 2013, Members of Congress will be in their districts, conducting town halls and meeting with constituents to understand what issues are impacting them. AIDS United has put together an August recess toolkit that can be used by individuals and organizations to make the most out of this month-long recess.

Our August recess advocacy toolkit is specifically designed for HIV/AIDS advocates like you! Using Prezi, a web-based presentation application, we will take you through a fun and easy-to-follow presentation that will enable any HIV advocate – including you! – to 1) Find Your Members of Congress, 2) Organize a Meeting, 3) Meet Your Members of Congress and 4) Follow-Up – all from your home district! You don’t need to come to Washington, D.C. to have an influence on Capitol Hill!

Quick Start : Press the “play button” (the sideways triangle) on the Prezi graphic (or click the link) below. Once the Prezi is loaded, you may click to view the Prezi in full-screen mode by holding your mouse cursor over the “More” button which can be found at the bottom right of the Prezi graphic. In full-screen mode, use your left and right keyboard arrows to go backward and forward respectively in the presentation.

August Recess Do-It-Yourself Legislative Visits on Prezi

Quick Tips on How to Use the Prezi Presentation

RESOURCES

Bring two copies of each of the fact sheets to your meetings — one for yourself and one to leave behind for the staff person with whom you meet

Correspondence with Congress:

Meeting Request Letter, Sample

Meeting Follow-Up and Thank You Letter, Sample

Ask #1: Integrate and support the Ryan White Program throughout implementation of the Affordable Care Act

Fact Sheet and Asks: Integrate and Support the Ryan White Program Throughout Implementation of the Affordable Care Act

Ask #2: Appropriate increased funding for HIV-related programs

Fact Sheet and Asks: Appropriate Increased Funding for HIV-Related Programs

AIDS Budget and Appropriations Coalition (ABAC) Chart of Federal HIV/AIDS Funding for Fiscal Year (FY) 2014

Ask #3: Support a comprehensive immigration bill with a path to citizenship and health care access for aspiring citizens

Fact Sheet and Asks: Support a Comprehensive Immigration Bill with a Path to Citizenship and Health Care Access for Aspiring Citizens

Bonus Ask: Maintain SNAP as a viable safety net program and oppose further cuts

Fact Sheet and Asks: Maintain SNAP as a Viable Safety Net Program and Oppose Further Cuts

Follow-Up Survey – Click here to give feedback about your meetings!

Questions? Contact Melissa Donze, Policy Assistant, at mdonze@aidsunited.org or 202-408-4848 ext. 262.

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Want to join forces with others in your area for August recess HIV/AIDS advocacy? Join the Campaign to End AIDS today & email us for more info on getting involved in your region!

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Image: Human Rights Campaign headquarters entrance; flickr – Ryan Janek Wolowski

By Alexei Koseff for The Los Angeles Times

The District of Columbia Council passes the country’s most liberal policy for updating birth certificates, one that transgender activists hope will become a nationwide model.

WASHINGTON — Kaprice Williams has been waiting four years for a new birth certificate.

Williams, 50, transitioned from male to female when she was 15, but some essential legal documents still do not recognize her as a woman.

That had not been an issue until a job interview went sour when her paperwork revealed she is transgender. Efforts to change her birth certificate had stalled because Williams, a native of Washington, has not had sexual reassignment surgery and cannot afford thousands of dollars in lawyer’s fees.

Those obstacles are about to become history: Last month, the District of Columbia Council passed the country’s most liberal policy for updating birth certificates, one that transgender activists hope will become a nationwide model. The mayor is expected to sign it Tuesday.

Activists say the tremendous boost to gay marriage provided by the Supreme Court’s rulings in June ultimately will benefit everyone in the lesbian, gay, bisexual and transgender community. This, they say, is the time to focus on the needs of transgender people, who are seen as the most vulnerable of the four groups.

“Now we have momentum at our back, and we really need to use this time effectively to gain as many protections as possible for transgender people,” said Fred Sainz, vice president of the Human Rights Campaign, a Washington-based LGBT rights organization.

The Washington measure eliminates requirements for surgery and a court order that, transgender rights attorney Lisa Mottet said, make it too expensive and inaccessible for most transgender people to complete a legal transition.

Williams said she could finally breathe a sigh of relief.

“I’m glad to finally get this so I can move on with the rest of my life,” she said. “These are basic needs, and you can’t do too much without proper credentials.”

Nationwide, only 24% of transgender people can get the gender changed on their birth certificates because of restrictive laws, according to a study by the National Gay and Lesbian Task Force, where Mottet works. This can create problems when they enroll in schools or apply for jobs, she said.

Washington’s new policy “means that people can go about their lives and have their gender recognized, instead of having government documents that say you’re not who you say you are,” said Mottet, who was an advisor on the measure’s language.

Washington will grant new birth certificates to transgender people who provide a statement from a licensed healthcare provider that they have undergone “appropriate treatment” for a gender transition. The measure, which passed unanimously, also exempts them from a requirement to advertise a concurrent name change for three weeks in a newspaper.

The legislation makes it easier and more private for transgender people to align their legal documents with their gender identity, said Andy Bowen, an organizer with the advocacy group D.C. Trans Coalition. Bowen also met with members of the District of Columbia Council to advise on the measure.

Previously, updated birth certificates were granted only to those who had undergone sexual reassignment surgery, which Bowen says is unaffordable for most transgender people. Even then, the birth certificate was merely amended rather than reissued.

“Anyone who saw your birth certificate would see that you were transitioned, so there was a risk of outing,” Bowen said. Under the new policy, she said, the process becomes purely administrative.

Mottet said most states still made it difficult. Of the 47 states that allow a gender change on birth certificates, only four have dropped the surgical transition standard, she said. About half issue a new birth certificate and half amend the old one.

California is poised to follow Washington, said Masen Davis, executive director of the Transgender Law Center in San Francisco.

In 2011, the state reduced its standard for securing a court order to a physician’s statement that the individual had received appropriate treatment.

Now, Assemblywoman Toni Atkins (D-San Diego) is sponsoring a bill similar to Washington’s. Her office expects passage by the end of the year.

“Transgender people are entitled to have their official documents and their legal name reflect their true identity without a burdensome and expensive process that endangers their personal safety,” Atkins said in a statement.

Mottet sees Washington’s law as the start of a national movement.

“We’re at the very beginning of a snowball starting to be created here,” she said.

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Ready to make change? Join the fight! Join the Campaign to End AIDS today!

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New information on Ryan White & the Affordable Care Act: What You Need to Know webpage

~ Upcoming webcast: August 14, 2:30pm EST: Preparing for 2014: Overview of Ryan White Program Policy Updates and Guidance. The webcast will review new Ryan White Program policies and guidance.

New Policy Notices:

Ryan White HIV/AIDS Program Client Eligibility Determinations: Considerations Post-Implementation of the Affordable Care Act: Policy Clarification Notice (PCN) #13-03
This Policy Notice outlines the Ryan White HIV/AIDS Program (RWHAP) expectations for client eligibility determinations in the context of Affordable Care Act implementation.

Clarifications Regarding Clients Eligible for Private Health Insurance and Coverage of Services by Ryan White HIV/AIDS Program: Policy Clarification Notice (PCN) #13-04; relates to HAB Policy #13-01, #13-02, #13-05
This policy notice clarifies HRSA policy regarding the Ryan White HIV/AIDS Program (RWHAP) and its relationship to clients’ eligibility and enrollment in private health insurance.

Clarifications Regarding Use of Ryan White HIV/AIDS Program Funds for Premium and Cost-Sharing Assistance for Private Health Insurance: Policy Clarification Notice (PCN) #13-05; relates to HAB Policy #’s 10-02 and 7-05
This policy clarification notice reiterates HRSA policy regarding the use of Ryan White HIV/AIDS Program (RWHAP) for premium and cost-sharing assistance for the purchase and maintenance of private health insurance coverage. It also provides RWHAP grantees and sub-grantees with additional guidance on using RWHAP funds for premium and cost-sharing assistance.

Clarifications Regarding Use of Ryan White HIV/AIDS Program Funds for Premium and Cost-Sharing Assistance for Medicaid: Policy Clarification Notice (PCN) #13-06; relates to HAB Policy #’s 10-02 and 7-05
This policy clarification notice reiterates HRSA policy regarding the use of Ryan White HIV/AIDS Program (RWHAP) for premium and cost-sharing assistance for clients eligible for Medicaid. It also provides RWHAP grantees and sub-grantees with additional guidance on using RWHAP funds for premium and cost-sharing assistance in the context of the Affordable Care Act.

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a href=“http://www.c2ea.org/get-involved/join-c2ea”>Join the Campaign to End AIDS today!

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From Medical Xpress

The Food and Drug Administration’s approval last year of the drug Truvada for prevention of HIV infection was a milestone in the fight against HIV/AIDS, but experts are cautioning that it is only the beginning of new ethical concerns for health care professionals, policy makers, researchers and those taking Truvada to prevent HIV infection.

“For the first time, we will have a large number of individuals who are not infected with HIV taking medication for HIV, which introduces ethical concerns of well-being and justice,” says Jeremy Sugarman, Deputy Director for Medicine at the Johns Hopkins Berman Institute of Bioethics. He and Kenneth Mayer, the director of HIV prevention research at Beth Israel Deaconess Medical Center, advocate for ethical issues to be considered along with medical data in the Journal of Acquired Immune Deficiency Syndromes.

Sugarman and Mayer argue it is ethically critical to ensure that use of an antiretroviral drug like Truvada for “pre-exposure prophylaxis”(PrEP) does not have the ironic consequence of making individuals and communities less safe and healthy. Inconsistent, rather than daily, use of PrEP could result in HIV transmission and the evolution of drug-resistant strain of HIV, the authors warn. Likewise, misunderstanding of PrEP’s prevention capacity could lead to the spread of other sexually transmitted infections.

“Communication and careful monitoring by health care professionals is essential for PrEP to be successful,” says Sugarman. “Reinforcing the importance of daily dosing, incorporating safer sex counseling and frequent HIV testing will help meet the moral imperative that HIV be prevented and not exacerbated by PrEP,” he says. He and Mayer recommend training programs for health care professionals that include explicit consideration of PrEP’s ethical issues and their management.

Additionally, Sugarman and Mayer highlight what they say are ‘critical, unanswered questions’ of access and allocation. When limited antiretroviral drugs are available, should prevention be prioritized over treatment for those already infected with HIV, or vice-versa? Is a clinic environment the best setting to provide necessary counseling as part of PrEP? These questions, as well as how much PrEP should cost and who should pay for it, need to be answered as PrEP continues to be used and evaluated, the authors say.

“The fundamental moral claim for using PrEP, or any other HIV prevention strategy, is decreasing the burden of new HIV infections,” Sugarman says. “For PrEP’s full promise and medicine’s moral obligations to be fulfilled, these complex ethical issues must be monitored along with the performance of PrEP.”

Explore further: Effectiveness of HIV pre-exposure prophylaxis in Peru

More information: Sugarman and Mayer opinion in the Journal of Acquired Immune Deficiency Syndromes

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Join the Campaign to End AIDS today!

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Photo courtesy of In The Meantime Men

By Titania Kumeh for The Los Angeles Times

Last year in South Los Angeles, billboards overlooking Crenshaw Boulevard showed two shirtless black men standing and embracing each other on a beach. “Our Love is Worth Protecting …. We Get Tested,” read the sign.

The ads, 10 in total, were developed by Jeffrey King, executive director of the Los Angeles advocacy group In the Meantime Men. The message’s purpose, King said, was to promote love and HIV testing among black men who have sex with men.

After the billboards went up, however, “the immediate reaction of the community was shock,” said the Rev. Eric P. Lee, president of the Greater Los Angeles chapter of the Southern Christian Leadership Conference. “It showed how we have commonly dealt with homosexuality in the community, which is ‘Don’t ask, don’t tell,’ a silence that doesn’t condemn or affirm.”

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FOR THE RECORD: Safe sex billboards: An article in the July 22 LATExtra section about South Los Angeles billboards urging gay men to get tested for HIV quoted Rev. Eric P. Lee and identified him as president of the Greater Los Angeles chapter of the Southern Christian Leadership Conference. He is the former president and no longer speaks for the group.

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Safe-sex advocates say the reaction to the billboards shows how difficult it can be to tailor sexual health messages to fit some black communities in which the subject of sex, specifically non-heterosexual sex, remains taboo.

“Nobody wants to talk about the fact that our kids are having sex and a large part of them are gay and are having sex with each other,” King said.

That stigma, according to HIV prevention advocates and public health officials, keeps many black people from getting tested or receiving treatment.

Although West Hollywood has the highest HIV infection rate in L.A. County, health officials said, young black men with HIV tend to live in predominantly black communities, such as South L.A.

Nationally, black Americans are disproportionately infected. They account for 14% of the U.S. population but almost half of the more than 1 million HIV cases, according to 2013 data from the Centers for Disease Control and Prevention. Among men of all races who have sex with men, young black men account for the highest number of new HIV infections.

“It’s true nationally, it’s true locally, it’s true in most metropolitan areas in the nation,” said Dr. Jonathan Fielding, director of public health in Los Angeles County. “It’s been a very serious problem, and we’ve been aware of it for years.”

Public health officials are concerned that stigma is leading to less testing and treatment among various black communities, even though medical advances have greatly improved longevity when HIV is diagnosed early.

The controversial billboards in South L.A. have since been replaced by ads that feature a single word, in boldface capital letters and crossed out: “HOMOPHOBIA.”

The new campaign aims “to address one of the key factors in why we’re seeing high rates of HIV, especially among gay black men,” King said.

Although a lack of resources remains a prominent reason for the racial disparity in HIV infections among those who are lesbian, gay, bisexual, transgender or still questioning their sexuality, Fielding said the attitudes some people have toward men who have sex with men are also partly to blame. Black men who have sex with men “suffer from stigma, discrimination, from a reduced rate of acceptance for their same-sex orientation, and they also have historically had less access to healthcare,” he said. And, he said, they tend not to use condoms.

Also, King said, many gay and bisexual black men in South L.A. are not getting tested for HIV because the very act might “out” them, while many straight black men are not getting tested because they don’t want to be perceived as gay.

“One of the key reasons we’re seeing HIV rates as high as they are is linked to homophobia in the community, which is taught from a high place, which is the church,” King said.

Lee said he’s more “progressive” than most clergymen in South Los Angeles.“I don’t believe promoting safe sex is promoting sex. It’s promoting, if you decide to have sex, to do so with caution,” he said.

Lee added, “I think it’s the responsibility of leaders to ensure that the people they’re speaking to are provided with information that keeps them healthy.”

The Los Angeles-based AIDS Healthcare Foundation is paying for the In the Meantime Men ads, as well as other billboards that seek to promote the sexual health of men who have sex with men.

Across town, an attempt to tailor the safe-sex message to a more open community has raised different concerns. In heavily gay West Hollywood, billboards overlooking Santa Monica Boulevard feature provocative images of muscled, bare-chested male torsos. The men appear to be white and Latino, and near their bodies are the words, “Be Safe. Be Sexy. Be You,” a slogan coined by the West Hollywood safe-sex advocacy group Impulse.

Like the South L.A. ads, the purpose of this campaign is to promote safe sex in a neighborhood where HIV infections are high, said Jose Ramos, founder and president of Impulse.

Those public displays have elicited criticism about not only who is being portrayed in the majority of safe sex messages but also how they’re portrayed.

“This does not represent us,” said Gregory Victorianne, a researcher at UCLA and a member of the Black Los Angeles HIV/AIDS Coalition (BLAAC). Victorianne, who identifies himself as a “black man who has sex with men,” explained: “I need to see myself up there, but nothing in a compromising position. That’s not good.”

Christopher Hucks-Ortiz, an evaluation specialist at the nonprofit John Wesley Community Health Institute, also said that messages promoting the sexual health of gay and bisexual men should use models who represent a spectrum of races and ethnicities.

“Men who are taller, bigger, who don’t fit this lean six-pack shape, may not go any further if they can’t relate to these images,” said Hucks-Ortiz, a member of BLAAC who identifies as gay.

Sexual health advocates agreed that curbing HIV infection rates requires more than billboards that promote safe sex. They said more resources are needed to aid education and the implementation of safe-sex practices.

In West Hollywood, Impulse distributes condoms at nightclubs and has chapters opening up nationwide where parties are held that promote safe sex, Ramos said.

“All the people in Impulse, including myself, we really do it from a place of love for the community,” he said. “Are we doing it a hundred percent correctly? Probably not. But at least we’re trying.”

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a href=“http://www.c2ea.org/get-involved/join-c2ea”>Join the Campaign to End AIDS today!

"HOLD ON TO HUD!"

HOUSING RALLY

Wednesday July 24TH @ 1pm ~
Capitol Southeast Lawn
1st St. & Independence Ave. SE • Washington, D.C.
Nearest metro stop: Capitol South (Orange/Blue Line)

KEEP UP THE FIGHT TO END HOMELESSNESS!

Housing and AIDS activists and advocates from around the country are standing up and calling for a repeal to sequestration and rallying against the GOP’s proposed cuts to Department of Housing and Urban Development (HUD) funding. Housing is essential to living healthy lives and HUD is experiencing major cuts that threaten programs vital to providing housing for those most in need.

Sponsored By:
National AIDS Housing Coalition • Housing Works • Harlem United • HELP/PSI

Supporting Organizations:
Coalition on Human Needs • National Healthcare for the Homeless Council • National Alliance to End Homelessness • Mercy Housing • Supportive Housing Network of New York • Campaign to End AIDS • Washington Legal Clinic for the Homeless • HIV Prevention Justice Alliance • AIDS Foundation of Chicago • National Coalition for the Homeless • The Women’s Collective • Gregory House Program • National Disability Rights Network • Sasha Bruce Youthwork • So Others Might Eat • Miriam’s Kitchen •National Low Income Housing Coalition • National Network for Youth

Bring your Organizational Banners & Signs!

FMI:  Christine Campbell ~ campbell@housingworks.org or 202.408.0305
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FOLLOW US ON TWITTER for updates on the rally! ~ @housingworks and @c2ea

Spread the word! Please use #holdontoHUD & #endsequestration as your hashtags, and be sure to tweet, tweet, and retweet!  @gopconference & @housedemocrats!

*Pre-event (before 1p)! ~ Sample tweets*

~ Rally @ 1pm on Capitol SE Lawn to fully fund HUD, END HOMELESSNESS, and REPEAL sequestration #holdontoHUD #endsequestration

~ Join us at 1pm rally at Capitol SE Lawn in Washington, D.C. to END HOMELESSNESS #holdontoHUD #endsequestration

~ Keep up the fight to END HOMELESSNESS and rally @ 1pm today on the Capitol SE Lawn! #holdontoHUD #endsequestration


*During and after the event (1p and later)! ~ Sample tweets*

~ @gopconference & @housedemocrats—While ur home sleeping, 100k+ Americans put out on the streets! STOP CUTS NOW! #endsequestration #holdontoHUD

~ @gopconference & @housedemocrats: End sequestration, end homelessness! #endsequestration #holdontoHUD

~ @gopconference & @housedemocrats can’t handle flight delays, but will make Americans homeless?? SHAME! #holdontoHUD #endsequestration

~ @gopconference & @housedemocrats—Who will be kicked out of their shelter next?? #holdontoHUD #endsequestration

~ @gopconference & @housedemocrats—Fund HUD programs! Housing is Healthcare! #endsequestration #holdontoHUD


*AND/OR! Tweet at these news stations to spread the word and turn out media to cover this important issue!*
 
•WJLA.com ABC 7 News: @ABC7News
•WUSA 9 CBS: @WUSA9
• Fox DC: @myfoxDC
•NBC 4 Washington: @NBCWashington
•Washington Times: @WashTimes
•Washington Post: @WashingtonPost
•New York Times: @nytimes
•McClatchy Information Bureau: @McClatchyDC
•WMAL Radio: @wmalnews
•Bloomberg: @bloombergnews
•Reuters: @reuters
•Washington City Paper: @WCP
• Washington Post Express: @WaPoExpress
•CNN: @cnn
•WPFW: @WPFWDC
•Univision: @univision
•Politico: @politico
•Huffington Post: @HuffingtonPost
•Slate.com: @Slate

Washington DC July 16 2013—On July 24th, 2013, housing and AIDS activists and advocates from National AIDS Housing Coalition, Housing Works, Harlem United, HELP/PSI, and many other organizations are standing up to call for a repeal to the sequestration and drawing attention to proposed cuts to Department of Housing and Urban Development (HUD) funding. Housing is essential to being able to live healthy lives and HUD is experiencing major cuts which threaten programs that are vital to providing housing for those in need. We will gather at the Capitol South Lawn (1st and Independence Ave SE, Washington DC) at 1pm.

The rally will make the following essential demands for working to end homelessness:

HUD Programs must receive more funding in the FY2014 federal budget.

The Obama Administration is requesting $2.381 billion for HUD’s Homelessness Assistance Grants in its 2014 budget. This proposed funding would help those with the greatest needs— ensuring housing for 213,000 people. Additionally, the President’s budget requests that HUD receive the following additional funding: $1.4 billion in for VA’s targeted homeless veterans programs, $75 million for 10,000 HUD-Veteran’s Affairs Supportive Housing program vouchers, full funding of the National Housing Trust Fund, funding to secure all existing Section 8 vouchers, and the replacement of any funding for housing that was lost as a result of sequestration. The House would like to cut the proposed budget significantly with additional funding losses due to sequestration.

Sequestration should be completely overturned.

The deep cuts that are taking place as a result of sequestration include funding to discretionary programs including virtually all targeting homelessness and supporting affordable housing for low-income individuals and families, including veterans. The Center on Budget and Policy Priorities estimates that sequestration will reduce federal housing assistance by more than $2 billion in 2013. HUD estimates that more than 100,000 homeless and formerly homeless people will be removed from housing or shelter programs as a result of sequestration, severely impacting the provision of safe and affordable housing and necessary supportive services.

Proposed cuts to HUD programs will reverse the recent decreases in homelessness.

The House’s proposed cuts to HUD programs coupled with the cuts through sequestration will undermine what has been a slow but significant decrease in homelessness. Between 2009 and 2011, there was a 1% reduction (about 7,000 people) in homelessness in the U.S. as a result of increased investment in HUD and other federal efforts to end homelessness.

“As a community fighting for an end to homelessness across the country, we are concerned by the impact of both proposed cuts to housing programing in the FY2014 budget and the impact of the sequester on these vital programs aimed at supporting those most who are most vulnerable,” says Christine Campbell, Vice President of National Advocacy and Organizing for Housing Works. These programs have moved the U.S. forward towards our goal of ending homelessness and that work must continue. We will rally on July 24th to demand funding to continue that work. We will gather at 1pm on July 24th at the Capitol Southeast Lawn (1st and Independence SE, Washington DC).

Supporting organizations include:

Coalition on Human Needs • National Healthcare for the Homeless Council • National Alliance to End Homelessness • Mercy Housing • Supportive Housing Network of New York • Campaign to End AIDS • Washington Legal Clinic for the Homeless • HIV Prevention Justice Alliance • AIDS Foundation of Chicago • National Coalition for the Homeless • So Others Might Eat • The Women’s Collective • Gregory House Program• Sasha Bruce • National Disability Rights Network • National Low Income Housing Coalition • National Network for Youth

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MEDIA ALERT: Hold on to HUD! Housing Rally

Wednesday, July 24, 2013, 100pm ~~ Capitol Southeast Lawn (1st Street SE & Independence Avenue SE)

COALITION OF ORGANIZATIONS RALLIES TO SAVE HUD PROGRAMS, FIGHT HOUSING CUTS, AND REPEAL SEQUESTRATION

FOR IMMEDIATE RELEASE

Media Contact: Rebekah Horowitz rebekah.horowitz@gmail.com 215-964-7452

Washington, DC July, 22 2013 —On July 24th, 2013, housing and AIDS activists and advocates from National AIDS Housing Coalition, Housing Works, Harlem United, HELP/PSI, and many other organizations are standing up and calling for a repeal to sequestration and drawing attention to proposed cuts to Department of Housing and Urban Development (HUD) funding. Housing is essential to the ability to live healthy lives and HUD is experiencing major cuts which threaten programs that are vital to providing housing for those in need and reverse the recent decreases in homelessness. We will gather at the Capitol Southeast Lawn (1st and Independence Ave SE, Washington DC) at 1pm.

The rally will make the following essential demands for working to end homelessness:

HUD Programs must receive more funding in the FY2014 federal budget.

Sequestration should be completely overturned.

Proposed cuts to HUD programs will reverse the recent decreases in homelessness.

“As a community fighting for an end to homelessness across the country, we are concerned by the impact of both proposed cuts to housing programing in the FY2014 budget and the impact of the sequester on these vital programs aimed at supporting those most who are most vulnerable,” says Christine Campbell, Vice President of National Advocacy and Organizing for Housing Works. These programs have moved the U.S. forward towards our goal of ending homelessness and that work must continue.

Supporting organizations include:

Coalition on Human Needs • National Healthcare for the Homeless Council • National Alliance to End Homelessness • Mercy Housing • Supportive Housing Network of New York • Campaign to End AIDS • Washington Legal Clinic for the Homeless • HIV Prevention Justice Alliance • AIDS Foundation of Chicago • National Coalition for the Homeless • So Others Might Eat (SOME) • The Women’s Collective • Gregory House Program• Sasha Bruce Youthwork • Miriam’s Kitchen • National Disability Rights Network • National Network for Youth

WHEN: July 24th, 100pm
WHERE: Capitol Southeast Lawn (1st Street SE and Independence Ave SE)

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From the HIV Justice Network

The United States is closer than ever before in ensuring that their HIV-specific laws are reviewed and amended in order to be consistent with current medical and scientific knowledge.

Earlier this week, the U.S. House Appropriations Committee passed an amendment proposed by Congresswoman Barbara Lee to the FY2014 Commerce-Justice-Science Appropriations Act that would require the Attorney General to initiate a review of Federal and State laws, policies, and regulations regarding criminal and related civil commitment cases involving people living with HIV.

This wording is very similar to the content of Lee’s REPEAL HIV Discrimination Act, which was re-introduced in May with bi-partisan support, and which currently has 32 co-sponsors.

“HIV criminalization laws breed discrimination, distrust, and hatred. These laws are based on fear, not science. This is an important first step in ensuring that our laws reflect current scientific understandings of HIV.” notes Congresswoman Lee in a press release. This amendment passed on a voice vote as part of the manager’s amendment.

The amendment reads as follows:

Modernizing laws with respect to people living with HIV/AIDS.

The Committee is aware of the position of the President’s Advisory Council on AIDS (PACHA) that current criminal laws require modernization, should be consistent with current medical and scientific knowledge and avoid imposition of unwarranted punishment based on health and disability status. The Committee directs the Attorney General, within 90 days following enactment of this Act, to initiate a review of Federal and State laws, policies, and regulations regarding criminal and related civil commitment cases involving people living with HIV/AIDS. The Committee further directs the Attorney General, no later than 180 days from initiating the review, to make best practice recommendations to ensure such policies do not place unique or additional burdens on individuals living with HIV/AIDS and reflect contemporary understanding of HIV transmission routes and associated benefits of treatment.

The Appropriations Act (officially titled ‘S.1329 : An original bill making appropriations for Departments of Commerce and Justice, and Science, and Related Agencies for the fiscal year ending September 30, 2014, and for other purposes’) has now been placed on Senate Legislative Calendar.

The Sero Project has issued a press release welcoming the amendment and explaining what it means for advocacy against overly-broad HIV-specific criminal laws in the United States.

SERO. Appropriations Amendment Release