AIDS Action Committee’s Blog

Joe Sudbay over at AMERICAblog has a post today talking about the need for a focused plan to end the AIDS epidemic, and the National AIDS Strategy that’s trying to make that a reality.

We’re all hearing a lot about the 2008 presidential race already, and the National AIDS Strategy is working to focus the candidates on the need to seriously address the problem here at home. It’s called for every candidate to develop a results-oriented strategy to fight HIV/AIDS domestically.

On the table is not only the fact that an estimated half of the million-plus Americans living with HIV/AIDS are not in care, but the huge disparities in who’s affected by the disease: the disproportionately high impact the epidemic is having on people of color, women of color (as the site points out, in 2004, HIV/AIDS was the leading cause of death among black women ages 25 - 34; for more on the impact of HIV on all women, see this post), gay men and other groups that can easily be made invisible in politics.

AIDS Action Committee of Massachusetts and hundreds of organizations and individuals have already signed on to send the message to the candidates that this should be a priority. Hopefully they’ll listen. We urge our supporters to sign on and to ask other organizations and your friends and family to sign as well.

Find out more at www.nationalaidsstrategy.org.

Last week was a bad week for the Bush administration’s abstinence-only-until-marriage programs.  Abstinence-only proponents were still reeling from the ab-only doesn’t work Mathematica bomb when it was announced that the ACLU, SIECUS and Advocates for Youth had sent a nine-page letter to the Secretary of HHS, Mike Leavitt, demanding the medical inaccuracies in abstinence-only-until-marriage programs (ala the Waxman report) be corrected within 30 days or HHS will face legal action.

Friday was even worse:   more than 65 organizations signed on to letters to the Chairman of the House Appropriations Subcommittee on Labor, Health and Human Services and Education calling for the end of abstinence only until marriage grants for community based programs and for the government to begin allocating dollars for comprehensive sex education.   Friday also saw the resignation of Randall L.Tobias, the former ab-only guru for the Bush administration, after it was widely reported that he had hired an “escort.”  The Randall development underscores not only a good dose of hypocrisy but more importantly that the standards of behavior that the Bush administration has laid out as expected and acceptable is unrealistic for even the most ardent adult supporters.

Yesterday, the Globe ran a story about Governor Patrick rightly rejecting abstinence-only-until- marriage federal funding in his budget. Predictably, ab-only proponents immediately cried that the Governor wants to give up federal grants that are merely used to teach students about abstinence. They want people to believe that the Governor doesn’t believe in abstinence and wants kids to go around “doing it” as much as possible.

This is standard fare for proponents of ab-only. They want people to believe that without abstinence-only-until-marriage programming, abstinence isn’t valued and won’t even get a quick mention in typical sex education classes. They are (gasp!) wrong. Quite the contrary, comprehensive sex education curricula are abstinence-based, emphasizing that delaying sexual activity is a great choice for young people and not having sex is the only sure fire way to avoid pregnancy or disease.

Comprehensive sex education doesn’t stop there; it also provides information about contraception and safer sex. The goal of comprehensive sex education is to avoid unplanned pregnancies and the transmission of disease. It recognizes the fact that most young people become sexually active before leaving high school and many need information. Abstinence-only-until-marriage programs may not discuss contraception or condoms except to emphasize their failure rates.

So, what is the goal of abstinence-only-until-marriage programming? The federal guidelines governing this funding require, among many things, that students be taught that the “expected standard of sexual activity” is abstaining from sex outside of a “mutually faithful monogamous relationship within the context of marriage.” (More on these guidelines and gay kids tomorrow)

Moreover sexual activity is defined “as any type of genital contact or sexual stimulation between two persons including but not limited to sexual intercourse.” No sexual stimulation between two persons? Let’s be honest, if you’re over-the-moon gaga for someone at fifteen, sexual stimulation doesn’t take much – it could be holding hands or a hug. The above definition isn’t abstinence – it is chastity, a religious virtue more appropriately taught in a private religious institution, and an entirely inappropriate goal in a public school class.

Activists rallied on Thursday in support of CORI reform. CORI stands for Criminal Offender Record Information, and it’s a record compiled by the state of all criminal charges brought against an individual. It includes charges that were either dismissed or resulted in acquittal, it can go back several decades and it can frequently include misinformation. It’s a difficult document to read, and many of the people who are making decisions based on viewing them don’t always understand what they’re looking at. A CORI can be seen by criminal justice and government agencies statewide, but also by public housing authorities, schools and private employers. Applicants are frequently required to consent to a CORI check when applying for subsidized housing, schooling and many types of jobs.

AAC’s housing advocates frequently see how current CORI regulations affect the populations we work with. Clients who have spent several years on subsidized housing authority waiting lists learn that the housing authority has rejected their application due to CORI activity, frequently for charges from many years prior, and for charges that are non-violent or substance abuse related. Housing advocates help AAC clients navigate the complicated process of appealing CORI-related rejections, but it’s not easy, and while their appeals are being processed, many of these clients remain without housing. These types of regulations seemingly ignore the link between chronic homelessness, poverty and criminal activity. Denying low-income people subsidized housing because of previous mistakes discourages those who are trying to make positive and stabilizing changes in their lives.

Currently legislation is pending to reform the CORI process in Massachusetts. Proposed changes would continue to make information available to law enforcement, but also make it easier for people who have made a commitment to reform and rehabilitation to get access to jobs, housing and education. Now it’s critical to support a move toward a system that’s rehabilitative, not punitive, and one that helps the people we know need it the most.

For more information on CORI reform, check out Massachusetts Alliance to Reform CORI.

Today, the Somerville News published an article blaming a rise in incidences of used syringes being found on the street on the Pharmacy Access Law passed last year which made it legal for anyone to purchase syringes in pharmacies without a prescription. Before the passage of this bill, Massachusetts was one of only three states where the over-the-counter sale of syringes was illegal. When we crafted Massachusetts’ law, we recognized that syringe disposal was an issue in the Commonwealth, which is why we required a statewide disposal system to be part of the new law.

Unfortunately, conversations about whether drug users would use safer disposal options are premature. The harsh reality is that there are few disposal options for anyone who uses a needle outside of a medical facility. Although the Department of Public Health under Governor Romney was directed to compile a list of disposal options, create a program, and issue regulations no later than 90 days after the passage of the Act, DPH did nothing. Ironic given that the Romney administration’s objection to, and veto of the bill was supposedly based on the improper disposal of needles.

Fortunately, John Auerbach, the new commissioner of DPH under Governor Patrick understands the disposal problem and is committed to fixing it. Although syringe disposal is a genuine concern, it does not negate the Pharmacy Access Law’s ability to halt the spread of HIV among some of the Commonwealth’s most at-risk populations.

Thanks to AIDS Action’s Public Policy All Stars, you probably already know that the Massachusetts Department of Public Health recently switched to names-based system for reporting new HIV cases. Between 1999 and 2006, Massachusetts reported on its HIV cases using unique identifier codes to maintain confidentiality. Starting January 1, 2007, health care professionals are required to report on the names of all people who test positive for HIV infection.

(To read more about this issue, and how it affects people living with HIV/AIDS and the organizations that serve them, check out Denise McWilliams’ written testimony opposing the adoption of names-based reporting in Massachusetts.)

Recently, it was reported that Vermont, Maryland and Hawaii, the last three states to track new HIV infections using unique identifier codes, will be switching to a system of names-based reporting by the end of 2007. Despite the real and continued concerns that names-based reports are vulnerable to security breaches and could discourage people from getting tested, the states are making this switch because beginning this fiscal year, federal funding via the Ryan White CARE Act is going to be tied to names-based reports of new HIV infections. States that don’t submit names-based reports risk a reduction in their allocation of CARE Act funding.

So that’s the old bad news. What’s the new bad news? This article on the switch mentions toward the end that the Department of Housing and Urban Development (HUD) is considering using names-based HIV case reports to drive its funding allocation, proposing to Congress that this change take effect in the 2008 fiscal year. HUD’s Office of HIV/AIDS Housing manages several programs that assist people living with HIV/AIDS, including Housing Opportunities for People with AIDS (HOPWA). AIDS Action Committee receives HOPWA funding to administer its Rental Assistance, Housing Advocacy and ROOF (Roofs Over Our Families) programs. Programs like these recognize that people living with HIV/AIDS are more likely to receive stable medical care if they have stable living situations and that housing is one of the main concerns of the population that we serve. Tying HOPWA funds to names-based reporting means that existing concerns of confidentiality and under-reporting could soon apply to this funding source as well, jeopardizing programs that link housing to health care.

If you’re interested in learning more about issues relating to HIV/AIDS public policy and advocacy, you can join our CyberAction Network.

Volunteers contribute over 1,100 hours every month at AIDS Action to help stop the epidemic. From each volunteer application, an individual of conviction and compassion quickly shines through the words.

“I can’t bear the idea of people out there going through [the experience of living with HIV] alone.”
-- now a Check-In volunteer, providing long term, weekly support to people living with HIV over the phone

“Being gay makes me want to reach out to people in my community and help all that I can.”
— now an Outreach volunteer, talking one-on-one with people in the gay community about safer sex

“I’ve always felt that AIDS played a part in my life because my uncle, who died before I was born, was an AIDS activist.”
— now a Boomerangs volunteer, raising money for AIDS Action programs

“I think this needs to be a disease that is on everyone’s mind.”
— now a Hotline volunteer, helping field the over 1,000 calls received each month

I believe that when people understand this epidemic, they are moved to action. Every day I see victories in the fight against complacency and silence. When someone calls the Hotline seeking counsel, the voice on the line will be a volunteer. When a person living with HIV needs nutritious groceries, they will come from a volunteer’s hands.

Each person of conscience can contribute. Just as important, each person must act as an ambassador to their community, broadening this fight, and moving others to transform their compassion into action.

We offer many support groups at AIDS Action Committee. From the members of these groups we have gathered that their health concerns are moving beyond those of just T cell counts and viral loads. This is not to say that HIV is not foremost in my mind when I am speaking with a client. This disease is still killing people every day and it will continue to do so until we stop this epidemic

However, many of our clients have been successfully managing their HIV and are now incurring other medical issues. Unfortunately it seems that HIV docs are not responding in an appropriate manner. Many clients at AIDS Action have expressed frustration. Many feel like numbers rather than patients. I realize how difficult it was for docs in the first 15 years of this epidemic. However with increasingly safer, efficacious drugs now available it is time for doctors to stop treating HIV solely and to start treating patients as human beings again. I think it is time for HIV docs to be HIV docs and let Primary Care docs take care of the rest.

I owe my life to HIV docs. Throughout the years, through their dedication I have survived. Now I am living and aging. I am no longer consumed with HIV and all its baggage. Until this is over my primary purpose will always be to end this epidemic. For now I want to live as normal as possible. Routinely I will see my HIV doc four times a year. The rest of the time I will live.

LET ME GET THIS STRAIGHT: last week the Bush Administration saw fit to increase funding for abstinence –only-until-marriage programming by 28 million dollars while simultaneously eviscerating healthcare funding for poor children. That means our government is putting kids at greater risk of HIV/AIDS, pregnancy and cervical cancer but is taking resources away from the very programs that will help these kids when they get sick and/or pregnant.

Young people need access to comprehensive health and sexuality education to make responsible decisions, prevent disease, and reduce unintended pregnancies so that they can lead healthy lives. Abstinence-only-until-marriage programs masquerade as education but in fact promote sexual ignorance. As a member of the AIDS community -and a new mother- I think that abstinence is a very important choice for young people. But it must not be presented in such a way that the health and well-being of young people are placed at greater risk.

For example, abstinence-only-until-marriage programs promote ambivalence about the efficacy of condoms. Under federal guidelines, these programs are prohibited from even discussing condoms except to emphasize their failure rates. Public Health professionals have spent the last 25 years trying to convince sexually active people of any age to use condoms to protect themselves. Besides – there is no evidence that these programs work. In fact, they have not been proven to delay the initiation of sexual activity, reduce the frequency of sex or the number of partners. To have the progress against the spread of HIV/AIDS undermined by programs that put ideology ahead of safety and health is heartbreaking and unconscionable.

Massachusetts currently accepts federal abstinence-only-until-marriage funds. We must join California, Maine and New Jersey and halt use of these funds immediately and reject any further funding. The health and well being of our young people depend upon it.

February 7, 2007 is being celebrated as National Black HIV/AIDS Awareness Day. Organizations have events planned all across the country. I’m sure prominent politicians and spokespersons of color will be trotted out and speak passionately about how this still devastating disease is wreaking havoc in communities of color. Their words will ring true.

This epidemic could be renamed the Black Plague, because HIV/AIDS is quickly becoming a disease of people of color. The numbers in developing countries and on the African continent coupled with the numbers in Black America make this real. As a black man who has lived with HIV/AIDS for 10 years I’ve seen first hand the devastation in my community. AIDS is the leading cause of death for black men/women aged 25-44. Think about that. A whole generation of folks, wiped out in their prime. Here in the Commonwealth people of color make up only 12% of the state population, yet they account for over 50% of new infections. For women the news is even more frightening. Black women account for 1/2 of all new infection in women and they have a 39 times higher likelihood to be positive than white women. These statistics are unacceptable. That our President didn’t even mention HIV/AIDS in the U.S. in his State of the Union is shameful.

In Massachusetts, February 7th is also our annual Lobby Day at the State House in Boston. We need to hit the State House in full force. We must let our new Governor and the legislature know that HIV/AIDS is still a devastating disease in the Commonwealth and it needs to be funded at the highest level. Please join us in the fight.