Preview of 2012: The Battles that will Shape the Future of HIV

January 6, 2012 in Policy/Advocacy

by Ronald Johnson, Vice President of Policy and Advocacy

With all the achievements, as well as a few disappointments, of 2011 officially behind us, our attention now turns to 2012, which almost certainly will prove to be an historic year in the fight against HIV. Below, we preview some of the policy issues in 2012 that could turn the battle against HIV, for better or worse.

Affordable Care Act

In 2012, 10 new provisions of the Affordable Care Act are set to be implemented. The provisions take important steps toward preventing fraud and changing the way that the government pays for health care. However, the highlight of 2012 surely will be the Supreme Court’s ruling on the constitutionality of the Affordable Care Act, with a focus on the individual mandate that requires all Americans to buy health insurance by 2014 or pay a penalty. The Court is expected to hear the case in March. The ruling is due by July 2012, and will be critical to determining the extent to which the ACA can be implemented in its original form. A second major highlight in 2012 will be work to develop the Essential Health Benefits (EHB) package. The EHB is one of the key provisions of ACA. It guarantees that plans provide adequate benefits to their enrollees — benefits that will mirror the typical employer-sponsored plan.

Appropriations

The President will submit his Fiscal Year (FY) 2013 budget proposal to Congress no later than the first Monday of February. The President’s FY 2013 proposal is expected to conform with the spending cap mandated by the Budget Control act. The FY 2012 budget cut $700 million from the Departments of Health and Human Services’ budget, though some notable domestic HIV/AIDS programs essentially were able to maintain their FY 2011 funding levels, including the Centers for Disease Control and Prevention’s HIV/AIDS, Viral Hepatitis, Sexually Transmitted Diseases and Tuberculosis Prevention programs; the Minority AIDS Initiative; and the Ryan White HIV/AIDS Program.

Deficit Reduction

In 2011, debts and deficits drove fiscal policy, as well as political rhetoric, and 2012 looks to be no different. Deficit reduction talks in 2012 will revolve around the Budget Control Act of 2011, the legislation that mandated Congress to develop a plan that would reduce the deficit by $1.2-$1.5 trillion over the next 10 years. Congress’ deadline for approving a plan is January 2, 2013. If Congress does not reach an agreement, $1.2 trillion will be cut automatically with 50% coming from defense programs and the other 50% coming from nondefense programs. Certain Members of Congress already have called for defense programs to be exempted from the automatic cuts. Though AIDS United does not take a position on cuts to defense programs, any attempt to shift cuts from defense programs to programs that serve people living with HIV would be unacceptable and would be met with our vigorous opposition.

The Temporary Payroll Tax Cut Continuation Act of 2011 was signed by President Obama just before the Congressional recess. The extension gave Congress until February 29 to negotiate continuing a tax cut for social security from 6.2% to 4.2%, a tax cut that is supported by the President. Also included in the extension was a postponement of cuts to Medicare reimbursements for doctors. Medicare payments to physicians were scheduled to be cut by 27% this year. A congressional conference committee has been created to extend the payroll tax cut and to come up with a long term solution for Medicare reimbursements. The committee is expected to first meet the week of January 16.

Elections

Elections in 2012 will determine the makeup of the 113th Congress, as well as the occupier of the White House. The new Congress and the winner of the presidential election will be faced with reauthorizing the Ryan White Care Act in 2013, implementing the major reforms of the Affordable Care Act, continuing the implementation of the National HIV/AIDS Strategy, and determining funding appropriations for domestic HIV/AIDS programs under the mandates of the Budget Control Act and annual fiscal year budgets. Additionally, a number of biomedical HIV interventions are being developed, and will require the financial commitment and the vocal support of all our political leaders.

Syringe Exchange

Deplorably, Congress included a ban on federal funding for syringe exchange programs (SEPs) in the final Fiscal Year 2012 appropriations omnibus. Despite the fact that SEPs have been incontrovertibly proven to reduce rates of HIV transmission in a way that is significantly cost-effective, the ban, which was originally instituted in the late 80s and overturned in 2009, was reinstated. In 2012, HIV advocates and organizations will and must work to hold Congress and the White House accountable for this reprehensible step backward in the fight against HIV.

Biomedical advances

The past couple years have seen a flurry of biomedical advances that have given many hope that science is finally starting to gain in the fight against HIV. In 2011, we saw encouraging results in trials that tested vaccines, pre-exposure prophylaxis (PrEP), and the efficacy of ARV treatment in preventing transmission among serodiscordant couples. In 2012, the Food and Drug Administration will consider an application from Gilead Sciences, that requests Truvada be labeled as an HIV PrEP in addition to its current label as an HIV treatment drug.  PrEP is the use of HIV medications to prevent an HIV infection. Gilead’s request is based on findings from a worldwide study showing that PrEP containing the HIV drug Truvada, reduced the rate HIV incidence by 44 percent. Additionally, the Follow-on African Consortium for Tenofovir Studies (FACTS)Trial is conducting a study to investigate the effectiveness of a vaginal microbicide gel containing the HIV drug, Tenofovir. The FACTS 001 study will test if a vaginal gel containing Tenofovir is effective at preventing HIV and Herpes Virus 2 transmission among women when used immediately before and after sex. Results are expected in 2013.

In recent news, researchers testing HIV vaccines in monkeys have found their most successful vaccine, which used two different strains of adenovirus that normally causes colds, to be 80 percent effective at preventing infection. “As far as animal trials go, this is a solid step in trying to track down the [biological markers] of immunity,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, which provided partial funding of the study.

National HIV/AIDS Strategy

In July of 2012, we will mark the end of the second year of the National HIV/AIDS Strategy (NHAS). The milestone will find us 2/5 of the way toward 2015 from when the Strategy was originally released in 2010. The Administration has sought to reach the goals of NHAS by collaborating and enhancing their partnership with state and local HIV authorities. NHAS has called for ambitious levels of reduction in new HIV incidence, increases in access to care and improved health outcomes for people living with HIV, and reduction in HIV-related health disparities. The Administration will be expected to show quantifiable progress that has been made toward these goals over the past two years. Reaching the goals of NHAS would be impossible without better access to healthcare for people living with HIV, therefore, the Supreme Court’s ruling on the constitutionality of the Affordable Care Act will be pivotal to determining the success of NHAS over the next three years.

International AIDS Conference

For the first time in 20 years, the International AIDS Conference (IAC) will be held in the United States. Appropriately, the conference host will be Washington DC. The timing in an election year, as well as the location of IAC will create an extraordinary opportunity for HIV activists to call for presidential and Congressional candidates to take a position on the myriad legislation and policies that impact people living with HIV.

JRI/NBGMAC Convene PrEP Training for Black Gay Men

January 4, 2012 in Uncategorized

By: Charles Stephens, AIDS United Regional Organizer

The Justice Resource Institute (JRI), in partnership with the National Black Gay Men’s Advocacy Coalition (NBGMAC), convened a two-day speakers training in mid-December for black gay men focusing on Pre-exposure Prophylaxis (PrEP).  PrEP is the use of HIV medications to prevent an HIV infection.  The goal of the training was to create a network of black gay male leaders that will speak about PrEP in their communities and enhance the awareness and engagement of black gay men around PrEP.  I had the opportunity to participate in the training, which included participants representing a range of professional experiences, disciplines, ages, approaches to HIV prevention, and geographic locations.

The training included rigorous discussions about research ethics, barriers to implementing PrEP, the importance of research literacy, and cultural humility in connecting high-risk populations to PrEP.  Participants learned how to address community concerns, develop effective messaging, and talk about scientific terminology. Each of us had the opportunity to give mock presentations about PrEP.

We also learned more about iPrEx, which was the study that indicated the effectiveness of PrEP for men who have sex with men (MSM).  Robert Grant, who was the protocol chair for the iPrEx study, was also one of the presenters. We took the opportunity to ask him questions, and get his perspective on the development and execution of the study, in addition to learning more of his insights about PrEP.

As next steps, we were encouraged coordinate trainings in our respective communities for black gay men around PrEP. For some of us, this will also include educating our staff and colleagues to more effectively and strategically target our efforts to have the greatest possible impact. This training — and other similar activities — gives us a way forward in having greater parity not only in access, but also information.

World AIDS Day 2011 in Tulsa, OK

January 3, 2012 in AmeriCorps, Community Partnerships, HIV/AIDS Awareness Days, World AIDS Day

OttWorld AIDS Day was certainly a long one this year, as there were two events going on in Tulsa. Instead of picking one, Team Tulsa decided to do them both! First we attended Tulsa CARES’ annual World AIDS Day Symposium. Tulsa CARES is an HIV/AIDS organization that works with HIV-positive people living in poverty. Then we went to Tulsa’s World AIDS Day program and premiere of “We Were Here,” a documentary about the early days of AIDS epidemic in San Francisco and how the city responded.

At the symposium, we learned about issues from a wide variety of sources facing people living with HIV/AIDS  in Tulsa . The first presenter, Jim Ott, talked to us about the “rush to judgment” that we fight against in our work with HIV. Then we had a panel of health experts talk about current and promising medical advances, including new drugs and trials. It was very informative, especially hearing from our HIV-positive audience members and learning their health concerns.

harrisonAfter lunch, Dr. Timothy Harrison from the  US Department of Health and Human Services explained how the National HIV/AIDS Strategy was created and how it would affect Oklahoma. Christopher Grano from the Northern Colorado AIDS Project talked to us about taking stigma out of our prevention materials. Instead of using scare tactics that make people living with HIV seem evil, negligent, or dangerous, he wants us to put people first and have sex-positive prevention materials that focus on good behaviors (getting tested, wearing condoms, not discriminating against people with HIV, etc). Our last presenter asked us to be mindful of the ethics in how we share information about clients with other agencies. Even though sharing might be legal through releases or lack of laws, it might not be ethical. The whole program helped us professionally and personally and was a good reminder that we have the information and medications to end AIDS.

At the candlelight vigil, we had a chance to remember our co-workers, clients, and friends with HIV who have passed. Then we went inside the independent movie theater to listen to stories from Tulsa’s early response to the HIV epidemic. We had a lot of former AmeriCorps site supervisors and an AmeriCorps member from the first team talk about their experiences at the beginning of the epidemic and their hopes for the future. There were lots of people dying in Oklahoma at the beginning, and Ric Harrison, a former AmeriCorps member, was a part of a VNA hospice group that help ease the passing of Tulsans with AIDS. Janice Nicklas, our city supervisor, talked about founding TCAP, Tulsa Community AIDS Project, and Tulsa CARES. It was good for the AmeriCorps team to hear these stories of the beginning of the epidemic since none of us had been born during that time. Hearing all the stories and hopes for the future made us feel more committed to the cause. We’ve come a long way since the beginning of the epidemic, but there’s still a lot more to do!

Team Carolina | World AIDS Day

in AmeriCorps, World AIDS Day

On World AIDS Day, Team Carolina worked together to observe the impact of HIV and honor all those who have lost their lives to the pandemic. We were extremely grateful that so many organizations were honoring this day with community events, dance demonstrations, testing events, and university campus-wide shows. Due to the overwhelming amount of activities, Team Carolina members participated in their own host agency events as well as other community events. These events were located at North Carolina Central University, Shaw University, Veteran Affairs Medical Center of Durham, and the Hayti Heritage Center in Durham, on both November 30th, and December 1st.

At Stephanie’s placement, the Durham Department of Veterans Affairs Medical Center was holding a World AIDS Day celebration at the chapel. The celebration kicked off with a Congolese drum and chant led by Dr. Ken Wilson, a physician from the infectious disease department, and his friend Pline Mounezo with the Durham VA Choir accompanying them. After the upbeat start to rev up the audience’s energy, we welcomed three speakers. Stephanie started things off and shared her previous experiences with HIV in Vietnam, how that translated to her work currently in the VA, and how HIV is disproportionately affecting the South. Jessica Fulton, the psychology intern in the infectious disease department, spoke of the mental health and issues HIV positive patients face. Our keynote speaker, Dr. Karen Goldstein, focused on HIV in women veterans and the importance of directing care and resources to this population. The chaplain, Carl Clark, gave closing to the ceremony through a moving vigil. With such a jam-packed program with enthusiastic speakers and performers, the program was very well received by the audience.

In addition, Partners in Caring, in collaboration with Duke University, participated in providing HIV testing to students at Shaw University in Raleigh, NC. While partnering with another advocacy organization, our team was able to test 45 university students. We also provided students with basic safe-sex education counseling, various educational pamphlets and brochures, and contraceptives. This initiative helped raise awareness and reduce the sigma around getting tested. The turnout was more than expected, but in our line of work, this is always an awesome thing.

Project SAFE is North Carolina Central University’s only HIV prevention organization. It  held its annual World AIDS Day event in the Miller Morgan Auditorium on NCCU’s campus. While Project SAFE put in many long hours to making this event happen, the event’s success could not have been achieved without the help of others. Several HIV agencies and organizations from the community came to set up informational tables to be viewed before the event. Furthermore, the event was held in collaboration with many other student organizations around campus. Each organization created some type of work to be shown or performed at the event, including skits, videos, and spoken word. Each performance helped to raise awareness about HIV and safer sex practices among students at NCCU. The event included a keynote speaker who was HIV positive to talk about his story and give the issue a human face. Over 300 students attended this event and free HIV/Syphilis testing was provided to those who were interested.

Josh represented the Alliance of AIDS Services – Carolina (AAS-C) on the planning committee and coordination of two events.  The first event was the Durham County World AIDS Day Celebration, which was a huge success!  Hundreds of community members turned out to check out exhibitors, participate in the Facing AIDS Campaign, get free HIV testing, eat delicious food, and view a program with amazing dancers, singers, artists, and speakers.  Some of the speakers included the founder of a local AIDS service organization, people living with HIV of all races, ethnicity, genders, languages, and ages, HIV case-workers and prevention educators.  Josh’s role was to recruit and coordinate volunteers throughout the program, and particularly a group of dedicated volunteers from the AAS-C AIDS Care Teams to help prepare and serve food to attendees.  The experience was incredibly empowering, with personal stories, a diverse crowd, Spanish-language performers, speakers, and translators, song, dance, and attendees and volunteers who are truly committed to helping those infected and affected by HIV/AIDS.  Josh also coordinated a food drive which resulted in loads of food items to be donated to the AAS-C’s food pantry.

Lastly, Josh, as an Associate Faith Ministries Coordinator in his AmeriCorps placement, put countless hours into planning a World AIDS Day Interfaith Worship Service in neighboring Raleigh, NC.  The beauty of this service was the diversity of faiths represented and contributing to the program.  This event showed that HIV/AIDS can be confronted from non-judgmental, multiple faith perspectives, and that people of faith and people of no faith community can come together to “Remember the Lost, Remember the Living, and Remember Those We Must Protect,” the motto of AAS-C.  In spite of being unable to attend the service due to dual obligations on the evening of World AIDS Day, Josh was particularly touched that his parents, both local Baptist ministers, affirmed him and his HIV-positive status, and accepted an invitation to read passages as a part of the Worship Service.  Nothing is more meaningful than one’s own parents moving towards a place of acceptance and affirmation and joining the fight for their son and every other person living with HIV/AIDS. These events were how we as AmeriCorps members move people to get up and ACT to fight HIV/AIDS.

Team NOLA on World AIDS Day 2011

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Throughout the week of Dec. 1, 2011, New Orleans joined other cities around the world in observing World AIDS Day– a time of remembrance and awareness.

On Nov. 30, Team NOLA volunteered at a screening of “The Other City”– a documentary about the HIV/AIDS epidemic in Washington, D.C. Donations were collected at the door to support a project to make HIV Awareness license plates for Louisiana. Team NOLA helped to promote, set-up, run, and break-down the event.

On Dec. 1, Team NOLA participated in the Facing AIDS project. We walked around parts of New Orleans, asking people if they would like to have their pictures taken with a message about how they are Facing AIDS. We were pleasantly surprised by how many people agreed.

The first part of our mobile photo shoot took place in the French Quarter. Next we went to the AIDS memorial in Washington Square Park where the Louisiana Office of Public Health does a wreath-laying ceremony every year. The last part of our photo shoot took place in the Marigny neighborhood of New Orleans.

We took pictures of ordinary citizens as well as people who have been involved in the fight against HIV/AIDS for many years. Everyone was given red ribbons and a flyer with our facebook page where they could access their photo later.

At night, at the request of the Office of Public Health, the lights on the Superdome were red in honor of World AIDS Day.

For other behind-the-scene shots, check out our facebook album!

Team NOLA: NO/AIDS Walk & Halloween 28

in AmeriCorps

NO/AIDS Walk

On September 25, 2011, Team NOLA joined hundreds of Louisianans in the 22nd annual NO/AIDS Walk. The NO/AIDS Walk is a fundraiser that benefits the NO/AIDS Task Force and other HIV/AIDS service organizations in Louisiana. It is one of the largest fundraising events for AIDS Service Organizations in Louisiana. This year the Walk raised over $180,000. Team NOLA is proud to have participated in this awesome event.

Registration started at 8 am, with the Walk kicking off at 10 AM. It was bright and sunny– perfect weather for a 5k stroll through Uptown New Orleans. It’s still pretty hot in New Orleans in the end of September, so within a few minutes we were sweating. But teams of volunteers provided us with water and encouragement along the way. At the end of the Walk, we were greeted with beautiful flowers and fresh bananas.

The Walk was attended by representatives from a lot of local businesses, universities, organizations, and non-profits as well as from several national corporations. Many of our co-workers were there. Everyone involved had a lot of enthusiasm and energy. It was fantastic to be a part of a huge, well-attended event that was for such an important cause.

Halloween 28

In honor of Make a Difference Day, part of Team NOLA volunteered at Halloween 28, a benefit ball for Project Lazarus. Project Lazarus has been providing housing and other services to people living with HIV/AIDS for 25+ years. Team NOLA had a lot of fun greeting guests who attended the fundraiser.