Developing HIV/AIDS Strategies in the South: Day 2

September 30, 2010 in Southern Initiatives

By Jeff Graham, Executive Director
Equality Foundation of Georgia

Day two of the Southern REACH convening allowed us the opportunity to work in smaller groups to share information on issues and activities that support HIV/AIDS advocacy in our region.  My friend and colleague Dazon Dixon Diallo of SisterLove summed up the goal of our work when she reminded us that it’s important to speak from one page as a region and realize how each group’s work support our collective goals.

As someone who has worked on HIV advocacy in the south for more than 20 years, it’s always refreshing to hear how others are approaching this work.  Groups broke out to create broad strategies that address the intersection of issues such as Reproductive Justice, Housing, Human Rights, PWLHA Organizing, coordinating Legislative Advocacy Days and promoting Harm Reduction.

Reproductive rights breakoutMy agency looks primarily at how issues of importance to Georgia’s LGBT community intersect with the issues of people living with HIV/AIDS.  Although the topic of Harm Reduction is usually seen as a domain defined exclusively by injection drug users, as the discussion unfolded, we realized that many groups of people such as diabetics and public safety officials can benefit from syringe access programs.  We even identified uninsured transgender individuals as a group who may benefit from these programs if they are forced to share syringes for hormone injections.  Clearly the work that may at first only support one group actually serves to help many others. Housing breakout group

In the afternoon we looked at the how Strategic Communications can advance our cause.  The highlight of this panel was an in-depth look at the Kaiser Family Foundation’s national campaign: We are Greater than AIDS.  This innovative program leverages some of the best talents in the marketing and communications world to bring the issue of the domestic HIV epidemic to a public that has begun to forget that AIDS is still a plague on many of our communities. It’s an excellent example of how we can all benefit when multiple sectors find ways to work together and share our talents towards creating a world where HIV infections are rare and all people living with HIV/AIDS are treated with dignity and respect.

Developing HIV/AIDS Advocacy Strategies in the South

September 28, 2010 in Southern Initiatives

by Jeff Graham, Executive Director
Equality Foundation of Georgia

Convening of NAF Southern REACH Grantees, Day 1

The first day of the National AIDS Fund’s Southern REACH convening was filled with reconnecting with colleagues from throughout the South who are committed to doing the work necessary to address the numerous disparities that define the fight against HIV/AIDS in this hard hit region.

Panel, National HIV/AIDS Strategy

NHAS panel

The opening panel discussed the implications of the National AIDS Strategy and federal health care reform on our work.  The South is a region that has carried an extraordinary burden with extremely limited resources.  While the promise of both the newly released National AIDS Strategy and the passage of federal healthcare reform are reasons for hope, they also present a new set of challenges.  Southern states have unique barriers in fully implementing both of these new strategies.  State legislatures are mostly hostile to the expansion of Medicaid to new populations and there are great concerns that as additional people enter the system, low reimbursement rates and restrictions on the services offered to those currently enrolled will result in further disparities if not adequately addressed.  And while the National AIDS Strategy does specifically mention the burden of the South, many of the recommendations do not adequately address the need for increased resources to alleviate the historical underfunding of services, especially in rural communities.

Panel on impact of HIV/AIDS on Latinos

Panels on both legal strategies and the special needs of Latino/Hispanic communities further defined the specific challenges facing people living with HIV/AIDS and their advocates.  Harsh criminal penalties for HIV transmission and the growing trend of using health care settings to identify and arrest undocumented migrant workers, while not unique to the South, add a new sense of urgency to our work.

Day 1 closing strategy discussion

The day closed with a discussion of how to identify and implement effect strategies to address the growing list of challenges and disparities. Throughout the discussion it is apparent that the people gathered here in New Orleans are truly committed to justice.  With the vision and support of the National AIDS Fund and the Ford Foundation, Southern HIV/ AIDS advocates are finding new resources, gaining new allies and crafting new strategies to address an epidemic that has had a distinctive impact on our region.

Creating the Right Message for Women of Color

September 23, 2010 in Every Life Matters, Every Dollar Counts

Dr. Valerie Montgomery Rice

Dr. Valerie Montgomery Rice

by Valerie Montgomery Rice, MD
Executive Director and Dean
Center for Women’s Health Research
Meharry Medical College
Nashville, TN
Chair, Every Life Matters, Every Dollar Counts

As a member of the National AIDS Fund Board of Trustees, I am proud to be associated with the the organization’s work, and especially with the Every Life Matters, Every Dollar Counts campaign. When you look at the risk of HIV in this country, you begin to clearly recognize that the some of the people most impacted are women of color. Black women constituted about 63% of all new cases in the U.S. in 2005. To put it another way, if you were to look at the demographic of new cases per 100,000 women in this country, here is what you would find: 45.9/100.000 black; 13.8/Hispanic; and only 2/100,000 white. These statistics apply for women between 18 to 40 years of age.

Why are women of color so disproportionately affected? The fact is, there have always been a disproportionate number of black people being affected, even in the early 90’s when AIDS was thought of as a gay white man’s disease. What has happened is that while we’ve seen a significant decrease in the death and prevalence in the white population, we haven’t seen the same in the black population. Part of this is because of lack of access to treatment, and the second part of it is that heterosexual contact is the number one way that black women are becoming HIV positive. And even though we don’t like to talk about this, this goes all the way back to men being in prison. The highest percentage of people in prison are black men. They become positive in prison, and then spread the disease to women. In many cases, black women are involved without even knowing they are at risk.

So when we talk about how to make a difference, we can not underestimate how important education is toward prevention. We especially know that we have to make sure we’re creating the right message for women of color. So, the Every Life Matters, Every Dollar Counts initiative is going to raise dollars that will be directed to communities of color — especially women in those communities — around education and prevention.


A VOCAL Victory

September 13, 2010 in Syringe Access Fund

by Sean Barry,
Director, NYC AIDS Housing Network (NYCAHN) &
Voices Of Community Advocates and Leaders (VOCAL)

No one should be locked up for trying to protect themselves and the community. Who wants to do the right thing and keep getting the wrong results?” — participant in VOCAL’s Stuck in the System report on legal barriers to syringe access in New York.

Governor Paterson and members of NYCAHN/VOCAL

Carrying new syringes and safely disposing of used ones to prevent the spread of HIV should be lauded as responsible public health, not treated as a crime.  But that’s exactly how New York’s Penal Code defined syringe possession until a law passed this summer updating it nearly two decades after syringe exchange programs first became legal in our state. What’s equally remarkable is that the new law passed because of grassroots organizing by active and former injection drug users through an innovative campaign supported by the Syringe Access Fund.

The VOCAL-NY Users Union, a project of the NYC AIDS Housing Network (NYCAHN), is building power among active and former drug users to create healthier and more just communities.  VOCAL members decided to work on a syringe access campaign because many of them had experienced police harassment and arrests for syringe possession.  Moreover, they knew that the fear of being locked up discouraged people from using syringe exchange programs that could save their lives, even though program participants were issued cards explaining it was legal to possess syringes under the Public Health Law.

The problem was that New York’s Penal Code was never updated to exempt syringe possession from the paraphernalia law or residue from the controlled substances law, despite Public Health Law exemptions.  These inconsistencies in state law resulted in confusion among law enforcement, unwarranted arrests and confiscation of syringes.  This had a broader chilling effect that helped drive a massive “syringe gap” among drug injectors in New York and high rates of syringe sharing, reuse and unsafe disposal.

VOCAL members launched the campaign by convening a meeting with staff from Governor David Paterson’s office and state legislators in charge of health and criminal justice policies.  VOCAL members presented data and anecdotal experiences of how law enforcement, confused by inconsistencies in the law, were undermining public health programs by arresting syringe exchange participants, and they presented clear recommendations for how to change it.

As a result of the meeting, the Governor submitted a bill to the legislature that would accomplish three things: clarify that possession of new syringes obtained through public health programs do not violate the paraphernalia law, exempt syringe residue from the controlled substances law, and require ongoing education of law enforcement about syringe access programs, which opens up the possibility for a new health-based dialogue between drug users and police.

To build momentum for the bill, VOCAL members conducted a community research project documenting the experiences of users who had been arrested despite lawfully possessing syringes, built a statewide coalition of syringe exchange programs, met with conservative lawmakers to educate them about harm reduction, and pitched media stories highlighting the need to reconcile state laws.  Positive press coverage of our campaign and report, titled Stuck in the System: Expanding Syringe Access By Reconciling the Penal Code With The Public Health Law [www.urbanjustice.org/pdf/publications/Stuck_in_the_System.pdf], included the New York Times [http://www.nytimes.com/2010/03/22/nyregion/22union.html] and Daily News [http://www.nydailynews.com/news/2010/01/29/2010-01-29_cops_state_law_sticks_it_to_safeneedle_push_study_sez.html].

The bill ultimately passed the legislature with bipartisan support and was signed into law by Governor Paterson.  In his statement after the bill passed, the Governor quoted Jill Reeves, a VOCAL member who had been wrongfully arrested for syringe possession [http://www.state.ny.us/governor/press/073010HivBill.html].

Perhaps more important than the legislative victory, this campaign built the leadership of active and former drug users to advocate on their own behalf.  Our members are now working with top law enforcement agencies in the state, health departments and other stakeholders to plan implementation of the new law [http://www.buffalonews.com/editorial-page/from-our-readers/another-voice/article171581.ece].  By training users on their new rights, VOCAL members are also identifying future campaigns that will further expand syringe access so that no one contracts HIV or hepatitis C through injection drug use in the future.

The reality is that people who use drugs and their allies have always been at the forefront of activism to prevent the spread of HIV/AIDS and fight for human rights, despite formidable obstacles.  But in a pattern common in the HIV/AIDS world, many activists have been drawn away from advocacy into direct service work, while others, we can’t forget, have passed away.  However, the necessity of investing in community leadership to expand syringe access and improve drug user health is only growing more urgent, which VOCAL/NYCAHN has proudly benefited from due to the collaborative efforts of the Syringe Access Fund.

NAF AmeriCorps Kicks off 2010-2011 Program Year

August 30, 2010 in AmeriCorps

by Robert Sturm

Program Director, New Mexico Community AIDS Partnership
City Supervisor,  NAF AmeriCorps Team New Mexico

Earlier this month, the 54 participants in NAF’s 2010-2011 Americorps/Caring Counts program converged on Santa Fe, New Mexico to begin their year by participating in PreService training.    With the addition of a new team in New Orleans, there will be eight teams in the program this year.   Chicago, Indianapolis, Detroit, Washington, D.C., Tulsa, Durham, and New Mexico (Santa Fe and Albuquerque), host the other teams.

While in Santa Fe, team members went through extensive training in HIV basics and related issues. They learned about the history of the epidemic and how things have changed over the years.  They were introduced to the structures of NAF’s program and what will be expected of them.  They also had a chance to meet the members they will be working with all year and the members of the other teams, to share their excitement and their motivations for dedicating a year of their lives to service.

Team building at the Santa Fe Mountain Center

The week of training culminated with a day at the Santa Fe Mountain Center, an organization dedicated to serving the community with Experiential Learning programs.  The team members, their city supervisors and several National AIDS Fund staff people explored their fears and boundaries on high ropes events in the morning, learning the power of having a team behind them, and for some, learning that they could participate fully without leaving the ground.

In the afternoon, everyone participated in games and activities, designed to help them explore group dynamics and communication, and learn different strategies for collaborating to overcome obstacles and reach goals.  They also met as individual teams to discuss goals for the year and norms of behavior team members want to use with one another.   All in all, the day allowed members to learn more about themselves and their team mates and to start building the relationships that will support them throughout their year of service.  In addition, the entire day was a demonstration of the experiential learning model that is central to the AmeriCorps experience.  Each activity began with a briefing session in which the event was described and explained and goals and intentions were set.    Then, following each activity, there was a debriefing session in which participants were encouraged to share what they felt and learned through participation in the activity.   This model  will be used by the teams over and over throughout the year in planning and processing Fifth Days and other projects.   What a great way to start out the year and get everyone on track to have fun while serving our communities.

A Territory Away…

August 26, 2010 in Puerto Rico Direct Grantmaking

by Stephanie Cruse, NAF Program Associate

I was able to travel to San Juan, Puerto Rico at the beginning of August to conduct site visits to a few NAF grantees through our direct prevention grantmaking portfolio there, as well as to attend a Johnson & Johnson grant ceremony with Kandy Ferree, NAF President and CEO. It was a fantastic opportunity to see our grantees’ work in action in addition to reading about their projects in our Washington office.

Carlo

Carlo

I spent Thursday visiting three grantees, each with very different prevention programs.  The first grantee was called PR Concra,(Puerto Rico Community Network for Clinical Research on AIDS). I met with Carlo, who is the peer educator for a program that we fund just outside of San Juan, near the University of Puerto Rico in an area called Rio Piedras. PR Concra is a center mainly for gay youth, and they provide HIV/AIDS prevention and treatment services, as well as medical/dental/mental health services.

PR Concra is the only organization on the island to provide programming for young gay men. The project Carlo works on focuses on conducting outreach to young gay men via social networks, primarily Facebook. After joining the Facebook group, young men are invited to go to PR Concra to take an HIV test or receive services.

My next site visit was to an organization called ASPIRA, and I met with the Executive Director, Adalexis Rios and the peer educator for the program we fund, Lizbeth Rivera. The NAF-funded program is an HIV prevention intervention called Solo para Chicas, and Lizbeth travels to four different rural sites around the island giving the intervention to adolescent girls.  Two of the sites are actually on separate, smaller islands off the Eastern coast of Puerto Rico, Culebra and Vieques. It’s hard to imagine, but these islands are even more remote and receive even less information and services than the island of Puerto Rico does.  In workshops, Lizbeth emphasizes self-esteem, trying to empower young women to feel comfortable with themselves and in their decision-making skills when it comes to their sexual health.

Iniciativa-Comunitaria's syringe exchange vending machine

The last visit was to Iniciativa Comunitaria, an organization that offers 13 programs in both prevention and direct care services.  NAF funds the Punto Fijo syringe exchange program through its Syringe Access Fund, and the syringe vending machine through our direct grantmaking program.  During this visit Kandy and I learned more about the vending machine which was introduced to the community in October 2009.  This project received quite a bit of international attention when it was implemented because it is the first of its kind in the Americas, so I was really excited to see it.  The justification for this project was that injection drug users (IDUs) couldn’t always make it to the syringe exchange room during business hours, so the vending machine is available 24/7 to those who have a token. They receive a packet from the machine which includes a clean syringe, needle, other necessary equipment and educational sheets on how to clean syringes/needles and HIV prevention.

I was so grateful to go on this trip because even though I had learned about the grantees’ projects here at NAF, being there and seeing the programs in action in the local context really opened my eyes.  There were a few main themes that I took away from my experiences in San Juan. The first is that all areas of Puerto Rico, but particularly rural areas outside of San Juan are in dire need of basic HIV/sexual health information. Secondly, stigma is a huge issue, and there is a lot of discrimination (sometimes violent) against gay or transgender individuals, as well as IDUs.  This results many times in lack of support systems, which push people even further into the margins, and can result in riskier behaviors, putting them at higher risk for HIV.

My last thought is that as “mainland” funders, we should be mindful of the context in which we make grants in Puerto Rico, and to really make an effort to understand how Puerto Rico’s territorial status affects relationships with the local and federal government, and with funders from the U.S. mainland.  I’ve had many conversations with our grantees, who express frustration that Puerto Rican community-based organizations often fall through the funding cracks, because they are considered internationally-based by many U.S. funders, but international funders consider them to be U.S.-based organizations.  Due to its unique status as a U.S. territory, Puerto Rican organizations are unfortunately not receiving adequate funding for the great need there.  I am proud that NAF has taken a leadership role and will be able to continue our funding in Puerto Rico and convince other potential stakeholders to invest in the many organizations that are doing a great amount of work with very few resources.