AIDS 2012: Two Days Down
July 24, 2012 in 2012 International AIDS Conference, Access2Care
By Beth Stringfield, Project Coordinator, Positive Charge Initiative
We must have strong backs to support those who are tired… we can change the story of AIDS…courage, dignity…HIV and poverty are intertwined…achievable…unleash the power…communities lead the way. These are some of the words and images that have shaped the first two days of the International AIDS Conference for me.
As I have listened to speakers, watched films, read posters, and talked with fellow participants, there is a sense that we truly are at a turning point in the epidemic; there is excitement about the evidence that continues to build upon itself that treatment is prevention, that medications are again changing the trajectory of the HIV in the course of history. But that is tempered by frustrations over conversations that recur year after year – overlooked populations, stagnant systems, and relying on medication as the solution to HIV without addressing the social factors that so heavily impact HIV transmission and access to care
Poverty, fragmented systems, racism, violence, and fear are among the many companions to HIV that we must find human solutions to. It’s a daunting task, and having not solved those problems over the course of human history, chances are slim that we’ll solve them in the next few years. But it doesn’t mean we can ignore them either.
Access to care work is not simply about finding medical care providers for our clients and scheduling their appointments. It’s about recognizing and acknowledging that social factors are as much at play in one’s ability to be healthy as medications and medical appointments are. We must work for safe housing for all, transportation systems that meet the needs of our rural folks, societies free of racism, communities in harmony, and families that embrace and value all members.
But knowing that this work will take time, access to care is about helping clients meet the daily needs of living that can then allow them to focus on HIV, and further it must also be about helping a client set goals, exploring personal motivations to stay sober, practicing communication, determining values, and planning for the future. Essentially it is helping clients to build the skills to excel in spite of the challenges that continue to surround them; to be better than HIV. That is what access to care is about.
Perhaps, if we are truly on the cusp of achieving treatment as prevention, we can now turn our attention to the other co-morbidities that no pill can help.
Beth Stringfield works on North Carolina Community AIDS Fund’s Positive Charge access to care program, funded by AIDS United and Bristol-Myer Squibb.
Facing the Issues of MSM and HIV
in 2012 International AIDS Conference
by Dr. Russell Brewer
Director of HIV, STDs, and Reproductive Health
Louisiana Public Health Institute
New Orleans, LA
The theme of the MSM Global Forum pre-conference held on July 21, 2012 was “From Stigma to Strength.” This theme could not be more fitting given that MSM from all corners of the world experience stigma, homophobia, criminalization, and discrimination in their everyday lives. These experiences affect their ability to access HIV prevention, care, and treatment services. The MSM Global Forum pre-conference began with an announcement by Congresswoman Barbara Lee (D-CA) that she has introduced a new bill called “Ending the HIV/AIDS Epidemic Act of 2012″ that lays out a policy and financial framework to creating an AIDS- free generation in the United States and worldwide. It’s great to see policy makers taking a leadership role in ending the HIV epidemic.
The introduction of the next speaker (the Hon. Michael Kirby with the Global Commission on HIV and the Law) by Robert Suttle, Assistant Director of the SERO project (www.seroproject.com) provided a face and story of an individual (Robert Suttle) who was convicted and incarcerated in Louisiana for HIV non-disclosure. I’ve read about HIV criminalization and how it perpetuates stigma but I’ve never actually heard a story from someone who was impacted by this law. The presentation that followed by the Hon. Michael Kirby really hit home for me in terms of the devastating impact of HIV among MSM not only in the United States but also globally and how laws that criminalize MSM will continue to fuel the epidemic. For example, Michael Kirby mentioned that 60% of new infections in the world are among MSM and fewer than 10% of MSM worldwide have access to treatment and preventive services. In addition, 41 of 54 countries that are part of the Commonwealth still criminalize MSM. We need leadership, education, and mobilization to help repeal these laws.
Later on during the day, Maurice Tomlinson, Legal Advisor with AIDS Free World gave the first Robert Carr Memorial Lecture to pay tribute to the life and legacy of the late LGBT activist Dr. Robert Carr. Maurice describes himself as an accidental activist. He actually wanted to be a patent lawyer but instead ended up being an advocate for all forms of marginalization that provide a safe harbor for HIV. Maurice talked about his efforts to challenge the anti-buggery (male same sex intimacy) law in Jamaica. In a recent survey, 82% of Jamaican people indicated that they were prejudiced against gay people. Maurice mentioned that in order for the law to be repealed, there needs to be ground swell support in the country and for the last few years, he and other activists have embarked on a plan to change the hearts and minds of Jamaicans through public education, walks and stands for tolerance, and other strategies. His presentation could not have stressed more the importance of challenging and repealing human rights violations in order to end stigma and discrimination; and create safer and more tolerant environments that enhance access to HIV prevention, treatment, and care services.
Rebuilding and Healing
July 13, 2012 in Policy/Advocacy, Southern Initiatives
by Maya Wyche, Program Manager
Southern REACH
On May 24, 2012, Women With A Vision (WWAV), a member of our AIDS United and Southern REACH family, fell victim to arson. While the crime is still under investigation, the women who embody and those who look for comfort in and through WWAV, are doing their best to move on through the smoke. The surrounding community, clients, and peer advocates, as well as national and international partners and supporters have answered their cry for help. Assistance has varied from heartfelt $1.00 to thousands, such as $5,000 donation from AIDS United, and from the provision of temporary office space within a local church to the potential for donated property. Although they have come a long way from where they were in the immediate aftermath of the fire, with the slow to start resumption of services, much healing has yet to manifest.
As a woman and fellow New Orleanian, it is disheartening to know that some individuals will go to such lengths to disrupt progress and further marginalize woman of color. I wish I could say that injustices such as this were rare in the South and specifically New Orleans. However, the marginalized and disenfranchised populations, such as the women serves by WWAV who are facing challenges such as addiction, domestic violence, and most notably all ills resulting from poverty, are all too often victimized. This crime could be perceived as a catalyst for a bleak and hopeless situation – from my viewpoint it is an opportunity for change. Crisis calls attention to serious matters and this fire will be fuel for heightened advocacy, which holds the potential for far reaching, long standing systems changes. Let us continue to stand with WWAV and most importantly the women encouraged by and dependent upon their powerful advocacy and nurturing assistance.
Stay updated with the work of WWAV by clicking the links below:
“My First Day” by Shaun King
“For All that We Have Won, For the Future We Will Make” by Rebecca Gibson
OraQuick In-Home HIV Test: Another Tool in the Toolbox
On Tuesday July 3, 2012, OraSure Technologies, Inc. announced that the U.S. Food and Drug Administration (FDA) has approved the Company’s OraQuick In-Home HIV Test, which would be available for purchase online and at retail stores beginning in October. AIDS United interviewed Ace Robinson of Gay Men’s Health Crisis (GMHC) and Joseph Interrante of Nashville CARES (Community AIDS Resources, Education and Services) about their opinions concerning FDA’s approval of the first and only rapid over-the-counter (OTC) HIV test.
AIDS United Policy Update: What are the benefits and challenges you foresee following the FDA’s approval of the OraQuick In-Home HIV Test?
Ace Robinson: The FDA’s approval of Over-the-Counter (OTC) HIV test kits is a step forward in the battle against HIV. This additional instrument in the HIV Prevention tool chest will help reduce a barrier to testing for some individuals. The CDC estimates about 20-25% of HIV-positive people in the United States are unaware of their status. Additionally, qualitative studies have confirmed what we already assumed: that people who are aware of their HIV-positive status adapt their behavior to lower their risk of infecting other people upon learning their status.
Some people will avoid being tested for HIV for a variety of reasons:
- Being seen in the clinic
- Shame after detailing risk behavior
- Accessibility due to location and/or opening hours (especially for non-urban dwellers)
These hindrances, and other factors, will be reduced with OTC testing for the general population. However, the overarching fear is that people who test positive for HIV will not have the supportive resources and environment currently required in most states at HIV testing centers. These OTC tests also will include a help desk to immediately console and educate a newly diagnosed person as to the best follow-up to immediately improve the health outcomes, both for themselves and also their activity partners. The fear of OTC home test kits, e.g. hormone pregnancy tests, leading to immediate rash and unhealthy behavior has been great historically dispelled over time.
Joseph Interrante: The in-home HIV Test increases available resources for testing and has the potential for helping to “normalize” and 
de-stigmatize the process of testing for individuals. I suspect that a significant segment of those who use the in-home test will be people who, for a variety of reasons, do not and will not come in for face-to-face testing. (We’ll have to see if carrying an HIV test kit up to the counter at your local pharmacy doesn’t pose as great a barrier, given the stigma that sometimes accompanies the very process of asking/going for a test. As/if we get reports of people being treated poorly or prejudicially, advocates and educators will want to be prepared to intervene.) So the in-home test increases access along with other initiatives like face-to-face testing through pharmacies in rural communities.
But this underscores the greatest challenge to in-home testing, which is ensuring linkage to care for those who test HIV-positive. In a face-to-face HIV test (at least the way we do it at Nashville CARES), personal follow up and linkage occurs immediately at the time of the preliminary positive test result. While a web site and a toll-free hotline to provide both education and referral information will be available in connection with the Orasure Test Kit, these strategies have in the past proven far less successful in helping people get into care than face-to-face support from an actual specialist, both during and after that traumatic moment when you discover you are HIV-infected—no matter how well prepared you may think you are for such a result. Will the same fears and concerns that deter people from face-to-face testing also deter them from seeking the care that makes knowledge of HIV infection meaningful? That is one of my main concerns, one with implications for both treatment and prevention.
We also need to ensure that information and education is available widely about HIV testing and what a single test result may and may not tell you about whether you are infected, much less whether you are at risk for HIV infection. Many of the limitations to the in-home test are the same as those for HIV testing offered in any context, such as the so-called “window period” for antibody development. There may be additional limitations to the in-home test due either to the technology or to user error. (I am concerned by the reported 8% error rate in negative test results, if that in fact proves to be the case.) Linkage to care could also be enhanced by having local resources for education and support distributed along with test kits at point of sale, though how we implement that without creating additional, excessive burdens on already strapped local organizations is unclear.
As with any technology, there is also the potential for misuse. For example, private purchase of test kits makes possible the forced testing of women, minors or gay men in relationships of powerlessness without their consent in order to use HIV-positive status to perpetuate (or initiate) the exercise of power, control, and/or abuse. Potential for misuse should not in itself be a reason not to have the technology available, of course, but we need to recognize that potential and be prepared to address it and even prevent it—probably through collaboration with groups whose primary mission is domestic violence and/or sexual abuse, and making sure that our own educators and service providers are educated about these benefits and challenges.
AUPU: What impact would the availability of the OraQuick In-Home HIV Test have on HIV prevention efforts? Do you think physicians and other health care providers would recommend the use of OraQuick HIV Test in your region?
Ace Robinson: OTC HIV testing will help HIV prevention efforts on two fronts. It will lead to greater accessibility to testing and also will reduce the burden of cost for HIV testing at clinics. Insomuch, the scarce resources available for HIV prevention can be redirected to other HIV/STI preventative initiatives.
Yes, healthcare providers in NYC have historically led in the incorporation of HIV Prevention and Intervention measures that increase a person’s autonomy over their personal health.
Joseph Interrante: I don’t think that it will lead to any meaningful reduction in targeted testing and counseling or broad-based screening in clinical settings, to the extent that those activities are focused (like ours at Nashville CARES) on poor and marginalized populations. Frankly, this test is not an affordable option for poor people.
There is a possibility, maybe even likelihood, that (repeated) personal testing could be used by some individuals at high risk as a substitute for other prevention measures like condom use. (I’m reminded here of Walt Odets’ discussion of substance abuse among some purportedly HIV-negative gay men, as a pretext for rather than a cause of risky behavior.) Prevention efforts will need to address this within the broader discussions about risk-taking and why/how it occurs.
Will health care providers here in Middle Tennessee recommend use of the in-home test? Some may, hopefully within a conversation with their patients about HIV and risk reduction, though I fear that such contextual discussions will continue to be all too infrequent. I certainly hope that providers will encourage use of face-to-face HIV testing, which is free and confidential through CARES and other agencies, as the preferred option for individuals.
AUPU: What do you think the next steps are in furthering HIV prevention and more generally, confronting the HIV/AIDS epidemic?
Ace Robinson: Accessible combination therapy for HIV Prevention must be enhanced especially for populations with the highest HIV incidence. These methods must include behavioral modification and biomedical intervention. Treating HIV-negative and HIV-positive persons must not be segregated between those two arms of Prevention. The first and foremost challenge to confronting HIV/AIDS is education. People must know the basics to HIV infection, increased susceptibility and available care and how to quickly access care, if necessary. While AIDS ravaged many urban cities, it was brought under control due to massive education and treatment advances. Unfortunately, that is no longer the case at the same level. Many youth do not learn how to best protect themselves and/or loved ones from infection.
Joseph Interrante: We need to continue to build on our recent successes in reducing the number of HIV-infected individuals who do not know they are positive and linking to care those who are positive as well as sustaining their involvement in care. There are still far too many individuals who are diagnosed concurrently with HIV and AIDS or develop AIDS within a year of testing HIV-positive. Use of strategies like social network assessment to guide our targeting of testing resources can help us ensure that we are focusing on those (sub)groups within disproportionately impacted populations where the disease burden truly is heaviest.
Treatment is prevention—we know that. The individual and public health benefits are clear. But let us not focus so narrowly on “treatment adherence” or preventing subsequent HIV transmission that we ignore other health concerns much less other social and material needs that people with HIV/AIDS have. If we really want to build and support self-management skills, a holistic approach is vital.
Important as they are, these efforts should not be accompanied by a reduction, much less abandonment, of prevention work with HIV-negative individuals at high risk. There’s enough research that has identified significant co-factors for risk that enable us to move beyond mere prevalence or incidence by race, ethnicity, gender, or sexual orientation to target these activities for greatest impact. I realize that in a flat or reduced funding environment, there is tremendous pressure to shift scarce resources to HIV-infected individuals where “results” or at least surrogate markers are more easily measured. But I think we lose much in the larger battle to end AIDS by doing so. We put ourselves in a bit of a conundrum wherein we fight (and rightly so) against stigma, and its most pernicious manifestation in HIV criminal exposure laws, on the one hand, while in practice we end up doing something that comes dangerously close to the same thing by focusing on those with HIV infection as our sole approach to preventing transmission.
As someone living with HIV, I am firmly committed personally and professionally to fighting HIV-related stigma in all its manifestations. But I wonder if we set ourselves an impossible (and somewhat naïve) goal by aiming to eliminate stigma, which is how I hear the goal articulated to an increasing degree. Maybe it’s my Catholic upbringing, but I often think that trying to eliminate stigma is like playing “whack-a-mole” (or trying to argue with an AIDS denialist if you prefer a more relevant analogy). We’ll be far more successful working to make sure that stigma presents no barrier to prevention, testing or care for those who need them.
Finally, prevention depends on effective and responsible public policy. That means advocating for comprehensive and inclusive sex education (especially for young people). It also means advocating for comprehensive strategies to address injection and other forms of substance abuse, including syringe exchange and other harm reduction as well as more traditional abstinence-based strategies. I’ve already mentioned HIV criminal exposure laws and the need to advocate for repeal or at least for an end to their application. These are truly policy challenges in much of the south, but policies and practices to which we at CARES and many of our sister organizations are fully committed.
Ace Robinson is the Managing Director of Community Health & Research, Public Policy, and Advocacy at Gay Men’s Health Crisis (GMHC). Ace is a specialist in HIV prevention with a diverse array of experience taken from his work in Senegal, South Africa, Chicago, Los Angeles, Haiti, and New York City. He worked on HIV vaccine design and harm-reduction programs in Africa; led strategic structural-change initiatives on HIV with faith-based leaders, CBOs, and elected officials in Chicago; and directed infectious disease programs in Haiti. Ace also served as the AIDS Prevention Unit Director at the David Geffen School of Medicine at UCLA and recently has been working as an advisor to the International AIDS Society and Black AIDS Institute.
Joseph Interrante is Chief Executive Officer (CEO) of Nashville CARES (Community AIDS Resources, Education and Services), the oldest and largest AIDS services organization in Tennessee. On an annual basis, Nashville CARES provides HIV prevention education, testing and linkage to care, and social services support to 60,000 Middle Tennessee adults and youth. He joined the staff of CARES in May of 1994.
Interrante received his B.A. from Brown University in 1974 and his Ph.D. from Harvard University in 1983, and has taught at Harvard University and Oberlin College. In the mid 1980s he moved from academics to nonprofit work with the AIDS Action Committee of Boston MA and later the AIDS Taskforce of Cleveland OH. In the early 1990s, he was a member of the Education Advisory Committee for the American Foundation for AIDS Research (AmFAR) and the Citizen’s Committee on HIV/AIDS for Greater Cleveland. More recently, he has served on the boards of the Center for Nonprofit Management and the AIDS Action Council of Washington DC and as a community advisor to the National Quality Center for HIV/AIDS. Currently Interrante is a member of the Public Policy Committee of AIDS United, the Board of the Southern AIDS Coalition and the Greater Nashville Ryan White HIV/AIDS Planning Council. In 2005, Interrante was recognized as Nonprofit CEO of the Year by the Middle Tennessee Association of Nonprofit Executives and in 2006 as Public Citizen of the Year by the Tennessee Chapter of the National Association of Social Workers. He is a 2005 graduate of Leadership Nashville. Interrante has been an AIDS caregiver and has been living with HIV infection for more than 27 years.
To read the FDA’s consumer update about the approval of OraQuick, click here.
To read AIDS United’s written testimony to the FDA in support of the approval of OraQuick, click here.
Finding Common Ground With Lawmakers, Law Enforcement, Substance Users and the Community
July 9, 2012 in Harm Reduction, Policy/Advocacy
by Tessie Castillo, NC Harm Reduction Coalition
It’s not every day that law enforcement and active drug users agree on something, or that Democratic and Republican politicians find common ground. But on Tuesday, June 12th, the Summit on Law Enforcement Safety and Drug Policy forged unlikely collaborations on issues of law enforcement safety in North Carolina. During the event, law enforcement, civil servants, academics, public health workers and concerned community members discussed various topics affecting law enforcement, including the importance of preventing needle-stick injuries to officers and the community, the need to include law enforcement to address the epidemic of prescription drug overdose, and reducing recidivism among prison populations.
Preventing Needle-Sticks to Law Enforcement
The Summit was held at the legislative auditorium in downtown Raleigh. During the first panel of the morning, former officer Jen Earls spoke articulately about her first needle-stick as a rookie cop in Chicago. “Getting stuck by a needle was one of the scariest moments of my career,” said Earls. “I pulled over a woman driving a posh Lexus in a rough neighborhood. She told me her driver’s license was in her purse and when I put my hand in, I got stuck on a needle. I didn’t know what to do and didn’t want to make a big deal out of it because no rookie wants that kind of attention. So I put a band-aid on it and went on with work.”
Conference participants, including Republican Representative Glen Bradley, Democratic Representative Dianne Parfitt, Jon Sanders of the Jon Locke Foundation (a conservative think-tank), and several members of law enforcement, articulated the need for syringe decriminalization laws in North Carolina. Syringe decriminalization would allow residents, whether the state’s 680,000 diabetics or 25,000 urban injection drug users, to carry clean syringes without fear of arrest. Current N.C. laws, which categorize syringe possession as a Class A misdemeanor, discourage people from declaring syringes to an officer during a search and result in 1 in 3 officers receiving a needle-stick during their careers, with 28% receiving multiple sticks. Syringe decriminalization has been shown to reduce the incidence of needle-sticks to officers by 66%, as well as to reduce HIV and hepatitis transmission in communities where it has been enacted.
“Representative Bradley and I are usually on opposite ends of the political spectrum,” said Representative Parfitt during the Summit, “But we are in 100% agreement on this issue [of syringe decriminalization]. I think the will is there and we will look at a way to make this happen.”
“I believe a combination of harm reduction programs and syringe decriminalization will make a vast difference in the lives of law enforcement officers,” explained former officer Earls. “I think officers need to know how to safely handle paraphernalia and needles. They need to know when to wear gloves and when to take extra precautions.”
“There are many costs associated with needle-sticks, such as the lifetime costs of HIV and hepatitis infections that are born by taxpayers for people without insurance,” said Jon Sanders of the John Locke Foundation. “Even diabetics who live in a bad neighborhood are afraid to carry their own needles and they put their own health and the health of law enforcement at risk. Syringe decriminalization is a low cost measure that will lower health costs and raise public health, and for those reasons I support it.”
Reducing Recidivism
Following the needle-stick panel, Republican Representatives Leo Daughtry and John Faircloth, as well as Democratic Senator Ed Jones, led a discussion on the need to reduce recidivism rates in North Carolina, which have climbed to nearly 40% for adults in recent years. The legislators championed the Justice Reinvestment Act, passed by the NC General Assembly in spring 2012, which aims to reduce recidivism by allowing parole officers to intervene more quickly to discipline parole violators instead of waiting months while the case lags in the courts and the negative activity continues. “The Justice Reinvestment Act is about taking money that goes into prisons and putting it into rehabilitating people,” explained Representative Daughtry.
“Communities will be safer, law enforcement will be safer, if there are more efforts directed towards opportunities to find housing and jobs [for ex-offenders],” said retired officer Ronald Martin.
“When I started [in law enforcement] 35 years ago I had the idea that we should lock up everybody and throw away the key,” said Senator Jones. “I know now that we can’t do business that way…we have to think about people as being a part of society and not remove them from society…I would ask you to make every effort to see that these [ex-offenders] have a decent starting life when they get out.”
The Representatives spoke alongside Dennis Gaddy, Executive Director of the Community Success Initiative, Bill Rowe, General Counsel and Director of Advocacy at the NC Justice Center, and Jon Sanders of the John Locke Foundation.
Utilizing Law Enforcement to Decrease Overdose Deaths
The final Summit panel addressed law enforcement’s roll in reducing the epidemic of drug overdose deaths. Overdose death from prescription painkillers has recently passed motor vehicle fatalities as the number one cause of accidental death in the United States. North Carolina suffered over 1000 overdose deaths last year alone, mostly from opiate painkillers. Research shows that most people overdose in the presence of another person. However, current laws discourage witnesses to an overdose from calling 911 for fear of drug possession charges. Consequently, many witnesses wait too long to call emergency services, or don’t call at all, often resulting in the death of the person who has overdosed.
Some police departments around the country have begun requiring their officers to carry Narcan, a drug that reverses fatal overdoses. As police are often first to arrive at emergency scenes, especially in rural areas where ambulance arrivals are delayed, law enforcement officers have a unique opportunity to save lives with Narcan.
Lieutenant Detective Pat Glynn, champion of a Narcan program at the Quincy police department in Massachusetts, joined the Summit to discuss the success of the Quincy program.
“A couple years ago we had 47 overdose deaths in Quincy over an 18 month period,” said Lt Det. Glynn. “After we started the Narcan program, from October 2010 to June 2012 overdose deaths dropped to 16, and our officers conducted 90 successful overdose reversals with Narcan…We had a family member feel so comfortable [with police using Narcan] that they pulled up to the parking lot of the police station, knocked on the door and the police were able to come out with Narcan and save the individual’s life. It’s refreshing to see people coming to us and looking at [law enforcement] in a different light.”
In addition to Narcan programs, legislators participating in the Summit discussed 911 Good Samaritan laws, which would grant amnesty to witnesses to an overdose who call emergency services to save a person’s life.
Representative Parfitt offered a personal perspective on overdose. “At one point my 85 year old aunt was admitted to Duke with a drug overdose from Valium…we have to overcome the idea that [drug overdoses happen to] other people, not us…a lot of people are affected because someone inappropriately uses drugs…there are some simple solutions and one thing we can do here is look at the 911 Good Samaritan bill.”
“There is a larger problem with prescription drugs in America than there is with illegal drugs,” said Representative Bradley. “We have here potential programs to help reduce the rate of overdose and death… and one is immunity for emergency 911 calls, the medical amnesty program, and another is the Narcan program to keep Narcan in vehicles so we can respond right away.”
“The Good Samaritan laws and Narcan programs honor life…this is an issue that unites people across the political spectrum and I find that personally refreshing,” said Jon Sanders of the John Locke Foundation.
Comments on the Summit from Participants
“I thought [the Summit] was fantastic. [We] had a great cross section of people from different professional groups, which was really important. The only thing [we] needed was some people who were really not believers so we can hear them and ask what their problems are… I need to find out what is standing in the way, what those road blocks are.”
– Representative Dianne Parfitt, (D)
“[Last year] I said we needed to reach out more to law enforcement [on syringe decriminalization], and that has been done. The foundation is now really solid to walk up to groups who can really make [syringe decriminalization] happen in the legislature, the Sheriffs Association for example, or the Police Benevolence Association… if you get these groups on board not only will you get legislation passed, but you will get it passed overwhelmingly.”
– Representative Glen Bradley, (R)
“I thought it was a remarkable event and a tribute to NCHRC that [they] were able to pull this off. I wish every state would do this. It’s good to raise awareness with legislators and let them know what is going on.”
– Leigh Maddox, retired Captain of Maryland State Police
“If I had had a chance to work with the guys like [Lt Det Glynn], I might have stuck around [the force] longer…nobody is talking about [these law enforcement issues]. It almost has to come from the top down. A lieutenant needs to bring it up and say, here is what we are going to do.”
– Jen Earls, retired Chicago police officer
“There is really no down side to [adopting these measures].”
– Ronald Martin, retired law enforcement detective from the New York police department
“I really enjoyed the forum today, and I learned a lot. [The Summit] will help build agency collaboration on issues we have been fighting for over the last 3-4 yrs at the legislature.”
– Dennis Gaddy, Executive Director of Community Success Initiative
On the Scene of a Historic Health Care Victory
June 29, 2012 in Policy/Advocacy
by Tran Doan, Pedro Zamora Fellow
The first on the scene was also the least practical place to be at if I wanted to be the first to hear the Supreme Court’s decision on the Patient Protection and Affordable Care Act (ACA). Yet there I was standing outside of the Supreme Court on an oppressively hot Thursday June 28th morning with a yellow notepad and pen eagerly awaiting the ruling. Accompanying me is a political circus, and its diverse band of performers — the supporters and protestors of President’s Obama health care legislation, pro-life and pro-choice advocates, tea party and occupy movement activists, church-goers, doctors in white coats, single-payer belly dancers, numerous news media (i.e. journalists, news anchors, cameramen, photographers, bloggers), hundreds of signs plastered with clever sayings (like “Keep Your Ovaries Off My Rosaries”), and even one Obama Chia Pet — all showed up to hear the Supreme Court ruling.
Despite the diverse, often heated opinions regarding the ACA, at this moment we could all agree on one thing — that everyone, absolutely every single American citizen, has a stake in this decision. The United States does not have universal healthcare, but health itself is universal. Whether a person gets sick, requires vaccination, is involved in an accident, or is born with a pre-existing condition, every U.S. citizen has his or her own health to protect and nurture, and at some point he or she has used the nation’s health care system. Health is personal.
Take me, for example. I am a 24 year old young adult and graduate student. I grew up with a single mother and younger brother in Pittsburgh, Pennsylvania. After high school, my brother joined the U.S. Marine Corps, and has health insurance coverage through the military. When I turned 19, I was not eligible for the Pennsylvania Children’s Health Insurance Program or CHIP (which covers all uninsured children and teens in the state) any longer. As a result, my mother (a naturally anxious person who refuses to let me go without health insurance) paid out-of-pocket for “bargain basement” health insurance- that is “low-cost” monthly premium, high deductible, high co-pays, and minimum coverage of benefits. I hardly used the health plan because I did not want to pay towards the high deductible for simple preventative health services that would require ten minutes of a physician’s attention. In my opinion, the health plan does not do much to promote better health practices. Since the passage of the ACA in 2010, parents are able to enroll their children under the age of 26 onto their health plan. I enrolled right away on my mother’s health plan, saving my family $100 a month!
The ACA does not only provide peace of mind for my family, but also for millions of families. For example under the ACA, no one will be denied health coverage or charged a discriminatory premium due to a pre-existing condition (resources to additional benefits listed below). Almost every Western country believes that its government has a responsibility to protect its people. Both provisions in the World Health Organization Constitution and United Nations Universal Declaration of Human Rights (1948) believe that access to quality health services is a fundamental right of every human and nations should protect this right. Shouldn’t the United States, one of the richest and most powerful countries in the world, believe in protecting its people too?
As the 10 a.m. designated time of announcement approached, the intensity of emotions on the steps of the Supreme Court was noticeably heightened with nervousness, excitement, fear, amusement, hope, anger, and desperation. Ten minutes until 10 a.m., groups were still marching; several people were on microphones at the same time; the church-goers are singing “Amazing Grace,” and finally at 10:08 a.m., we hear a burst of cheering from one side. Which group is cheering? Which group is crying? The liberals? The conservatives? The belly dancers? Around me I hear, “My heart is beating so fast right now,” “I’m so nervous,” and “I couldn’t sleep last night.” What I cannot hear was the ruling itself. In fact, most people can’t hear! Almost everyone buried their heads into smart phones attempting to look up the results, but the internet connection was too sluggish. We were receiving conflicting rulings, mostly due to a misreporting of a certain news source. After even more minutes (that felt like hours), I felt that I was the last person to hear that the Supreme Court ruled 5-4 to uphold the Affordable Care Act. But the wait was worth it.
With a huge smile plastered on my face, I realized that I was on the scene of a historic health care victory. As I walked away, I decided to take a piece of history with me by picking up a marching sign left on the ground of the Supreme Court.
Tran Doan is a Pedro Zamora Fellow at AIDS United and graduate student at the University of Pittsburgh Graduate of Public Health.
ACA Benefits impacting families are outlined in a statement from Families USA, a non-partisan nonprofit organization dedicated to the achievement of high-quality, affordable health care for all.
ACA Benefits impacting people living with HIV/AIDS are outlined in the AIDS United Statement on the Supreme Court decision.