gov mark sanford of south carolina approves $4million new state adap funds, reducing persons there with AIDS waiting for meds from 470 to 362.

July 2nd, 2007

Across The Nation | South Carolina Gov. Sanford Approves $4M for HIV/AIDS Treatment
[Jul 02, 2007]

South Carolina Gov. Mark Sanford (R) on Wednesday approved a measure that will provide $3 million annually, as well as a one-time grant of $1 million, to provide increased access to HIV/AIDS treatment in the state, the Columbia State reports. The funds also will be used to reduce the number of people on the waiting list for the state’s AIDS Drug Assistance Program. As of June 29, the state’s ADAP waiting list stood at 362 people (Reid, Columbia State, 6/29). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals.

South Carolina has the largest ADAP waiting list nationwide. HHS in April awarded a $26.8 million grant to the state to provide HIV-positive people with increased access to treatment and care services and remove 93 people from the ADAP waiting list. According to Sens. Lindsey Graham (R-S.C.) and Jim DeMint (R-S.C.), $25.6 million will be allocated to provide low-income individuals and families in the state with access to treatment. The remaining $1.2 million will be given to three South Carolina community health centers for a variety of uses — including risk-reduction counseling and ongoing health services for HIV-positive people (Kaiser Daily HIV/AIDS Report, 5/10).

According to the State, the measure provides less than the $8 million requested by the South Carolina Department of Health and Environmental Control and HIV/AIDS advocates. Bambi Gaddist, executive director of the South Carolina HIV/AIDS Council, said that the approved amount is “monumental,” even though it is less than the $8 million requested.

By mid-June, 210 people had been removed from the ADAP waiting list with federal funds, but the ADAP receives about 25 new applications weekly. The health department expects to receive additional federal funds in August, the State reports.

The South Carolina HIV/AIDS Care Crisis Task Force will meet in early July to discuss this year’s progress in curbing HIV/AIDS in the state and to set goals for next year, the State reports. The task force plans to collect data on the effect HIV/AIDS has on hospital systems in the state, particularly in rural areas, and to help lawmakers understand the virus’ impact in the state. The funds are part of the state budget, which became law on Sunday (Columbia State, 6/28).

rahul bedi reports from new delhi: millions of free condoms converted, sold as balloons, toys, construction materials

champ teleconference 7-19-07: anal carcinoma and pap screening

seth berkley, AIDS vaccine initiative: there’s “no way out of this epidemic without an AIDS vaccine”

Opinion | Development of HIV/AIDS Vaccine Crucial to Fight Against Pandemic, Letter to Editor Says
[Jun 29, 2007]

A recent Washington Post article “shed welcome light on how, despite advances in access to AIDS treatment in the developing world, the disease is overwhelming efforts to combat it,” Seth Berkley, president and CEO of the AIDS Vaccine Initiative, writes in a Post letter to the editor. However, the article “failed to explore how these facts underscore the imperative for doing everything possible to find a safe, effective vaccine for AIDS,” according to Berkley. He adds that researchers have “made significant progress addressing the scientific challenges to designing an AIDS vaccine” and that more than “30 clinical vaccine trials are underway.” However, “more must be done to accelerate this research,” including expanding “developing-country involvement” in vaccine research and development; collaborating “creatively to deliver improved vaccine candidates” to trials; securing “sustained funding to overcome the enormous scientific” barriers; and developing “novel incentives to increase private-sector involvement in AIDS vaccine research.” Berkley concludes that the international community should “continue to build on current programs but not forget that there is no way out of this epidemic without an AIDS vaccine” (Berkley, Washington Post, 6/29).

NASTAD ADAP watch: 529 PWAs fester on HIV med waiting lists or under formulary restrictions nationwide (470 in south carolina) 6-25-07

chers—

529 persons with AIDS in Alaska, Montana, Puerto Rico and South Carolina line up to stay alive, line up on waiting lists to receive life-sustaining HIV meds paid for by ADAP funds (AIDS Drug Assistance Programs), according to the ADAP Watch report issued by NASTAD (National Alliance of State and Territorial AIDS Directors) Monday, 6/25. Tuesday morning Kaisernetwork carried the story.

from my notes for an april 2, 2007 workgroup report for campaign to end aids,

karen [bates] said in south carolina, 512 hivers are currently on the waiting list to receive adap drugs there for the last 6-8 months. five hivers have died waiting. karen reports other hivers are getting themseves arrested so they can receive treatment in jail.

april 02
kearns @ aids-write: c2ea workgroup report 4-2-07 & upcoming meeting 4-16-07 (603)

it has not been possible to confirm the deaths karen reported.

but the waiting line to stay alive in the land of health & wealth & the capitol of the global war industry raises troublesome questions.

suppose tomorrow — national HIV testing day, 2007 — was wildly successful beyond our greatest deranged imaginings and we identified every one of those CDC-estimated quarter of a million persons with HIV infections in the united states.

could we treat them?

would we?

who would profit?

who profits now?

how much?

what’s too much?

who dies first?

namasté

—lyr

nastad’s press release:
Waiting Lists Continue for ADAPs;
Preliminary FY2008 Funding Levels do not Match Need
june 25, 2007

Washington, D.C. – According to NASTAD’s latest ADAP Watch, released today, a total of 529 individuals were on AIDS Drug Assistance Program (ADAP) waiting lists in four states (see attached Watch for details). Two of those states have had ADAP waiting lists for nearly two years. . . .

In the coming year, states are anticipating that ramped up testing efforts through CDC’s testing initiative will find more people in need of care. States must have the resources to provide immediate access to care and treatment to newly identified eligible HIV - positive individuals. Not everyone who tests positive will need ADAP services, but many will. In addition, three new promising antiretroviral medications will be available to help in the treatment of drug-resistant infection. ADAPs highly anticipate the arrival of these new therapies, but adding them to the formulary will be costly for the programs.

from the 6-26 kaiswenetwork report

Recent Releases | New Report on AIDS Drug Assistance Programs
[Jun 26, 2007]

“ADAP Watch,” National Alliance of State and Territorial AIDS Directors: The report found that a total of 529 people in Alaska, Montana, Puerto Rico and South Carolina were on waiting lists for AIDS Drug Assistance Programs as of May 16 (ADAP Watch, 6/25). ADAPs are federal- and state-funded programs that provide HIV/AIDS-related medications to low-income, uninsured and underinsured HIV-positive individuals (Kaiser Daily HIV/AIDS Report, 5/10).

• Alaska’s waiting list has one person,
• Montana’s has 22 people,
• Puerto Rico’s has 36 people and
• South Carolina’s has 470 people (ADAP Watch, 6/25).

The report also found that two ADAPs have adopted additional cost-containment measures to stay financially solvent. These measures include capped enrollment and formulary management, which have been instituted since April 1 (NASTAD release, 6/25). Indiana and Michigan have implemented such measures, according to the report. Kentucky reported that it anticipates having to implement new cost-containment measures during the current ADAP fiscal year, which ends on March 31, 2008 (ADAP Watch, 6/25).

According to the report, many states in FY 2007 received a significant funding increase because of new Ryan White Program funding formulas.

from ADAP watch text

In FY2007, many states did receive a significant increase in funding to their HIV primary care and support service grants (Part B base of the Ryan White Program). As a result, 12 states have indicated they will be able to enhance their programs by expanding program formularies, eliminating the need to institute a waiting list, adding additional staff members, enhancing primary health care, raising financial eligibility, increasing capacity, and removing clients from waiting lists.

ADAPs provide life-saving HIV treatments to low income, uninsured, and underinsured individuals living with HIV/AIDS in all 50 states, the District of Columbia, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, the Northern Mariana Islands, the Federated States of Micronesia, American Samoa, and the Republic of the Marshall Islands. Since the advent of highly active antiretroviral therapy (HAART) in 1996, AIDS deaths have declined and the number of people living with HIV/AIDS has markedly increased. ADAPs have played a critical role in making HAART more widely available.

ADAPs with Waiting Lists
(529 individuals as of May 16, 2007)

Alaska: 1 on waiting list
Montana: 22 on waiting list
Puerto Rico: 36 on waiting list
South Carolina: 470 on waiting list

ADAPs with Other Cost-containment Strategies (instituted since April 1, 2007)

Indiana: Capped enrollment
Michigan: Formulary management

Nine ADAPs also have capped enrollment for Fuzeon access and one state does not include the drug on its formulary (52 ADAPs reporting), as of May 16, 2007

Two ADAPs also have capped enrollment for Aptivus access and two states do not include the drug on their formularies (52 ADAPs reporting), as of May 16, 2007

One state does not include Prezista on its formulary (52 ADAPs reporting), as of May 16, 2007

One state does not include Atripla on its formulary (52 ADAPs reporting), as of May 16, 2007

ADAPs Anticipating New/Additional Cost-containment Measures (before March 31, 2008*)

Kentucky

• March 31, 2008 is the end of ADAP FY 2007. ADAP fiscal years begin April 1 and end March 31.

NASTAD (www.NASTAD.org) is a nonprofit national association of state health department HIV/AIDS program directors who have programmatic responsibility for administering HIV/AIDS and viral hepatitis health care, prevention, education, and supportive services programs funded by state and federal governments. To receive The ADAP Watch, please forward your e-mail address to Britten Ginsburg at bginsburg@NASTAD.org.

bryant responds to green responding

chers---

i am remiss in not having posted this on the 20^th, when i received it. i talked with larry on the phone, when he double-checked about permission to post ted’s response.

to compensate, i offer the following metaphoric anecdote.

namasté

---lyr

[winston] churchill, who considered himself a true democrat, constantly opposed granting freedom to india. In more ways than one, [mahatma] gandhi was a much greater democrat, especially in believing in self-determination of people and the universal equality of mankind. . . . [in 1931], gandhi met face to face with churchill during the indian round table conference -- "...i have an alternative that is unpleasant to you" he told churchill and his clan of imperialists. "india demands complete liberty and freedom...the same liberty that englishmen enjoy... and i want india to become a partner in the empire. i want to partner with the english people ... not merely for mutual benefit, but so that the great weight that is crushing the world to atoms may be lifted from its shoulders".

http://www.kamat.com/mmgandhi/churchill.htm

larry bryant writes:

This is very interesting... Dr. Green cites his international work (mostly in southeast Asia and Africa) constantly in framing his discussion about prevention in the states. It's not like I was the only one in the room.

The larger point that I, and others, would like to make is that this 'advisory' body needs some, um, updating. I don't doubt the experience and education of PACHA. However, again and again, stereotypical and misguided (at best - ignorant and racist at worst) ideas and statements come from members of this group. Statements like stigma due to HIV/AIDS doesn't exist, HIV infection rates would decrease if everyone practiced "normal" sex are just symptoms of a much larger problem that is not limited to PACHA. Planning Councils, CPGs, and other groups share these same perspectives when it comes to addressing the epidemic among communities of color, gay men, and beyond. It's a little more that the fact that most of these individuals don't share the same zip code as these target populations.

Trust me, I am sure that you and me have heard much worse in our HIV lives. My question is: Have we fallen so deep into an apathetic sleep that the run-of-the-mill stigma and descrimination just floats by us like exhaust fumes on the street? We just get so used to smoke and the stink that it's more of a shock when we receive fresh air?

"We need to expand the civil-rights struggle to a higher level - to the level of human rights."

- Malcom X

Larry Bryant, National Field Organizer
Housingworks - Advocacy & Organizing
925 15th Street 2nd Floor, NW
Washington, D.C. 20005
(202)408-0305 office
(202)408-1142 fax
(202)419-9810 cell

2007 Youth Action Institute - Raleigh, North Carolina Go to www.campaigntoendaids.org <http://www.campaigntoendaids.org/> for information and to register or call 1 877 END AIDS (363 2437)

[RECTALMICRO] LUBRICANT SURVEY: JULY DEADLINE APPROACHES!

chers---

thought i’d pass this along. jim pickett, from the aids foundation in chicago, posted a lot of interesting stuff on the TimeToDeliver site at the toronto AIDS conference.

namasté

---rk

------ Forwarded Message
From: Jim Pickett <JPickett@aidschicago.org>
Reply-To: Jim Pickett <JPickett@aidschicago.org>
Date: Tue, 19 Jun 2007 14:12:11 -0500
To: LISTSERV.CRITPATH.ORG>
Conversation: LUBRICANT SURVEY: JULY DEADLINE APPROACHES!
Subject: [RECTALMICRO] LUBRICANT SURVEY: JULY DEADLINE APPROACHES!

IRMWG members ---- many of you have taken the survey, and perhaps there are those who have not yet. Please take a minute or two to either forward the survey on to friends and listservs... or take the survey yourself and then forward it on! You can use the blurb below in your emails to people. We have had incredible response to this survey - over 4500 have already completed it - and want to really increase our numbers before we close it out in July.

Thanks,

Jim

---------------------------------------------------------------------

LUBRICANT SURVEY: JULY DEADLINE APPROACHES!

Please participate in an important survey on lubricants used for anal sex before it closes on July 31! It takes less than 10 minutes to complete. Join the 4,500 women and men from 89 countries who have already participated!

Visit http://www.irmwg.org org>

WHY? Right now, lubricants do not need to be tested for safety before being sold. Some lubes commonly used for anal sex may not be as safe as others. By filling out the short survey, you will help scientists prioritize the next round of lubes that should be tested. Also, you will be giving valuable insights to researchers working on a new prevention technology called rectal microbicides.

HOW? On the homepage of the International Rectal Microbicide Working Group http://www.irmwg.org there is a link to the survey in English, French, Spanish, Portuguese, German and Turkish!

WHO ARE WE? The International Rectal Microbicides Working Group (IRMWG) is a group of community advocates and researchers from 35 countries who are working to increase options for the prevention of HIV and sexually transmitted infections for the men and women around the world who have anal sex.

Please complete the survey today! Post a link on your web site! Forward this message to listservs!

Check out the new gay/bi men's sexual health and wellness website from the Sexual Health Xchange - www.LifeLube.org .org/> .


Jim Pickett
Director of Public Policy
AIDS Foundation of Chicago
411 South Wells Street Suite 300
Chicago, IL 60607
(312) 334-0920 - direct
(773) 600-6407 - mobile voice/text
(312) 922-2916 - fax
www.aidschicago.org

green responds to bryant about pacha: a different story

chers---

acz contacted dr. green and obtained the following response to larry bryant’s (info@campaigntoendaids.org 877-ENDAIDS) 6-15 press release that demanded an apology after a meeting with the Presidential Advisory Council on HIV/AIDS (PACHA).

dialogs are hard work. what else can be said here?

namasté

---rk

From: EGreendc@aol.com [mailto:EGreendc@aol.com]
Sent: Monday, June 18, 2007 11:55 AM

. . . I didn't say what they claim. I did say that Africans are unfairly accused of being "promiscuous" and that this is plain not true. The people who wrote the attack must really look down on Africans to project the idea that African-Americans must be outraged to be somehow associated with backward Africans, or whatever was in the minds of those at the gay website. They sure need to examine their views about Africans!

The record will show that the last item of the 2nd day was Dr Benny Primm, the most senior and most respected African-American on PAHA, saying he was satisfied that Ted Green would make the arguments for PEPFAR paying more attention to AIDS in the Caribbean (an issue Benny and I have been on together for a couple of years) . I have had only the best of relations with all Black members of PACHA--more than with Whites!

It was also Benny who brought up the statistic that more African Americans than whites are in jail, proportionately. However, I wish Frank Judson had not said this was "because Blacks commit more crimes," because that just opens a big emotional issue that can be attacked with reference to unfair sentencing practices..

I can't remember if I cc-e you on my letter to the editor, but here it is

cheers,

Ted

Edward C Green, PhD
Harvard Center for Population and Development Studies

Dear Advocate

I hope you will allow me to respond to an article that misrepresents discussion at the recent PACHA meeting (I am a member of the International Committee). The Washington Blade gave me equal time a couple of years ago, after a well-meaning but misguided activist tried to identify me with "Abstinence-only." I hope you will afford me the same courtesy.

Let me describe what actually happened at the recent meeting of PACHA. When the transcript becomes available at PACHA.gov, you will be able to see for yourself. I was asked by an African American member to explain the difference between generalized and concentrated epidemics. I did so and I hoped that the lesson would be learned that, whereas condoms have been effective in countries like Thailand and Cambodia, they have not been effective in Africa. A 2003 UNAIDS review of condom effectiveness found no examples in Africa of higher rates of condom use translating into lower levels of HIV infection, at the population level (of course, UNAIDS tried to bury this report. After all, no one want to be wrong. Still, it was published in Studies in Family Planning).

Now, western AIDS experts hate hearing these findings for any number of reasons including the fact that the condom is an icon of sexual freedom. Let me state here and now that, as I have said before, I totally support gay rights, gay marriage, women's liberation, fair drug sentencing practices (not 10 years for Blacks and 5 months for Whites for the same violation) tearing down unfair patriarchal structures and all the rest—after all, I am a lifelong leftie-- but that doesn't mean condoms are going to work to solve African AIDS. I wish I could say otherwise (my career would not have been destroyed, for one thing…).

Having fewer concurrent sexual partners is the thing that has worked in Africa. But there are no billion dollar programs behind partner reduction. No medical products get sold nor any medical services utilized (and calling this factor "Abstinence-only" is a big red herring that only prevents the truth from getting out.)

Back to PACHA: When I was next asked to translate these empirical findings from Africa to better understanding the situation of African Americans, I tried to beg off, saying that my expertise lies in Africa. I did point to several factors that have been mentioned by African American experts such as Dr. Benny Primm that might account for higher infection rates among African American men and women. I won't address comments directed at other members of PACHA but I would urge readers of this website to look at the survey and epidemiological evidence from Africa. I'm happy to discuss empirical evidence with anyone, anywhere, anytime.

You might also check out my article in the gay press:

Green, E.C., "Can we learn about AIDS from Africa? The Washington Blade. Sept. 2003.
http://washblade.com/2003/9-12/view/columns/africa.cfm

Republished in Southern Voice, Oct 2003
http://www.sovo.com/2003/9-19/view/columns/aidsles.cfm

And if you want to know the real deal about condoms in Africa, rather than the corporate
cheerleading (and I once was a major cheerleader myself) please read

Hearst, Norman and Sanny Chen, Condom Promotion for AIDS Prevention in the Developing World: Is It
Working? Studies In Family Planning 2004;35 [1 ]:39 -47)
http://www.usp.br/nepaids/condom.pdf

Edward C Green, PhD
Harvard Center for Population and Development Studies

AIDS ADVOCATES DEMAND APOLOGY FOR RACIST COMMENTS MADE BY MEMBERS OF THE PRESIDENTIAL ADVISORY COUNCIL ON HIV/AIDS

Contact: Larry Bryant, 877-ENDAIDS (877-363-2467); info@campaigntoendaids.org

Immediate action necessary to diversify council membership

Washington, D.C. June 15, 2007 — On Tuesday at the 33rd meeting of the Presidential Advisory Council on HIV/AIDS (PACHA), members of the council made egregious racially and ethnically insensitive remarks while discussing the state of the HIV/AIDS epidemic in the black community. HIV/AIDS activists, grassroots organizations, and community leaders are demanding that PACHA issue an apology that acknowledges the comments were racist and take steps to address the lack of racial diversity on the council.

During the PACHA Members Open Discussion period on the first day of a two-day open-to-the-public meeting at Washington, D.C.'s TK venue, the conversation took a surreal, but all too common turn, when Harvard researcher Edward C. Green, Ph.D., suggested that prevention research and interventions done in Africa should be utilized in America's black communities. The presumption that black people living in Africa and the U.S. are indistinguishable shocked the audience into stunned silence.

On the subject of the disproportionate incarceration rates of black men, Franklyn N. Judson, M.D., rationalized that, "there are more blacks in jail, since they commit more crimes." Judson, who last year declared that stigma "doesn't exist" for HIV positive people, ignored decades of common knowledge that black people receive disproportionately longer sentences than white people. Judson and Green's remarks are just the latest in a stream of seemingly unconscious insensitivity and ignorance involving race, ethnic background, and sexuality.

HIV/AIDS organization and grassroots leaders are raising their voices to counter the insensitivity and ignorance of the councilmember remarks. "The racial and ethnic insensitivity was deeply disturbing," says Donna Crews, director of governmental affairs at AIDS Action. "For a statement to be said for the record that `there are more blacks in jail, since they commit more crimes' disregards the sentencing disparities that have been the norm in this country for more years than anyone would care to remember."

Larry Bryant, national field organizer of Housing Works and member of the Campaign To End AIDS (C2EA), who along with Ms. Crews was present on both days of the lightly attended full Council meeting, says that "black and Latino men and women as well as youth are sorely underrepresented at a table where trying reach those communities remains a mystery." PACHA is predominantly white but is addressing an epidemic in which over 70 percent of new infections are among people of color. "The collective face of HIV/AIDS in the U.S. has changed and so should its leadership," comments Mr. Bryant

National Demand For A Change

Actions are being organized to address the comments made by the PACHA members and to ensure and elevate the cultural competency and racial sensitivity of the council. C2EA, National Minority AIDS Council (NMAC), and the National Association of People With AIDS (NAPWA) are working to develop an effective and powerful strategy to force PACHA to acknowledge the comments as racist and apologize and change the makeup of the council, How can you help?

Express your comments and concerns about the cultural and racial insensitivity of the PACHA members and demand adequately diverse representation on the council to Mary (Marty) McGeein, Executive Director, Presidential Advisory Council on HIV/AIDS; (202) 401-8005. You can also send emails to info@campaigntoendaids.org and they will be forwarded to the Mary McGeein

For more information, press only, contact Larry Bryant, 1-877-ENDAIDS (363-2467), info@campaigntoendaids.org

june international carnival of pozitivities honored by blog carnival & call for july icp contributions

navajo nation AIDS awareness

TB Testing, Treatment Should Be Linked With HIV Prevention Programs, WHO Official Says

ICP 11 up

The 11th International Carnival of the Pozitivities is up at Living in the Bonus Round, a blog I've enjoyed reading for the past year or so. A recent ACZ article is featured this month, as well as posts by my friends at Acid Reflux and DIRELAND, not to mention some first-time appearances at ICP. Check it out!

acz blast from the past: brad biggers from the suicide prevention line in louisiana, january 2005

. . . three suicide calls in 2 hours is certainly a stressful event. They all are running together in my mind right now. Let me think about if I can sort out which was which.

The first one was one of our most common kinds of suicide call: the "I just found out I have HIV and my life is over" call. These calls are not easy. Living with AIDS or HIV means completely changing your life, which is often enough to make it feel like your life is over. You also have to overcome the stigma attached to AIDS, and make the choice of if and when to tell your friends and family, and what to do about your previous partners, and how to confront the person who you think gave it to you.

It truly shakes your world from the ground up, and it's more than some people can take (although a third of Americans living with HIV or AIDS say that their quality of life actually improved following their diagnosis. Meanwhile, a third said their life was about the same, and a third said their life was worse, and the result is that sometimes an HIV diagnosis makes people want to kill themselves. Many of those who do end up calling us.

My second one for the day was an uncommon one. The young woman who called us did not have any sort of AIDS related concern. Her husband had died three years ago, and her only child died in a car crash while driving home from spending Thanksgiving dinner with the caller. Basically she called us because when she opened up her phone book, she saw the words "trained counselors" next to our number, and so she called. It was my first non-AIDS related suicide call since I stopped volunteering at the suicide hotline, but Brianna told me she had taken two or three calls like that before.

The final call was by far the hardest. The caller was first diagnosed with HIV in 1984, and progressed to full blown AIDS in 1987. Back then he lived in New York, where he became active in HIV outreach among other young gay males. Many of his HIV positive friends did the same, however the last of them died in 1995, at which point he left New York for Louisiana, hoping to make a difference here. He became the associate director of an AIDS service organization in Shreveport before quitting to found his own clinic in a rural area with a disproportionate number of low income people with AIDS.

His health took a turn for the worse this past spring, 19 years after he was first infected with HIV. His temporary leave of absence from work soon became a permanent one, and he went under the care of his local hospice on November first.

For those of you who aren't familiar with hospice programs, they are set up to aid victims of terminal illness when they have less than a year to live. The ones I've had experience with are wonderful, caring organizations that make a tremendous difference to the patients they serve. Unfortunately, going into hospice care made my caller feel like his struggle with AIDS was nearing an end, and that he was tired of fighting. He was prepared to down a bottle of pain pills and wash it down with whiskey. Fortunately he did not. After 45 minutes on the phone with him, he agreed to call the hospice and let them know how he was feeling, and to call us back if he couldn't reach them or if he needed someone to talk to again. By that time my day was over, and I was ready to stop answering calls.

I hope my three callers are doing okay tonight.

[brad biggers]

claire howard @ the peoria journal star: 4-parter on HIV/AIDS in our heartland

from the kaiser family network hiv/aids report April 26, 2007

http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=44512

Across The Nation | Peoria Journal Star Publishes Series of Articles on HIV/AIDS

[Apr 26, 2007]

The Peoria Journal Star recently published a four-part series on HIV/AIDS. Headlines appear below.

• "Avoiding Infection" (Howard, Peoria Journal Star, 4/23).

http://www.pjstar.com/stories/042307/TRI_BD10FCHA.025.php

The Client Advisory Board at Heart of Illinois HIV/AIDS Center is a club no one should want to join.

"When you join this club, you don't ever get out for the rest of your life," said a CAB member in his early 50s. "Some people want to feel part of a group. I'd say to them 'choose another group.' If I had the chance, I would."

Members of CAB are the HIV-positive patients treated at the center.

Another CAB member, Christina Henry, has devised a six-point checklist to keep people out of the club. Her points address all prospective inductees.

No. 1 on the list: Condoms.

No. 2 on the list: Education

No. 3 on the list: Needles

No. 4 on the list: Testing

No. 5 on the list: Know your partner's status

No. 6 on the list: Vaccine

• "Devastated Families" (Howard, Peoria Journal Star, 4/24).

http://www.pjstar.com/stories/042407/TRI_BCVCRL1D.027.php

For more than 300 days, Michael Fleming was a regular visitor at Knox County Nursing Home, seeing his mother who was in the final stages of Alzheimer's and his "baby girl" who was battling HIV/AIDS and related brain cancer.

His mother died, and his daughter, Nicole Fleming, 30, came home after 11 months. She's lost her hair, which once fell to the center of her back. She still fingers the scar on the right side of her head where surgeons sawed into her skull to remove cancerous brain lesions.

Michael Fleming's younger brother died of HIV/AIDS . . . alone, without family with him.

Fleming recognizes his family's luck and vulnerability in the fight against HIV/AIDS.

The Flemings trace their lineage to the first black family settling in Galesburg in the mid-1850s. There was a Fleming living on Mulberry Street for 150 years. Only tangentially did HIV/AIDS first insinuate itself into their lives. Then, over the past decade, the grip tightened on this and other African-American families nationwide.

• "Silent Treatment" (Howard, Peoria Journal Star, 4/25).

http://www.pjstar.com/stories/042507/TRI_BD1JDPAD.025.php

Lisa Roeder's office bulges with documentation and looks like the work environment of any busy professional . . . except for one tell-tale indicator.

There is a handmade ceramic bowl filled with condoms on her desk, a practical and symbolic reminder of her fierce conviction that people have the right to truth and complete information regarding the spread of HIV/AIDS.

"We get 18- and 19-year-olds who learn they are HIV positive. That means they were HIV positive in high school," said Roeder, social services coordinator at the Heart of Illinois HIV/AIDS Center. "It's devastating for them. We hear them say time and again, 'I just didn't know.' It's heartbreaking. We have counselors and grief therapists to help them."

• "'Those Other People'" (Howard, Peoria Journal Star, 4/22).

http://www.pjstar.com/stories/042207/TRI_BD08IABN.027.php

[Christina] Henry, 51, has her own mission. She received her HIV diagnosis at the Peoria City/County Health Department on her birthday in 2003. She prepared to die. She worried about who would care for her grandson. But as the people and resources dedicated to HIV/AIDS in central Illinois found her, she developed resolve. She decided to look at her diagnosis as a gift.

"To try to eliminate TOPS ... 'Those Other People' syndrome," she said.

laurie garrett @ us council on foreign relations speaks to senate subcommittee 4-18-07

laurie garrett : "health systems are the key. Those targeted programs, such as PEPFAR (the President’s Emergency Plan for AIDS Relief), are terrific, but without functioning public health and medical systems in place, PEPFAR and its like are just big band-aids that barely cover gaping wounds."


excerpt from garrett's statement:

Treatment, yes: But not without prevention

Let me give you an example. About a year ago I was in a small town in Haiti. The people in this town were overwhelmed with infectious diseases. Their illnesses swamped the beleaguered clinics, where long lines of mothers and children stood in the tropical sun for hours on end, waiting to see a doctor. The children’s growth was stunted; mothers couldn’t produce enough milk to feed their babies; long-infected teenagers fought to keep their eyes open in class. In the parking lot of the town’s main hospital sat two rusted-out, broken USAID jeeps, the American insignias clearly evident. Though American charities were helping to subsidize the medical training and services in the hospital, nobody --- no Haitian government agency and no foreign donor, looked at this town and asked the obvious question: “Why are so many people sick with dysentery, typhoid fever, and intestinal problems? Why are so many children in this town dying before they hit their fifth birthdays?”

The answer: Water. The colonial-era water filtration and pumping system had long ago broken down. For about $200,000 the system could be fixed, children would drink safe water, and the disease and death rate would plummet. But no donor chose to take on that water problem. Instead, at the cost of far more lives, and dollars, the donors – including USAID – funded treatment of entirely preventable diseases, and supported the operation of a very busy morgue.

The emphasis my colleagues placed on maternal and child health is wise. What is killing babies and toddlers? The lack of essential public health services: clean water, mosquito control, basic nutrition, healthy moms.

What is killing their moms? The lack of medical systems: No safe C-sections, no sterile equipment for episiotomies, no prenatal care.

Public health systems keep babies and children alive. Medical delivery systems keep their moms alive.

Systems: Not individual, disease-specific programs – health systems are the key. Those targeted programs, such as PEPFAR (the President’s Emergency Plan for AIDS Relief), are terrific, but without functioning public health and medical systems in place, PEPFAR and its like are just big band-aids that barely cover gaping wounds.

We – Americans and the wealthy world, generally – have given, and given, and given for decades. Yet the gap between longest and shortest lived societies has widened, now a full five decades long. And despite mountains of foreign aid from the OECD nations, basic health markers such as life expectancy and child survival have barely budged over the last 60 years in any sub-Saharan African country – except, thanks to HIV, to go backwards in a few.

http://www.blogs.opc.on.ca/?p=111

Prepared Statement Before the Senate Subcommittee on State, Foreign Operations and Related Programs:

http://www.cfr.org/publication/13130/

canadian HIV/Aids activist june callwood dies at 82

Activist Callwood dies at 82

Catherine Dunphy and Debra Black
toronto star Staff Reporters
Apr 14, 2007 09:32 AM

http://www.thestar.com/News/article/203138

“I’m okay, I’m 82 years old for heaven’s sake. Dust to dust is the way it ought to be. The death of the young is inexcusable.”

During one of her last visits to Casey House, the AIDS hospice she helped found that is named after her late son, June Callwood noticed that the place felt tired and that there was a 60-watt bulb in the ceiling of the lounge. No one could sit there and read under that light, she fretted.

Friends rallied, the hospice’s original interior designer was contacted, and before she died Callwood saw photos of a sparkling, repainted hospice, replete with the fresh flowers Callwood believes that facility must always have because it symbolizes caring.

When she first went into the palliative care unit she glimpsed a sign limiting visitors to 10 minutes. According to friend Marg McBurney, Callwood was outraged that the visiting time was so short when people had to pay “so much” for parking.

More than 2,500 men and women from Ontario and across Canada have received palliative and supportive care at the downtown hospice.

After announcing four years ago that she had terminal cancer, Callwood continued to write and lobby and win awards, the most recent earlier in March when she was given the Writer’s Trust award for distinguished contribution. Last summer, a Toronto east end laneway was named after her.

“She’s showing all of us how to die — with caring and humour and unfaltering caring of other people,” McBurney said.

. . . Her own books include The Law is Not for Women (1976), Portrait of Canada (1981), Trial Without End (1995), the story of Charles Ssenyonga, who infected several women with AIDS, and The Man Who Lost Himself (2000).

From 1975 to ’78 Callwood hosted CBC-TV’s In Touch; more recently she interviewed people on VisionTV’s National Treasures.

Over the years, Callwood picked up numerous honours, including more than 15 honorary doctorates, the Order of Canada, Officer (1985), the Order of Ontario (1988), the Canadian News Hall of Fame (1984) and the Toronto Arts Foundation Lifetime Achievement Award (1990).

In what was billed as her last interview, on April 2 with the CBC’s George Stroumboulopoulos, Callwood talked about her life, her accomplishments, her love Trent Frayne, her husband of 63 years, and her illness.

“I’m a mess,” she said during an interview for CBC’s The Hour. “My cancer is all over the place. I’m blowing up like a Goodyear blimp, which I didn’t think was supposed to happen. I thought you were supposed to get lean and beautiful.”

Guest Post: AIDS is becoming feminine - Be conscious!

The following comes from AIDS Combat Zone reader Mohammad Khairul Alam, Executive Director of Rainbow Nari O Shishu Kallyan Foundation in Dhaka, Bangladesh. You can see other posts by Mr. Alam at his blog.

Lately, More than half of all new HIV infections occur in women between the ages of 15 to 24 years. The impact of HIV/AIDS on women and girls is particularly acute. In many developing or poor countries, women are often economically, culturally and socially disadvantaged and lack equal access to treatment, financial support and education. In a number of societies, women are mistakenly perceived as the main transmitters of sexually transmitted diseases (STDs). Together with traditional beliefs about sex, blood and the transmission of other diseases, these beliefs provide a basis for the further stigmatization of women within the context of HIV/AIDS.

AIDS is a deadly disease, but also everybody can safe from it by gathering knowledge. While men generally have more access to information on sexual issues than women, some cultural barrier, the sexual knowledge for adolescent girls are often overlooked. Recent survey in Bangladesh by Rainbow Nari O Shishu Kallyan Foundation & L.R.B Foundation has shown that while provide HIV information with discussions of safe-sex or gender issue may be discouraged for young girls and women because of the ordinary belief that to inform them about sexuality and safe-sex is to encourage sexual activity. Even though that for fear of encouraging sexual activity, mothers deny imperative information about sexual-live, safe sex, reproductive health information from their daughters.

Bangladesh is a poor country. Not all Adolescent girls are fortunate enough to attend school. This might be for one of a variety of reasons. In some areas, it is needed to pay for schooling, and poor parents may be unable to afford to send a child to school, or may be unable to send all their children to school. Sometimes children will be required to work. In some locations, young people may live in areas where a local school is not accessible. In some circumstances, young people may have been excluded from school for reasons that might be due to the young person’s behaviour, academic or intellectual abilities, or due to discrimination. These young girls are especially vulnerable and neglected, coming under the purview of government programs only once they are pregnant- the majority is out of school and are neither serviced by educational or school health programs nor by child health, reproductive health and nutrition services.

The developing world is now bearing the full brunt of the HIV/AIDS epidemic. Gender discrimination, less jobs opportunity, women's rights and limited access to financial resources of women are more likely to become economically dependent on men, relegated to the subsistence sector or forced into commercial sex work. Men are also beginning to seek younger sexual partners believing that these girls are less likely to be infected with HIV. Young girls are vulnerable to coerced sex, including rape and other sexual abuse - within and outside the family - and forced sex work. Any non-consensual or coerced penetrative sex can carry an increased risk of HIV transmission, particularly as men are not likely to use condoms in these situations. The majority infections take place in infants or young children, adolescent and sexually active adults.

Safe-sex knowledge is an important part of effective HIV prevention. It is generally believed that it enables people to acquire knowledge and develop skills which they can use to protect and promote their sexual health through minimizing the risks that they might face in the course of their sexual experiences. We should being informed them about the facts and the dangers of HIV/AIDS enables young people to protect themselves and is a crucial tool in the battle against HIV/AIDS. There is no cure or vaccine for HIV/AIDS, so prevention is the only method in which we can place any limits on the epidemic. One of the most economical and effective means of HIV prevention is education – involving young people themselves in the HIV prevention effort.

References: UNAIDS, World Bank, STD network, LRB report 2006

“A-A-A-A-AIDS," he said

sunday night, april 8, 2007 los angeles [dateline]

just got home from an unusual encounter at a los angeles-area medical cannabis dispensary where i spend time as an AIDS activist & a mmj (medical marijuana) advocate & a poet.

“johnnie,” a clinic patient with whom i’ve been talking for months now, told me tonight he has AIDS instead of leukemia. “not HIV,” he tells me. “AIDS.’

he could barely get the word out of his mouth for all his fear: “A-A-A-A-AIDS.”

suddenly, the two of us are at the beginning of a long dialog. here is someone who has asked me, and whom i know how to help.

“A-A-A-A-AIDS.”

how close did he come to saying nothing --- to me or anyone --- again tonight?

“A-A-A-A-AIDS.”

why did he pick tonight to speak? what did it take to speak?

“A-A-A-A-AIDS.”

johnnie lives on the street today. he says he’s in his thirties. he says he’s bisexual. he says he has two kids to whom he no longer has access. he says he “got away” with telling his family he had leukemia because he had an uncle who had it and died from it.

“really?” i ask.

we look at each other, and neither of us says “A-A-A-A-AIDS.”

johnnie gives me a confirmation about my work in the dispensaries here. i seem to be in the right place. it is a confirmation that saddens me. johnnie also breaks my heart.

i can’t post this among my regular notes, on my regular site. it’s an unfinished conversation as far as johnnie is concerned.

but the post isn’t about johnnie.

i feel a need to mark the moment as significant for me.

over the next weeks, i will work with johnnie to access the system i’ve learned my way around over the last twenty years. it is a relief to be able to help him out. PWAs in los angeles have access to a huge infrastructure of resources and services that persons with other diseases don’t have. PWAs and HIVers stand on the shoulders of others.

people with cancer, with chronic pain, or veterans even, don’t have what we have worked to build. (& there was a fire two weeks ago at the westside free clinic, so that’s the first option for everyone else down for the season.)

my aim is to share by metaphhor.

& i will always remember the way johnnie said it, repeating it several times during our conversation, wrestling with it each time:

“A-A-A-A-AIDS. i have A-A-A-A-AIDS.”

courage and shame in the same breath. triumph.

namasté

---lyr

acz chers---

thank you for the welcome. i look forward to the opportunity to be of service, and to act in support of brad & whitney's service in the peace corps in africa.

roy peter clark at the poynter institute characterizes journalism as a conversation, a culturally democratic and primarily american conversation. i look forward to our conversations that will follow.

(will have to learn labels as i go along)

---lyr

New ACZ Contributor - Richard Kearns

The AIDS Combat Zone family continues to grow. Fellow blogger, activist, poet, and ACZ friend Richard Kearns of AIDS-Write.org has offered to help keep the posts flowing during my time in Africa. Richard is a long-term AIDS survivor with an inside view of West-Coast AIDS issues, with special attention to medical marijuana, PLWHA's over 50, and the Los Angeles activist scene. Richard worked with me on TimeToDeliver.org last year during the 2006 International AIDS Conference and has been an active participant in the ICP Blog Carnival. Please join Faith and me in welcoming Richard Kearns to AIDS Combat Zone!

And don't forget, AIDS Combat Zone is still looking for contributors. Please leave a comment or send an email if you're interested in participating!

PEPFAR far away from effective prevention

I'm cross-posting today with my blog. Today is the first day of Blog against Theocracy and I'm participating...obviously.

PEPFAR is the U.S. President’s Emergency Program for AIDS Relief. In May 2003, Congress approved a $15 billion dollar U.S. expenditure on HIV prevention and treatment. 3 billion is supposed to be spent on prevention programs. It is, in my opinion one of the most theocratic, far-reaching, fucked up Bush Administration policies. Here’s why:

1. Just to start with, a major tenet of PEPFAR is ABC, otherwise known as the prevention model (in other words, it's for prevention-he he.).
   
   ABC stands for Abstinence, Be faithful, when necessary use Condoms. I like to say it stands for Arrogance Beyond Credence, Absolutely Bizarre Convictions or perhaps Absurdly Bigheaded Citizens (anyway, I'm sure you can come up with some better ones)
   
   
2. This plan aims to teach people of the third world, the majority of whom do not speak English and for whom the cleverness of ABC means nothing, that in order to prevent HIV infection they must abstain from having sex, be maritally faithful or use condoms as a last resort. Of the 3 billion dollars spent, at least 33% of it MUST go to abstinence-until-marriage programs.
   
3. Here’s why this is a problem.
1. Abstinence is great if you’re into it. I’m not disparaging abstinence AT ALL. It does work. However, in context with human lives throughout the world where people:
   i. Have survival sex
   ii. Cannot deny sex to spouse in order to survive
   iii. Have cultural/religious obligation to have children
   iv. Have hormones like any other human on this planet
   it doesn't work for everyone. Duh.

Let’s take an example: Sarvati is married to Rupesh who has a good job as a truck driver. Sarvati has heard the warnings around town that many of the men who drive trucks see prostitutes but she cannot withhold sex from her husband (abstinence) and she is faithful. Some of the prevention specialists visit the truck stops to teach the ABCs but when they leave, some of the prostitutes get rid of the materials they have left because it hurts business for a while after the prevention specialists come though they do keep the condoms they have brought even though they get paid less for sex with a condom. In order to support their own families, they must get rid of the materials.

Rupesh does not visit the prostitutes though. When Rupesh is driving, he tries not to think about his wife or his home because he knows that they would be ashamed of him. Rupesh likes to have sex with men but this is culturally taboo. He is ashamed, but on the road, some of the men are like him and he doesn’t feel quite so bad. After all, he does love his wife and the sex he has when he is on the road is not the same as real sex.

When Rupesh arrives home, Sarvati asks him if he has ever visited a prostitute. He answers truthfully, no, he has not. She feels lucky that her husband is not like some of the others.

Lets take another, less complex example.

Akwe is 12 years old. She is an only child. Her parents are both living. They want her to be a teacher and they scrape all of their money together for her education. Akwe spends quite a lot of time studying because she loves learning, she wants to be a teacher and she knows how much her parents have sacrificed to send her to school. When her teacher demands sex in order to give her the passing marks she deserved, she feels she has no choice but to accept.

b. The GAO -- a non-partisan investigative arm of Congress -- analyzed the effects of the abstinence-until-marriage requirement. In the report, it found that it limited efforts to design prevention programs that actually met the needs of the local population. This was primarily the teams who had experience with HIV prevention programs.

Well, of course! You might say. Who else is getting funding except those with experience in HIV prevention? Funny you should ask. PEPFARs New Partners Initiative provides funding to community and faith-based programs for HIV prevention outreach. Ideally, partnerships would be with proven effective, evidence-based public health programs. If it was about meeting the needs of communities PEPFAR would be partnering with institutions that have technical expertise in evidence-based HIV/AIDS prevention, treatment, and care, or expertise in poverty reduction, capacity building, reducing gender inequalities, reducing stigma and discrimination, and strengthening health systems.

However, this is not the case. Some of the organizations that have received funding include:
Choose Life - a program for church laity and pastors that advertises "In this programme you will explore knowledge, attitudes and perceptions about HIV and AIDS. You will be empowered to combat HIV and AIDS through ethical and spiritual conduct. You will discover how to transform your community into an ethical community." And all this for 200 Rand - about 10 x the daily average income for an average South African.

Beyond our country, our president is forcing religious morality down the throats of people who need, more than anything, facts. He is contributing to the deaths of thousands. I urge you to ask your Representatives to support the PATHWAY Act which would remove the abstinence-until-marriage earmark that requires that 1/3 of all international HIV prevention funding be spent on abstinence-until-marriage programs and ensure that HIV prevention programs are based on scientific evidence, public health practice, and human rights concerns, not ideology.

Ultimately (this here is my POINT) - If I had kids I'd want them to be perfect. I'm sure your kids are perfect as were your parents in teaching you how to avoid sex until the rings were firmly in place. However, some kids aren't perfect. Some parents are assholes. Some parents are not in the picture, some parents have died of AIDS and some parents have sex with their children to get their rocks off. Let's allow condom distribution for them. OK?

There's a c, d and at least e but I didn't want to write an entire journal article and besides, there's a ton of information out there for the browsing. For more concise, coherent and evidence based information, go to PEPFAR Watch.

quick note

I've written a guest post over at AIDS-Write.org. Check it out

Happy birthday Elizabeth Taylor

Dear Ms. Taylor,

Happy 75th birthday! Thank you for all of your work in raising awareness of HIV disease and raising funds for care and research.

Dame Elizabeth Taylor was the first celebrity to make noise about the HIV epidemic months before Rock Hudson died 21 years ago. For this alone, she should be commended, however, she continued to press on. She did not get bored or complacent like SO MANY other celebrities. Celebrities that are either doing it to enhance their image or doing it because they care so much for "the people with the AIDS" but then they hear that PETA is having a protest and, well, they get distracted...

Dame Taylor continues, to this day to be a steadfast advocate in the fight against HIV disease and raising funds for research and care for people living with HIV.

Elizabeth Taylor has been working with amFAR and the Elizabeth Taylor AIDS Foundation for 21 years because she is angry. She is angry at the ignorance of policymakers and she has no trouble saying so. She is annoyed at the lack of sex education in schools, she is livid that injection drug users do not have access to clean needles. She is steadfast in her support and I salute her.

Thank you Elizabeth and Happy 75th!!!

An AIDS warrior gets called to the front line

As many of you know, I am a prospective volunteer in the United States Peace Corps. I applied over a year ago with the intention of joining after I finished the coursework for my Master's of Public Health degree. The application process usually only takes around 9 months, but married couples such as my wife and me are told to allow 18 months, so we applied early.

For most of the past year, we have only had vague notions of where our Peace Corps placement would take us and when we would depart. We were told early on that our most likely placement would be Africa, but that with 24 potential countries, that didn't help much. We were more fortunate than most applicants in knowing for certain that we would be given a health assignment thanks to doing my master's field experience through the Peace Corps. Nevertheless, there was much uncertainty.

After many months of waiting, our official Peace Corps invitation finally came in the mail. We now know for certain that we will be going to Kenya on May 22, 2007 to be HIV/AIDS and Hygiene volunteers. We will be living in a rural village, working closely with its residents to increase knowledge of HIV/AIDS issues, prevent waterborne and vector-borne illness, and assess other health issues so that the community can be mobilized to address them. We will be doing this until August, 2009.

As you can guess, Whitney and I are thrilled to be embarking on this journey. This marks the next big step in our lives. We're even considering staying in East Africa to live and work beyond the end of our service (by then we're very likely to be fluent in Swahili). Our future seems wide open from this point.

It had been my hope to continue blogging here at AIDS Combat Zone throughout the duration of my Peace Corps placement, but I've become aware of certain policies that will make it impractical to continue blogging here. Therefore, co-blogger Faith will be taking over my editorial duties in my absence, though I plan on continuing to be involved here via periodic "dispatch from the front line" posts which I will relay through Faith (by snail mail if necessary).

As always, your comments and contributed writings are welcome and encouraged. Additionally, we could use an extra regular contributor (or two) so if you're a good writer interested in global AIDS issues send an email our way. We'd love to have you on board!