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Courtesy AIDS United
Wondering about the Supreme Court’s decision on HIV/STD prevention and care? Some help from The National Coalition Of STD Directors:
As you consider the impact of today’s Supreme Court ruling on the Affordable Care Act on different populations, I would like to share with you the impact of today’s ruling on our fight to prevent and treat sexually transmitted diseases.
Sexually transmitted diseases (STDs) remain a major epidemic in the United States. Each year, there are approximately 19 million new cases of STDs, approximately half of which go undiagnosed and untreated[i], giving the United States the highest STD rate in the industrialized world.[ii]
STDs cost the U.S. health care system $17 billion every year—and cost individuals even more in immediate and life-long health consequences, including infertility, higher risk of acquiring HIV, and certain cancers.[iii]
HIV-specifics from Lambda Legal:
“This is a victory for all Americans, but in particular, the Court’s decision today will save the lives of many people living with HIV – as long as states do the right thing. The Affordable Care Act will finally allow people living with HIV to access medical advancements made years ago but that have so far remained out of reach of many. With continuing prevention education, early detection, and quality care for everyone living with HIV, we have the power to stem the HIV/AIDS epidemic.
“But this is not a complete victory, because today’s decision allows states to opt out of the Medicaid expansion that would provide insurance coverage for many low-income people who cannot otherwise afford it. Our continuing challenge will be to make sure that states opt to expand Medicaid so that more low-income people, and particularly those with HIV, can get the health care they urgently need.”
Related articles
In keeping with the relevance of Montana Pride- and as a precursor to HIV Testing Awareness Day June 27th, free, anonymous HIV testing will be offered Friday and Saturday during Montana Pride in the MSU Strand Union Building, just look for these signs:
From The National Association Of People With AIDS:
It’s just over two years now since we first reported the ADAP funding crisis. We thought it would be over quickly. Sad to say, we were wrong. The number of ADAP-qualifying lower-income Americans on waiting lists for the HIV drugs that would keep them healthy peaked last year at more than nine thousand before coming down to this May 31’s 2,357.
More than 90% of those now wait-listed are in five Southern states: Alabama, Florida, Georgia, Louisiana, and North Carolina. All five have legitimate state budget shortfalls. All five, however, also have increasingly serious rural HIV epidemics, and extending immediate ADAP drug assistance to everyone who qualifies would be a useful step towards slowing the spread of the virus. The additional cost to the states would be trivial in the context of their whole state budgets – eliminating state ADAP contributions altogether would not materially improve their fiscal situations, and doubling them would not make them materially worse.
Here are the latest numbers from our friends at NASTAD:
Michael J. Coren writes a fascinating article about HIV: if health isn’t a good enough reason to protect yourself from HIV and STD’s, maybe money is.
Excerpt:
Scientists at MIT’s Poverty Lab recently published findings in BMJ Open that tested that theory in Tanzania. They used payments known as conditional cash transfers (CCTs)–known to encourage socially desirable behavior elsewhere in areas like such as school enrollment and medical check-ups–to deter risky sex among young people (18 to 30-year-olds) in Tanzania.
As much as 5% of Tanzania’s population is infected with HIV/AIDS. Although rates have declined there during the last five years, the country’s sub-Saharan neighbors are not so lucky. Just 10 sub-Saharan countries account for more than one-third of people infected with HIV worldwide; an equal proportion of new cases also occur there. It’s clear controlling existing infections is not enough; cheap and effective prevention is needed.
The MIT researchers asked about 2,000 participants to receive tests for four common STIs–chlamydia, gonorrhea, trichomonas, and M. genitalium–every four months during the course of a year. If results were negative, participants were paid $10, $20, or nothing depending on the experimental group. If positive, participants were treated, but did not receive cash. The STIs served as a proxy for HIV infection risk from sex, since payments were not contingent on HIV status, given the stigma attached to the infection in many communities.
From NAPWA: Recently released supplemental federal funding is slowly bringing state waiting lists down – 2,552 this week. Regional disparities are troubling, though. Ninety percent of Americans on ADAP waiting lists are in the South. The only non-Southern state with comparable numbers is Nebraska. The South is where HIV is spreading fastest, and providing HIV drugs to those who need them would help prevent new infections.
Here are the latest numbers from our friends at NASTAD:
An excellent article from Science Daily:
In the United States, where blacks bear a disproportionate burden of the HIV/AIDS epidemic, black religious institutions could help turn the tide. In a new study in PLoS ONE based on dozens of interviews and focus groups with 38 of Philadelphia’s most influential black clergy, physicians and public health researchers find that traditional barriers to preaching about HIV prevention could give way to faith-friendly messages about getting tested and staying on treatment.
The public health community has long struggled with how best to reduce HIV infection rates among black Americans, which is seven times that of whites. In a new paper in the journal PLoS ONE, a team of physicians and public health researchers report that African-American clergy say they are ready to join the fight against the disease by focusing on HIV testing, treatment, and social justice, a strategy that is compatible with religious teaching.
“We in public health have done a poor job of engaging African-American community leaders and particularly black clergy members in HIV prevention,” said Amy Nunn, lead author of the study and assistant professor of medicine in the Warren Alpert Medical School of Brown University. “There is a common misperception that African American churches are unwilling to address the AIDS epidemic. This paper highlights some of the historical barriers to effectively engaging African American clergy in HIV prevention and provides recommendations from clergy for how to move forward.”
The paper analyzes and distills dozens of interviews and focus group data among 38 African-Amereican pastors and imams in Philadelphia, where racial disparities in HIV infection are especially stark. Seven in 10 new infections in the city are among black residents. With uniquely deep influence in their communities, nearly all of the 27 male and 11 female clergy said they could and would preach and promote HIV testing and treatment.
That message, delivered by clergy or other influential figures, would provide a needed complement to decades of public health efforts that have emphasized risk behaviors, Nunn said. Research published and widely reported last year, for example, suggests that testing and then maintaining people on treatment could dramatically reduce new infections because treatment can give people a 96-percent lower chance of transmitting HIV.
“For decades, we’ve focused many HIV prevention efforts on reducing risky behavior,” said Nunn, who is also based at The Miriam Hospital. “Focusing on HIV testing and treatment should be the backbone of HIV prevention strategies and efforts to reduce racial disparities in HIV infection. Making HIV testing routine is the gateway to getting more individuals on treatment. African American clergy have an important role to play in routinizing HIV testing.”
The barriers clergy members face
Many religious leaders acknowledged that they’ve struggled with how best to combat the epidemic, particularly with challenges related to discussing human sexuality in church or mosque, according to the analysis in the paper.
“One time my pastor spoke to young people about sex, mentioning using protection,” the paper quotes a clergy member as saying in one example. “I was sitting in the clergy row; you could feel the heat! I was surprised he said that. Comments from the clergy highlighted they were opposed to that. It’s a tightrope walk.”
Many clergy members also said they face significant barriers to preaching about risk behaviors without still emphasizing abstinence.
“It’s my duty as a preacher to tell people to abstain,” one pastor told the research team, “but if they’re still having sex and they’re getting HIV, there has to be another way to handle this.”
What clergy can do
Many clergy members suggested couching the HIV/AIDS epidemic in social justice rather than behavioral terms, Nunn said. They also recommended focusing on HIV testing as an important means to help stem the spread of the disease and reduce the stigma.
“We need to standardize testing,” one pastor told the researchers. “One thing that we could do immediately is to encourage our congregations — everybody — to get tested. … We’re not dealing with risk factors. And we’re all going to get tested once a year. That’s the one thing that we could do that doesn’t get into our doctrine about sexuality.”
In general, many of the religious leaders said they could encourage discussion of HIV not only in main worship services, but also in ministries and community outreach activities.
From CBS News:
In a landmark decision, an advisory panel to the Food and Drug Administration voted to recommend approval of Truvada to prevent HIV infection. The FDA is not required to the follow the panel of experts’ advice, though it typically does.
In a series of votes, a Food and Drug Administration advisory panel recommended approval of the daily pill Truvada for healthy people who are at high risk of contracting HIV, including gay and bisexual men and heterosexual couples with one HIV-positive partner.
A final decision on Truvada is expected by June 15, but the FDA doesn’t confirm such action dates and says the review of the application is ongoing, a spokesperson told CBS News.
“I think this is a huge milestone,” Dr. Robert Grant, associate director of the Center for AIDS Research at the University of California, San Francisco, who led the panel’s research, told CBS News medical correspondent Dr. Jon LaPook. “I think we are in an era for the first time when we can see the end of the AIDS epidemic.”
Gilead Sciences Inc., based in Foster City, Calif., has marketed Truvada since 2004 as a treatment for people who are infected with the virus. The medication is a combination of two older HIV drugs, Emtriva and Viread. Doctors usually prescribe it as part of a drug cocktail to repress the virus.
Since Truvada is already on the market to manage HIV, some doctors have prescribed it as a preventive measure. FDA approval would allow Gilead Sciences to formally market its drug for that use.
While panelists ultimately backed Truvada for prevention, Thursday’s 12-hour meeting highlighted concerns created by the first drug to prevent HIV. In particular, the panel debated whether Truvada might lead to reduced use of condoms, the most reliable defense against HIV. The experts also questioned the drug’s effectiveness in women, who have shown much lower rates of protection in studies.
The panel struggled to outline steps that would ensure patients take the pill every day. In clinical trials, patients who didn’t take their medication diligently were not protected, and patients in the real world are even more likely to forget than those in studies.
“The trouble is adherence, but I don’t think it’s our charge to judge whether people will take the medicine,” said Dr. Tom Giordano of Baylor College of Medicine, who voted in favor of the drug. “I think our charge is to judge whether it works when it’s taken and whether the risks outweigh the benefits.”
My view: This also allows sero-discordant couples- one HIV+, one not- an extra layer of protection. It may also help adherence if two persons are taking the same meds (or at least having to share a daily regimen) in the same household. That in itself is worth it….
The second video in the Montana social marketing campaign for HIV Awareness:
This HIV prevention animation targeting the MSM population is a playful look at a young bull elk that is looking for a relationship in Montana. As the party music plays he searches the herd for another bull who has been “Checked” (tested) for HIV. This is a creative project that was created by Laura Dybdal and Amber Bushnell as a part of Montana’s HIV Prevention Social Marketing Campaign. It also directs viewers to getcheckedmt.org, a resource to find the nearest HIV testing location in Montana.
The first one was posted yesterday….
…from The CDC’s Annual Report from the Division of HIV/AIDS Prevention (DHAP), Accelerating Progress, Investing for Impact. This report provides an overview of some of the HIV prevention activities conducted and supported by the Centers for Disease Control and Prevention (CDC) during late 2010 to the end of 2011.
Too few Americans with HIV are getting the testing, treatment, and care they need to stay healthy and prevent transmission to others.
Surprisingly, only 28% of all HIV-infected persons are considered to have HIV under control ( viral load less than 200/ml). That’s not enough.
Percentage of HIV-infected Individuals Engaged in Selected Stages of the Continuum of HIV Care, 2010-11
All HIV positive individuals- 100%
Aware of their infection- 80%
Linked to HIV care- 62%
Retained in HIV care- 41%
Receive antiretroviral therapy- 36%
Have their virus under control*- 28%
*Plasma viral load < 200 cells/ml
Source: MMWR 60(47);1618-1623
From Eternity To Here 