From our friends at NAPWA:
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In my role as a therapist, I hear people complain about lack of sleep inability to fall asleep, fatigue and mental grogginess. It’s simple- we’re not getting enough sleep. Persons with chronic illness- including HIV- are especially susceptible and will benefit greatly from enhanced sleep hygiene.
Below is a helpful infographic Ken found on sleep:
Created by: MedicalBillingAnd CodingCertification.net
Senator Jon Tester’s office released the following today:
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Senator Jon Tester today released the following statement after voting against a controversial amendment by Sen. Roy Blunt, R-Mo., that would have allowed employers to deny health insurance coverage, including contraception, for any employee based on “moral convictions”:
“This is a reckless attempt to undermine individual freedom and restrict access to health care for women. This measure is unprecedented and out-of-touch with Montana, and it would have prevented women from making their own healthcare decisions.”
The amendment did not define “moral convictions,” meaning an employer could have denied insurance coverage for anything from blood transfusions and diabetes screenings to HPV vaccinations and treatment of HIV.
The measure failed by a vote of 51-48, failing to reach the 60 votes needed for approval.
It sounds like it would have given employers the right to discriminate for insurance coverage.
I’m especially glad the release specifically mentioned HIV- we have hundreds of Montanans living with HIV who are enrolled in health insurance through their employers….
Looking for a doctor who isn’t freaked out by your sexuality? Or a dentist that will work with you if you have HIV? Or a therapist that has experience with gay couple’s therapy?
The Montana Gay Men’s Task Force has a list of gay-friendly healthcare providers for the State of Montana which they have compiled through a referral and questionnaire network. The providers listed have also given their assent to be on the list.
Oh, and if you have a fabulous healthcare professional who isn’t listed- you can help them get on the list here.
When healthcare gets it right, I think it’s important to notice.
Contrary to the HMO stereotype, Kaiser Permanente has taken on the challenge of HIV and instituted policies and guidelines for the effective care and treatment of persons with HIV- to dramatic effect:
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Kaiser Permanente announced (January 26th) the Kaiser Permanente HIV Challenge to help health care providers nationwide improve health equity for people living with HIV by increasing access to HIV care and improving health outcomes.
The HIV Challenge was announced at the Center for Medicare & Medicaid Innovation Care Innovations Summit in Washington, D.C. ( www.hcidc.org ).
Kaiser Permanente, the nation’s largest nonprofit health care provider, has treated more than 60,000 people since the HIV epidemic emerged 30 years ago, and has reduced disparities among its current HIV population of more than 20,000 people by working to meet or exceed the objectives of the U.S. National HIV / AIDS Strategy.
The crux of the HIV Challenge (kp.org/hivchallenge) is to challenge other private health care providers and public and community health clinics to increase the number of HIV-positive people getting effective treatment by sharing Kaiser Permanente’s toolkit of clinical best practices, provider and patient education materials, mentoring, training and health IT expertise.
(Watch the excellent video series about Kaiser’s HIV Challenge here)
HIV is still an epidemic in the United States, with 56,000 people becoming infected each year and more than 1.1 million Americans living with HIV, but one in five people with HIV don’t know they are infected.
“The organizations presenting challenges here today are pushing the best minds in the country to create a better health care system. They represent exciting solutions to help address some of the nation’s most urgent health needs,” said CMS Acting Administrator Marilyn Tavenner.
Health care disparities are gaps in the quality of care associated with inequities encountered by racial, ethnic, poor and marginalized groups. The HIV Challenge is part of Kaiser Permanente’s larger work to identify, measure, research and eliminate disparities in health and health care in the United States. To learn more go to kp.org/healthdisparities.
“Too many people are unaware they have HIV because access to effective prevention and care is insufficient,” said Michael Horberg, MD, director of HIV/AIDS for Kaiser Permanente, executive director of research for Mid-Atlantic Permanente Medical Group, and a member of the Presidential Advisory Council on HIV/AIDS. “People with HIV need to get into treatment because quality HIV treatment prevents others from getting infected. Patients on effective therapy and better case management are living longer and more productive lives. However, quality HIV treatment requires effort.”
Kaiser Permanente has demonstrated excellence in HIV clinical care outcomes with:
As part of its HIV Challenge effort, Kaiser Permanente is sharing these best practices and tools for private health care providers and community health clinics to replicate: quality improvement programs that measure gaps in care; testing, prevention and treatment guidelines; how to set up multi-disciplinary care team models that emphasize the “medical home” so HIV specialists, care managers, clinical pharmacists and providers work together; and education for both the provider and patient.
For more details on the HIV Challenge, to download the best-practices toolkit and to watch videos of success stories in setting up HIV clinics and reducing disparities, go to: kp.org/hivchallenge
“Our success in the treatment of patients with HIV/AIDS results from the excellence of our clinicians, our advanced IT systems, our integrated delivery system and our effective coordination across specialties,” said Robert Pearl, MD, chief executive officer and executive medical director of The Permanente Medical Group and Mid-Atlantic Permanente Medical Group. “In the same way that we have reduced the chances of our patients dying from cardiovascular disease and cancer significantly below the national averages, we have achieved outstanding clinical outcomes for our patients with HIV/AIDS.”
The National HIV/AIDS Strategy ( http://www.aids.gov/federal-resources/policies/national-hiv-aids-strategy/ ) calls for increased testing so that all Americans can know their HIV status, increased access to culturally sensitive prevention messages, community-targeted prevention and condom and clean needle access. NHAS also calls for improving access to quality HIV care because HIV medications not only improve individuals’ health and extend their life expectancy, they also reduce their risk of transmitting HIV to others. A recent scientific study found that effectively treating HIV patients with antiretroviral medications reduces HIV transmission by 96 percent. The study, known as HPTN 052, found that treating people with antiretroviral drugs before they are symptomatic can reduce the amount of virus in the blood sufficiently to reduce the risk of sexual transmission of HIV to an uninfected partner.
The Kaiser Permanente HIV Challenge is part of Kaiser Permanente’s ongoing research of HIV and HIV treatment. Published Kaiser Permanente research studies include:
About the Care Innovations Summit:
Sponsored jointly by the Department of Health and Human Services, the Centers for Medicare & Medicaid Services, Health Affairs, and the West Wireless Health Institute, the Care Innovations Summit brings together more than 1,000 health care leaders, entrepreneurs, innovators, government officials, and finance experts to stimulate investment in a high-quality, sustainable health care system. Made possible by the Affordable Care Act and the Obama Administration’s commitment to open government, the Summit represents a new opportunity for industry and government to work together to help spur innovation in the public and private sectors to improve health care quality as never before and lower costs through improvement.
About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: http://www.kp.org/newscenter .
For more information:
Danielle Cass, danielle.x.cass@kp.org, 510-267-5354
Farra Levin, farra.r.levin@kp.org, 510-267-7364
SOURCE Kaiser Permanente
Phyllis and Bandit
I’m a dog lover. I’ve had many important dogs in my life- from the dog I got for my sixth birthday, Ruff- to Bandit and Phyllis, our dogs today. Animals can provide a lot of joy, comfort and support- and for a lot of persons with HIV, they often provide an excellent reason to take better care of themselves.
Science Daily reports today on a study showing that HIV+ women with pets cope much better than their petless counterparts. Excerpt:
(Allison) Webel set out to better understand how women manage their HIV/AIDS and stay on track to take their medications, follow doctors’ orders and live healthy lifestyles. She conducted 12 focus groups with 48 women to find out what they did to stay healthy. The women had an average age of 42, about 90 percent had children, and more than half were single.
During the focus groups, six predominant social roles emerged that helped and hindered these women in managing their illness: pet owner, mother/grandmother, faith believer, advocate, stigmatized patient, and employee. All roles had a positive impact except stigmatized patient, which prevented women from revealing their illness and seeking out appropriate supports.
“Much information is available about the impact of work and family roles, but little is known about other social roles that women assume,” Webel said.
Being a pet owner was an important surprise, added Webel, who collaborated with co-author Patricia Higgins, a professor of nursing at Case Western Reserve University.
“Pets — primarily dogs — gave these women a sense of support and pleasure,” Webel said.
When discussing the effect their pets have on their lives, the women weighed in. “She’s going to be right there when I’m hurting,” a cat owner said. Another said: “Dogs know when you’re in a bad mood…she knows that I’m sick, and everywhere I go, she goes. She wants to protect me.”
The human and animal bond in healing and therapy is being recognized, Webel said, as more animals are visiting nursing homes to connect to people with dementia or hospitals to visit children with long hospital stays.
I’m sure that this translates across genders, as well. I’ve known plenty of chronically ill men who have strong bonds with their pets.
Psychologically, it’s much more difficult to be depressed when there’s a pet in your life- taking care of someone/something other than yourself can be very beneficial and provide relief from feelings of isolation, sadness and fear. Organizations like PAWS (Pets Are Wonderful Support) have known this for years- that for animal lovers, nothing helps speed healing like the love of a pet- now science may make this an even more integral component of treating chronic illness….
This eloquent, excellent article is from The National Association Of People With AIDS/HIV (NAPWA) newsletter, Positive Voice. It outlines many of the challenges we face as a country- including homophobia, stigma, and stinginess- in getting HIV under control:
This is an exciting time for all of us who live with HIV or are affected by it. Theoretical models predicted for years that treatment-as-prevention could work, and the last year confirmed it. In the elegantly designed HPTN 052 trial, results showed that serodiscordant heterosexual couples had a drastically reduced risk of infection for the HIV-negative partner when the positive partner was receiving effective treatment with antiretroviral drugs.British Columbia didn’t wait for trial results. For several years, the province has aggressively sought to find and treat as many HIV-infected people as possible, and the numbers of AIDS deaths and new HIV infections are now coming down. Dr. Julio Montaner, father of the B.C. program, remarked recently that the falling number of (known) new infections was not the result of less testing, or of safer sex. That leaves only one plausible explanation: reduced community viral load.
So we can end this epidemic. It’s time to start calling it The Unnecessary Epidemic.
As NAPWA President and CEO told us in the previous issue of Positive Voice, ending the epidemic will take resources, resources, resources. Resources for high-impact prevention programs. Resources for treatment and support services for all who need them. Resources to fix an unfair health care system.
But it’s also going to take more than resources. It will take changes in public attitudes. Twenty percent of Americans living with HIV don’t know it. Some of them don’t because prevention and testing programs haven’t reached them. Other don’t because having HIV can be so stigmatizing that they would really rather die slowly than know their status.
So let’s look at some public drivers of HIV stigma, and then look at the consequences.
The evils of “second-hand sodomy”
On the site Conservapedia.com – think of it as Wikipedia for the “right”-minded – Americans for Truth (!) president Peter LaBarbera writes, Why isn’t there a concerted government effort – akin to the current anti-smoking campaigns – to reign in homosexual promiscuity – beginning with closing down all sex businesses (bathhouses) that facilitate homosexual perversion? (Of course, we favor closing down straight prostitution businesses as well.) We know that bisexual behavior (men on the “down low”) help spread dangerous diseases to the general population: how many deaths and illnesses have to result from “second-hand sodomy” before authorities take corrective action?
Translation: it’s all the gays’ fault. If we could just shut down all gay sex, the epidemic would go away. Never mind that a majority of African Americans living with HIV are women, in numbers that could not possibly be accounted for by some partners’ “down low” adventures, and HIV in Africa was a heterosexual disease from day one. LaBarbera is saying that sex he disapproves of is perversion, perversion leads to disease, and “second-hand disease” is tantamount to murder.
Just as bizarrely, Dr. Peter Duesberg continues to contend that HIV is harmless and AIDS is caused by gay sex and drug use. Somehow, we just don’t think most of the African American women living with AIDS have been having gay sex and sniffing poppers…. And never mind the experience of people with HIV who were on the ropes in 1996, when drug cocktails based on protease inhibitors were just coming into use, and eight weeks after we started our new drug regimens our viral loads were down, our T cells were up, and our dermatologists were telling us we didn’t have to come back anymore for our every-two-weeks appointment to zap new KS lesions. Practical lesson: control the HIV and the AIDS symptoms go away. Conclusion: the virus causes the symptoms. Discussion over, Dr. D.
Not victim-free expressions of opinion
We can laugh at these extreme opinions, but publishing them is not a victimless crime. Duesberg’s opinions delayed wide use of antiretroviral drugs (ARVs) in South Africa for years, and people died. The shame about non-majority sexual orientation spread by Conservapedia and others keeps people who know they should get tested from doing so and having to live with a positive result. Using criminal law as a (failed) tool to prevent new infections drives infected people and injection drug users underground, where prevention and treatment services can’t reach them.
How the Grinch stole your needle exchange
The 2013 federal budget just passed reinstates the former ban on federal funding for one of the most targeted, cost-effective HIV programs ever conceived: injection needle exchanges. The ban was one of many prices, just before Christmas, for passing any budget at all. The underlying thinking may have had something in common with Conservapedia’s panacea of outlawing gay sex: just say “there ought to be a law,” whether it’s a matter law can deal with effectively or not. It can’t, and we wonder whether many members of Congress demanding the ban knew that. Certainly those with competent health policy staffers did.
Naming stigma – and praising constructive action
As a community of people who live with HIV or serve those who do, we have a responsibility to call out stigma wherever we see – HIV stigma, homophobia, unease with transgendered people, the cruel expectation that people trapped in sex work or drug use are in control and should just go cold turkey and quit. This is more important than any quarrels we may have among ourselves about PrEP, condoms, or whether to concentrate on developing a preventive or therapeutic vaccine first (scientific accident will decide that for us).
From Eternity To Here 