Dispatches from the fight against homelessness and AIDS
Posted by Tim Murphy , September 11, 2013
Urge Cuomo to make ending AIDS in New York part of his January 2014 speech.
HIV/AIDS and LGBTQ advocates throughout New York State are working closely with state officials in Albany to urge Governor Cuomo to make launching a plan to end AIDS in New York part of his January 2014 State of the State address.
“We’ve got the science and the means to do this,” said Daniel Tietz, executive director of ACRIA and part of the coalition lobbying the governor. “It’s about committing human and financial resources in the most strategic way. We believe the Governor will see that, too, and do the right thing. He has a real chance to lead the nation on this, as he has on so many things.”
Activists, including Tietz, Housing Works’ Charles King and top honchos from agencies including Harlem United, Bronx AIDS Services, Hudson Valley Community Services and Long Island Association for AIDS Care, sent this letter to Governor Cuomo in early June. “The leaders of the New York HIV and LGBT organizations below respectfully request a meeting with you at your earliest convenience to discuss how best to ensure that New York continues to lead the nation as we together end AIDS,” the letter begins.
It then points out that the Affordable Care Act, for which enrollment begins Oct. 1, will go a long way toward providing the tools to end AIDS in New York State. But it stresses that New York’s loss of tens of millions of dollars in federal support on HIV prevention and care, plus the fact that fewer than 40 percent of all New Yorkers with HIV are on treatment and virally suppressed, means that the state still has to devote special funds and attention to ending the epidemic here. (Viral suppression is key in keeping people with HIV from transmitting it to others.)
In a paper released last month, prepared primarily by Housing Works, Treatment Action Group and attorney Virginia Shubert, coalition members outlined steps to ending the AIDS epidemic in New York State. They include:
>making sure that everyone is tested (and that high-risk people test 2-4 times a year).
>using a newer HIV test that picks up HIV infection immediately (when people are most infectious) rather than weeks after, to prevent ongoing infections.
>ensuring access to pre- and post-exposure prophylaxis (PrEP and PEP), which involves HIV-negative people taking HIV meds to stay negative.
>using the new perks of ObamaCare (such as expanded Medicaid access) to make sure that everyone who tests positive has immediate access to treatment.
>shoring up support for housing, mental-health care, needle-exchange and other auxiliary factors that keep people from getting HIV or, if they have it, from not accessing steady treatment and thus advancing to AIDS and putting others at risk.
According to the state’s AIDS Institute, in 2010, 18 percent of HIV-positive New Yorkers did not know their HIV status, 46 percent were not receiving regular care, and 63 percent were not suppressing their viral load with treatment. Advocates say that New York State, which reduced new HIV infections by 37 percent in the 2000s, should look to Massachusetts and San Francisco as places that have harnessed health-care coverage to dramatically lower rates of new HIV infections.
According to Tietz, energy for the new activist push arose in the spring, when activists heard that New York State had proposed consolidating and cutting dozens of health programs, including HIV, in the state budget, as well as possibly reducing or closing the AIDS Institute, which has driven AIDS policy in the state since 1983. After activists and state legislators, including health honchos Dick Gottfried and Kemp Hannon, protested, the cuts, which could have totaled $40 million, were averted.
It was then, says Tietz, that activists realized they should be pushing for not only a preservation of existing funding but for the Governor to launch a concerted effort to end AIDS in the state. In August, activists met with Courtney Burke, whom the Governor had just appointed deputy secretary for health. Burke was presented with the working paper linked to above. According to Tietz, she was enthusiastic about trying to bring the Governor on board with a plan to announce, in his January 2014 address, a plan to end AIDS in New York State.
According to Tietz, this can be done largely with careful reprogramming of existing resources. But, he says, it will require some new money. “You have to spend something to get something,” he says. He notes that preventing new HIV infections up front could save the state billions down the road in HIV treatment, as has been the case in Massachusetts.
He also points to a recent paper by health-care economist David Holtgrave, a member of the Presidential Advisory Council on HIV/AIDS, asserting that the goals of President Obama’s National HIV/AIDS Strategy have been undermined by under-funding. “The stakes are far too high” not to spend now to end AIDS in the future, writes Holtgrave.
New York City health officials—among whom turnover is expected with the arrival of a new mayor—will also have to play a large role in the New York State plan, says Tietz, as the city accounts for up to 90 percent of HIV cases statewide.
Housing Works top dog Charles King said that his organization will be putting considerable resources into the plan to end AIDS—not just on the city and state level but also nationwide and internationally. “We tried to do this in the mid-2000s with the Campaign to End AIDS.” (Which, by the way, continues its work.) “But the political and scientific moment wasn’t ripe yet. It is now. We know that price-bargaining can lower treatment costs, and universal HIV treatment equals HIV prevention. We also have prevention tools like microbicides and PrEP we didn’t have ten years ago. It’s all about putting the right resources in the right places at the right times. And about corralling the political will. Housing Works and its allies will be doing just that in the year to come.”
Stay tuned for more Housing Works posts in the weeks to come on plans to end AIDS on the city, state, national and global levels.blog comments powered by Disqus
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