Wednesday, November 28, 2012
World AIDS DAY Meet & Greet benefitting NM AIDS Services
New Mexico AIDS Services is proud to present our World AIDS Day Meet and Greet, hosted by County Commissioner Maggie Hart Stebbins and County Commissioner-Elect Lonnie Talbert.
World AIDS Day Meet & Greet
Date: Thursday, November 29th, 2012 at 6:00pm
Location: Albuquerque Aquarium – 2601 Central NW
Please RSVP by visiting www.nmas.net/events or call 505.938.7100
Suggested Contribution $50 Friends of NMAS $75 Advocates of NMAS $100 or more Champions of NMAS
Please join the Board of NMAS, CEO Kathleen Kelley, & the staff of NMAS to honor World AIDS Day and show your support for our organization and our mission.
Tuesday, June 12, 2012
Pride Blog on HIV by Marshall Martinez
“It’s time to come together and get to work!”
This was the rallying cry many of us active New Mexico Democrats received in our email inboxes Wednesday Morning of this past week. The primary is over and we must come together, work hard to defeat Mitt Romney, Heather Wilson and Janice Arnold-Jones etc.
At the same time, to those of us who are GLBT, The beginning of June means something else entirely! “Pride is about Unity” “Pride is about Community!” “Pride is about being comfortable, safe, expressing love, being who we truly are!” And these statements are all true. I, for one, love Pride Month!
But over the last couple of years, I have seen a darkening cloud over both of these exciting sets of events. As a lifelong active Democrat who enjoyed the coming together of the party after a primary, and as a relatively Young Gay Man who enjoyed the party and the excitement and the feeling of welcome-ness of Pride, My mind often wonders now, about something that seems to be left out of the discussions.
It is estimated that more than One Million people are living with HIV/AIDS in the United States today. Almost 35,000 new infections are diagnosed every year since 2005.
Why do I bring this up now? Why do I constantly bang this drum? Because not enough other people are!
The story may be different in other parts of the country, certainly in larger cities. But in Albuquerque, NM, we are behind the game, and we need to step it up!
The conversation about condoms and abstinence has been going on for a couple of decades in the US. And though we definitely could setup up our programs in Public Schools nationwide, it doesn’t seem to be as effective as we thought it would be in slowing the number of new infections. So what’s next?
The year is 2012. And unless the world really ends in December, (or August) we need to be rethinking our messaging and our approach to HIV Prevention. Arguments have been happening nationwide about offering a drug currently used for treatment of HIV, to people possibly exposed to HIV. The arguments have included the notion that this will allow people to be more reckless about their sexual activity, knowing there is a pill they can take. (By the Way - The same argument made about the morning-after pill, and other forms of contraception in the past) Maybe we should be talking about Risk Assessment and Harm Reduction not “prevention.” Maybe we should acknowledge that people like to have sex without condoms, and regardless of how irresponsible we may think it is as advocates, talk to them about other steps they can take to protect themselves. Maybe its time to have different conversations at PRIDE, and other venues. Let’s talk about how to discuss Viral Load, and its implications on risk; or about the use of lubricant and, other tools to help reduce risk of sex without a condom.
Maybe we should work harder to take the stigma out of the statement “I’m HIV Positive.” I have too many friends, loved ones, who do not reveal their status to potential partners, or friends and family even, because of all the baggage that goes along with that. Maybe if we started teaching gay men especially how to react with compassion rather than disgust when they hear that, then maybe we can start to open those lines of dialogue and allow people to feel more comfortable discussing the risks.
I don’t know the answers; I don’t know what direction we should take. But I know we have to come together to make a change. In this highly charged political atmosphere for Republicans and Democrats, in this time of celebration and memorials for a Queer community, we have to find a new approach to a problem that has plagued us for far too long. I propose that the first step is to put aside our ideologies about treatments, about messages, about methods, and become more willing to discuss all options. Only with the widest of approaches and most open of minds can we truly defeat HIV. Remember, as I have sad before, this is our Sons and Daughters, our Brothers and Sisters we are talking about. Don’t they deserve some new energy and effort on their behalf? Yes, yes they do.
Friday, February 24, 2012
HIV/AIDS Interview With CD1 Candidates; Guest Blog by Marshall Martinez
Roughly a month ago, I wrote a guest post on Democracy for New Mexico about Federal HIV Policy issues. (that blog can be found here.)
After writing that blog, I interviewed the 3 Democratic candidates for the First Congressional District house seat about these same issues. The goal of this post is not to endorse any of the candidates. It is not intended to portray any candidate in a better or worse light than the others. My goal is purely to remind the public of the importance of this issue, and relay to the public the thoughts of my local candidates and elected officials on this oft-forgotten issue.
In 2012, HIV continues to have a deadly grip on our society and there are many ways that the federal government can help us avoid necessary deaths and transmission of this virus. This issue will be near the top of the list of considerations I use when choosing my candidates for the June 5th Primary and November 6th General Elections. I implore you to put them somewhere on your own list, as well.
I interviewed Michelle Lujan Grisham—current Bernalillo County Commissioner and former Secretary of the NM Dept. of Health; Eric Griego—NM State Senator and former ABQ City Councilor; and Marty Chavez—former NM State Senator and Mayor of ABQ.
My first topic of discussion with the candidates was a relatively black and white issue: Syringe Exchange Ban on a federal level. This ban works much like the “Global Gag Rule” prohibiting any federal funding to be awarded to any organization that also provides clean/new needles to IV drug users to help prevent transmission of HIV and other blood-borne pathogens.
All three of the candidates immediately answered this question the same, they would approach such an issue from a public health perspective. They understood that morality and politics have no place in this particular debate, as we are simply putting more people at risk because we as a society have judged their behavior as unworthy of protection. Chavez called the issue a “low hanging fruit” for the conservatives who believe they could easily win on an issue that is hard to explain to the average voters, Griego stated that the issue “needs to be de-politicized” and Grisham stated that the “ideology behind the issue is inappropriate and irresponsible.”
Criminalization of HIV-positive people is a major issue in the US. Many states have laws that criminalize or increase the severity of crimes based on HIV status. There is no doubt the goal of this was to reduce transmission because of malice or negligence, but we now know as advocates that is not the outcome achieved. In discussing this issue, Grisham immediately said we need to do more work on education about the issue, since this is still a problem. She also insisted that we focus our energy on prevention, rather than continuing to spend resources enforcing criminalization statutes. Griego said the first step in addressing these issues is to think about public health; once we have discovered what works to expand public health, we do the “right thing,” regardless of fears or feelings of morality. Griego also said we can count on him not to support criminalization in New Mexico if any were to be introduced. Chavez, while questioning the role of the federal government in state laws on criminalization, pointed out his record as a state senator—sponsoring the difficult and often trailblazing legislation at the time, including his law that finally outlawed spousal rape in NM. The connection he made was that, though de-criminalizing HIV might not be popular even today, it’s the right thing to do and he would be happy to support it.
The issues get a bit more difficult, having to navigate budget/revenue issues and healthcare reform, while keeping the discussion focused on HIV policy. The candidates didn’t have a difficult time, but I sure did. AIDS Drug Assistance Program (ADAP) is funding used to help low-income and underinsured people living with HIV afford their medications. States face budget cuts in every area and some states have already begun to develop waiting lists for ADAP funding, preventing thousands of Americans from accessing the life-saving medications they need. Grisham immediately made connections that I didn’t have to draw for her: “treatment of the virus is prevention of the virus. We have to set the framework for priorities in our nation’s budget, which means we have to stop having the conversation as a budget conversation and have it as a policy conversation as well.” Chavez explained that we have severe budget issues in this nation, drawing the picture of borrowing .42 for every dollar spent from foreign investors. Griego drew the largest distinction on this particular issue, pointing out that he supports more broad changes to healthcare policy in America, rather than tweaking a still broken system. Griego was quick to demonstrate that there are many barriers to making HIV medications—and all life-saving/improving medication more affordable—including but not limited to patent laws, HMO/pharmaceutical formulary revisions, and our lack of better high risk insurance pool policy or “public option” in Federal Healthcare Reform. It’s not easy to parse budget, healthcare, and HIV Policy issues clearly. Each candidate demonstrated a different understanding and approach to these issues, though all agree clearly that access to HIV medications is our moral obligation.
Rounding up the conversations, I discussed prevention methods and their funding, how to make this issue more “sexy” on a societal level, and my own less frequently discussed issue of doctors giving positive test results without knowing or considering the emotional and psychological weight it has on the patient. The three candidates had much to say on these topics, though each of them were flattering and supportive in a similar fashion—telling me that the work I am doing is helping to raise the public profile of HIV Issues. I appreciate the flattery guys, but let’s not add to my already growing ego!!!
In all seriousness, each of the candidates approached this topic more conversationally, bringing in much more of their individual experiences and ideas about policy overall.
Griego pointed out his success with a Public Safety Tax for the city and creating programs that are geared toward prevention, his recent accomplishments on Addiction Issues in the South Valley and understanding a community approach to prevention and healthcare overall. Griego has a wonderful grasp on community based approaches to healthcare and especially prevention techniques for multiple issues, including HIV. Coming from a community that is close-knit and knows that positive relationships can have a huge impact the prevalence for higher risk behaviors, he understands that approaching high risk behaviors with our youth is the key to creating a healthier generation and or target of reaching a Generation without AIDS, soon.
Chavez has a lengthy legislative and executive history with many policies of which to be proud. He reminds us of the creation of the “311” system in Albuquerque, which is all about relaying information to people in Albuquerque, and points out that in a digital age, when technology puts information at the tip of or fingers there is no reason that we can’t create more easily accessible information and resources for doctors, patients and average citizens regarding HIV. He also pointed out that I do not know if our current Representatives’ or Senators’ offices would be able to direct a caller to information on testing, preventing or accessing counseling for HIV, if he were the CD-1 Representative his office will be able to direct constituents to HIV Information.
Grisham has much public health information to backup her understanding of these issues. She pointed out that we ought to create incentives for medical schools to develop curriculum that helps students deliver HIV positive test results with care for the emotional and psychological aspects. Grisham also understands, with incredible nuance the need and benefit of evidence-based prevention methodology. With such rich background in Public Health, Grisham is able to speak eloquently to the need to have full policy discussions around these issues, rather than trying to pull the larger issue away from the budget, prevention or healthcare debate.
It is fair to say that we are very fortunate to have such understanding, compassionate, and morally sound Democrats running in the First Congressional District, at least with Regard to HIV Policy. Whether it is Mayor Chavez speaking with remorse and grief over the loss of friends in the 80s and 90s to this horrific plague; Senator Griego speaking with passion to the abilities we have to prevent and even eradicate this plague from our society with the strength of a community-based approach to healthcare; or Commissioner Lujan-Grisham delving deep into the intricate details of policy and public health, ready to debate with the most conservative personality backed up by evidence; we are blessed in the First Congressional District.
All three candidates promised they would continue to research, discuss, advocate for, and champion the issue of HIV prevention and treatment. I challenge you, as voters and constituents in this district, to hold these candidates accountable to their promises; I will continue to do so to the best of my ability. This is an issue of moral and fiscal obligation in our time, 30 years after the onset of this plague, and we must band together to eradicate it from our world.
Thursday, January 19, 2012
Over 30 Years Since the Beginning of the HIV/AIDS Epidemic
It’s been over 30 years since the beginning of the HIV/AIDS epidemic. We’ve all seen the images of the quilt, the lists of names, the plays and movies that highlight the evolution of this epidemic in our society. My favorite movie is “And the Band Played On,” I love the soundtrack to the show “RENT,” I even begged for (Product)Red Converse for Christmas and wear a ribbon regularly. Maybe you share one or two of these same characteristics, watching the same movies, wearing the ribbon, maybe you only think about it once a year, Dec. 1 (World AIDS Day).
But in an election year, when there are environmental, reproductive rights, economic and corruption issues to discuss, among many others, it’s easy to forget about one of the largest healthcare crises in our society that steals lives from us daily. It is my intention to remind us that this complex of issues ought to be a priority for candidates running for federal offices right now, not forgotten as they often have been in the past.
This is the beginning of a series of blogs about these issues, where I will do my best to lay out the positions of these candidates on these issues of public health, that affect us all. This first post is intended merely to lay out the issues and explain their ramifications on federal policy moving forward, our control and management, and ideally eventual eradication of this awful epidemic.
My experience in Public health began when I was 14 years old, as peer educator on HIV/STD protection, and has continued to evolve throughout my adolescent and adult life. I have also researched these issues through national organizations, gathering information and analysis from the Center for Disease Control(CDC) HIV Prevention Justice, MPowerment Project, and various statewide HIV organizations, to name a few.
One Million People Living with HIV in the USA
I have an obvious bias. After 30 years of watching this virus take, destroy, or radically change the lives of my brothers and sisters; I believe we have a moral obligation to address the epidemic. While the problem is insane in Southeast Asia, and Africa, and we ought to be providing resources to those areas of the world without a doubt, my personal focus is on the American epidemic. According to the CDC It is estimated that more than one million people are living with HIV in the USA and that more than half a million have died after developing AIDS. It is estimated that someone contracts the virus every 2 hours in the United States. Federal healthcare costs can be up to 50,000 per year per patient, when the costs are calculated to include the medicines, checkups, blood work and multitudes of other “smaller costs.” There are currently over 4,000 people on the ADAP waiting list to begin treatment with government funded assistance. Some patients will be at full blown AIDS status (the measurement of CD4 counts in a patient, which essentially means they have a very low functioning immune system and are highly susceptible to multitudes of infections that a healthy immune system would fight off successfully with no noticeable struggle,) before obtaining treatment.
Whether your motivating factors are morally driven, or budgetary in nature (both call us to an obligation, in my opinion) there are clear reasons to put this issue back on the forefront of policy discussions, budget discussion and yes political discussions in an election year.
In my conversations with candidates for federal office and policy makers at this level I plan to discuss 6 intertwined areas of HIV policy, that I believe are major priorities for successful management of the disease at a societal level.
Syringe Exchange = Simple Effective and Cheap
Syringe Exchange, an often politicized public health issue, that some believe comes with moral implications, even more people don’t know enough about. Syringe exchange is a highly effective method of prevention for Virus transmission. It’s simple, when people who engage in Intravenous(IV) drug use share needles, they share any blood-born pathogens they might have, including HIV. The solution is simple, while we cannot yet tackle the huge issue of drug addiction, and likely will be torn in partisan debate about the issue for decades, we can at least spend a very small amount of money on providing a clean needle to users, ensuring that they don’t’ harm more people with whom they may engage in their recreational or addictive drug use. Federal ban on this practice works like the “global gag rule,” essentially saying that any organization or institution that receives federal funding for any reason, cannot also engage in syringe exchange, even with non tax-payer dollars. This ban had been lifted in recent years, and was then re-instituted in the last budget negotiations that took place in late December. We know that sharing needles is an almost guaranteed method of transmitting the virus, why would be haggle over the so called moral implications, when we can easily spend a small amount of money on tangible prevention, which has other measurable outcomes as well.
Criminalization = Shame
Criminalization is a major issue facing the HIV/AIDS community, and one that I personally feel is the greatest shame we carry into 2012. 34 states have laws on their books that criminalize people with HIV, or providing added criminal charges because of HIV status. There is a man in Texas serving a 33 year sentence for “assault with a deadly weapon against a police officer,” he spit at the officer during arrest procedures and is HIV Positive(HIV+). HIV cannot be transmitted via saliva; this is, or should be, a commonly known fact. NM is extremely lucky to have no criminalization laws on the books currently, but 34 states-that is too many. These laws were passed in the early years of the crisis, and with the best of intentions. We know now that these laws do not protect the public, they only feed stigma and fear, and public health officials know that the fear of being prosecuted for one’s status is fear enough to prevent many individuals from being tested or seeking treatment. In 2012 we need to move past the fear and the stigma and find prevention mechanisms that work, and encourage treatment for all individuals, as treatment is good prevention.
Treatment = Prevention
Treatment as prevention became a hot topic of conversation in recent months. HHS Secretary Kathleen Sebelius, Secretary of State Hillary Clinton, and President Obama himself, among many other discussed new(ish) research that confirms earlier beliefs. When HIV+ people are taking medications (anti-virals) to control the virus, they develop lower Viral Loads(the number of virus units per measure of blood/semen/breast milk/vaginal fluid). It stands to reason and now is scientifically proven that when a patient has a low viral load, they are much less likely to transmit the virus to other individuals. Sexual activity with a person who has a low or “undetectable viral load” is much less risky than with someone who has the virus and is not managing it with effective treatment.
From this perspective, one of the better things we can be doing as a nation is making sure that we are treating HIV+ people to ensure they don’t transmit the virus as easily to others. Why then, during budget cuts of the past few years, have we even allowed programs such ADAP (AIDS Drug Assistance Programs) to be cut as well? We currently have over 4,000 HIV+ people on waiting lists to access ADAP funding nationwide, (none in NM) therefore potentially being much higher risk to those they have sexual contact with that are not HIV+. Budget cuts are difficult and scary for all programs and in any time. But with a pledge to begin creating an entire generation free of the virus, at least in the US, cutting treatment is the worst way to kick off that execution!
There are many more issues to discuss when it comes to HIV Policy, but these are a good beginning. I had more specific questions for each of the candidates, and we have begun (I am still in process of interviewing) some great conversations.
Final thought is about Awareness
The final thought I have is about awareness. My fabulous Red Converse are a statement, the money spent on them went to benefit the Fight against AIDS, and whenever I put them on I think about my Brothers and Sisters, those who have gone too soon and those who are fighting this battle today. But does anyone else? It is not even questioned, If I was wearing a pink hat or pink shoes that most people would assume they are symbols of Breast Cancer Awareness. Why then have we allowed HIV/AIDS awareness to fall off of our radar? What can we do to bring this issue back to the forefront of people’s minds, and create that generation that won’t have to worry about their medication access, or Viral load, a generation of people who will not have known or mourned loved ones who lost their battle with this virus? I don’t know what we can do as a society, but I know what I’m doing; and I’ll continue to do so until this virus is over or my life is. What do you say? Want to join me?
Thursday, December 01, 2011
Guest Blog for World Aids Day: Why Medicaid Matters in the Fight Against HIV
This is a Guest Blog provided by Jacob Candelaria: A native of Albuquerque, New Mexico, Jacob Candelaria is a graduate of the Woodrow Wilson School of Public and International Affairs at Princeton University, and the current President/CEO of Equality New Mexico and the Equality New Mexico Foundation.
Since the onset of the global HIV/AIDS pandemic in the 1980s, 60 million people have been infected and over 25 million have died. This is a disease that recognizes no national borders, nor race, gender, age, religion or socio-economic status. HIV/AIDS is and remains a global problem, and one that continues to seriously impact the health of New Mexico communities and families.
In New Mexico, the State Department of Health estimates that in 2009 over 1,300 people were living with HIV, and an additional 2,000 were living with AIDS. In that same year, 152 New Mexicans were newly diagnosed with HIV/AIDS.
On this World Aids Day, we take the time as a community to remember those who have died, seek to empower those who live with the disease, raise awareness, and support those individuals and organizations that actively search for a cure.
To be sure, Medicaid deserves our thanks for the role it plays in the fight against HIV, the virus that, if left untreated, leads to the development of AIDS. As a primary source of healthcare coverage for those with HIV, it is critical that Medicaid remain fully funded at the state level and that an expanded Medicaid program, as required by federal health care reform, be as accessible as possible to those struggling with HIV who will become newly eligible for Medicaid coverage in 2014.
Major Source of Coverage
Medicaid is a federal-state program that provides health insurance coverage to low-income children. While poor kids comprise nearly two-thirds of those enrolled in Medicaid, the program is also an important source of coverage for a smaller number of very poor and medically needy adults.
Across the United States and in New Mexico specifically, Medicaid is the primary source of health insurance coverage for HIV patients. A recent study by the Kaiser Family Foundation found that 47% of all HIV patients with health care coverage get it through state Medicaid programs. Health insurance matters because having consistent and uninterrupted access to affordable, comprehensive medical services (especially anti-retroviral drugs that are essential to staving off disability and death) is critical to managing the disease and thereby sustaining both quality of life and indeed life itself.
The sad reality of current Medicaid rules, however, is that they generally require an adult with HIV to be very poor and very sick before they can qualify for assistance. This is because most adults with HIV qualify for Medicaid by virtue of being “medically fragile” or “disabled." Or, in other words, they are at a point where the disease has made it nearly impossible for them to work or live independently.
From a public health perspective, this just doesn’t make sense as we are essentially telling those with HIV who can’t afford private health insurance that they must let their disease get worse before they can access the healthcare they need through Medicaid.
Expanding Coverage for those with HIV through Federal Healthcare Reform
Beginning in 2014, all individuals under the age of 65 that are below 133% of the federal poverty line will qualify for Medicaid coverage. For a family of four, this means earning less than $29,726 per year. This expansion is expected to provide healthcare coverage to an additional 22 million low-income Americans, including over 200,000 working New Mexicans.
The Medicaid expansion will also extend coverage to many with HIV, particularly those who are not yet disabled. By determining Medicaid eligibility solely on the basis of income, federal healthcare reform will provide many struggling with HIV the opportunity to secure healthcare coverage without having to wait until they become very sick and disabled.
Moving forward, state policy makers charged with implementing federal healthcare reform should keep in mind the important role that Medicaid plays in the fight against HIV and ensure that all people that are newly eligible for Medicaid are able to access the medical services they require.
For Medicaid to continue as an important source of coverage for those with HIV, the state needs to make the right decisions, not only when it comes to rules and regulations that determine what medical services those with HIV receive, but also by guaranteeing that Medicaid is fully funded at the state level.