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NOVEMBER 30, 2012
AIDS United Welcomes Michael Kaplan as New President and CEO

AIDS United welcomes Michael Kaplan as our new President and CEO. Michael has been working with AIDS United staff since mid-October, but officially assumes his new role on December 1. Michael brings with him a great deal of expertise and knowledge, and we look forward to a strong future under his leadership.

To read more about Michael’s appointment as President and CEO, click here.

To read a recent interview with Michael in Washington D.C.'s Metro Weekly magazine, click here

HIV Stigma: Standing in the Way of an AIDS-Free Generation

By Michael Kaplan, President and CEO, AIDS United

So close, but yet so far.

These are the words that come to mind when I think about December 1— World AIDS Day—a day when survivors and supporters pause to reflect on a pandemic that over the last 30 years has killed more than 30 million people. And on this day, as in years before it, we will once again renew our pledge to ends AIDS in America.  To read Michael’s Huffington Post OpEd in its entirety, click here.

White House Commemorates World AIDS Day

The White House hosted an event for World AIDS Day yesterday, November 29, at the Old Executive Office Building. Speakers included Dr. Grant Colfax, Director of the White House Office of National AIDS Policy; Valerie Jarrett, Senior Advisor to the President and Chair of the White House Council on Women and Girls; Michel Sidibé, UNAIDS Executive, Director; and Secretary Kathleen Sebelius of the Department of Health and Human Services.

In her remarks Secretary Sebelius stated that the Administration would be issuing a rule to explicitly include HIV/AIDS on the list of chronic conditions every state may target in designing effective health homes (defined below). The announcement is a welcome effort to help states find ways to improve HIV/AIDS care and has generally been expected by advocates. The timing of the release occurs at the same time the Administration has been releasing a number other rules about implementation of the Affordable Care Act (ACA) following the November election. President Obama’s reelection ensures that the ACA will be the law of the land for the foreseeable future and the Administration appears ready to move forward more quickly. She additionally stated that the Ryan White CARE Act continued to be a necessary to fill in gaps of the health insurance system

AIDS United’s President and CEO Michael Kaplan attended the event and Public Policy Committee Member David Munar, the CEO of AIDS Foundation of Chicago, participated in a panel discussion on the domestic HIV epidemic. In his comments, Mr. Munar highlighted the need to maintain strong state advocacy for the implementation of the ACA.

The Secretary’s complete remarks can be found here (with highlighted remarks below):

“Finally, the Affordable Care Act has made a series of investments to help providers support patients with chronic diseases like HIV/AIDS.

"For example, under the law, states can receive extra federal funding -- an enhanced 90% federal match in the first two years -- to support coordinated care through 'health homes' for Medicaid beneficiaries with chronic health needs. The goal of a Health Home is to treat the whole person, coordinating all their care from primary and acute care to behavioral health and long-term services.

"With our guidance, New York and Oregon have already established health homes specifically to serve individuals living with HIV/AIDS. And we continue to work with other states on their proposals. Today, I am proud to announce that we will be issuing a rule to explicitly include HIV/AIDS on the list of chronic conditions that every state may target in designing effective Health Homes. This will help more states adopt the kind of innovations that we know can improve the care and health of people living with HIV/AIDS.

"These are all big steps forward. But we will continue to need the Ryan White program to fill in the gaps of our health insurance system. And we will keep reaching out to providers and community leaders on the frontlines to make sure those programs remain strong.”

Released as part of the White House World AIDS Day recognition, Grant Colfax and Gayle Smith, Special Assistant to the President and Senior Director for Development and Democracy with the National Security Staff, wrote a blog for World AIDS Day entitled “Moving Towards an AIDS-Free Generation.” To read the full blog click here.

You can watch this event by clicking here

Lame Duck Session of 112th Congress

The House and Senate reconvened on Monday, November 26 to continue the lame duck session of the 112th Congress in an attempt to complete work on all of the unfinished business. As we reported in the November 9 edition of the Policy Update “So Many Issues, So Little Time for Lame Duck Session,” there are numerous fiscal issues to be addressed before December 31 --  and before January 2, when sequestration is scheduled to take effect.

The fiscal issues will be decided by 3 factions – The White House, the Senate, and the House of Representatives. Staff continues to work since the election to put a plan together that can garner sufficient backing from all three of the parties. The work is difficult since there continues to be a wide discrepancy between all sides. Republicans in the House and Senate are standing firm on their pledge to not increase tax rates on income earners over $250K, but Democrats remain as resolute as prior to elections in their plan to increase tax rates for the wealthy in order to maintain the tax cuts for 98% of tax payers.

However, this week has seen many Republicans distance themselves from the pledge to oppose increases in tax rates for individuals and businesses. This pledge was made to conservative lobbyist Grover Norquist, who is the President of Americans for Tax Reform. This signals that it may be possible to bring these fiscal issues to a healthy debate. President Obama continues his campaign style work to explain the issues to the American people so they can request their members vote against any “bad” deal to address the fiscal environment. The President wants to explain to the country how devastating the tax increases would be on the middle class as well as continue to engage people to use their power outside of Washington on their elected officials. AIDS United defines a bad deal as a deal with additional cuts to non-defense discretionary programs without accounting for the $1.5 trillion that has already been cut without significant revenue growth included in the package.

AIDS United continues to remain focused on alerting Members of Congress to the real consequences of sequestration cuts to the HIV domestic portfolio as well as voicing our concerns over any changes in Medicare and Medicaid entitlement programs. As Congress and the White House continue to negotiate the likely framework for averting the fiscal crisis AIDS United staff will keep you apprised of the plans as they materialize. At the appropriate time we will ask that you weigh in with your comments to your Members of Congress.

New Recommendations for HIV and Hepatitis C Testing

HIV Testing

On November 20, 2012, the U.S. Preventive Services Task Force issued a draft recommendation statement on screening for HIV that indicates a major departure from screening practices in the past! The new statement recommends that “clinicians screen all people aged 15 to 65 for HIV infection. Younger adolescents and older adults at an increased risk for HIV infection should also be screened.” It also recommends that “clinicians screen all pregnant women for HIV. This includes women in labor who do not know their HIV status.”

The Task Force’s screening recommendation has been given a Grade A rating, meaning there is strong evidence that the test has large potential benefits and small potential harms. Previously, screening for HIV was given a Grade C rating, meaning it was only recommended depending on the patient’s situation and was considered to have at least a small overall benefit (often times, this meant only screening patients who were considered part of traditional high risk groups). However, such targeted screening “misses a substantial proportion of infected persons because of undisclosed or unknown risk factors.” This new Grade A rating will lead to greater awareness and transparency about HIV-related issues in medical offices, encouraging conversation and promoting safer practices!

Hepatitis C Testing

On November 27, 2012, the Task Force also issued a draft recommendation statement on screening for Hepatitis C. The statement recommends “screening for hepatitis C virus infection in adults at high risk, including those with any history of intravenous drug use and blood transfusions before 1992” and gives this recommendation a Grade B rating, meaning that screening for these populations has much more potential benefits than harm. The statement also recommends that “clinicians consider offering Hepatitis C infection screening in adults born between 1945 and 1965” and gives this a Grade C rating, meaning it has at least a small overall benefit.

Hepatitis C is the most common blood-borne infection in the United States, yet many people are not aware of their infection because they do not display symptoms for many years after contracting the virus. Receiving blood transfusions before 1992 and injection drug use are the most common ways that people contract Hepatitis C. Similar to screening for HIV, these updated recommendations will hopefully increase the dialogue about these pressing issues between patients and medical providers.

AIDS United is concerned that this recommendation does not follow the guidelines from the Department of Health and Human Services (HHS) report -- COMBATING THE SILENT EPIDEMIC of VIRAL HEPATITIS Action Plan for the Prevention, Care & Treatment of Viral Hepatitis -- for hepatitis testing, which is to implement routine viral hepatitis testing as part of the standard of care in a reformed health care system.

To read more about the Task Force’s recommendation on HIV screening, click here.

To see the fact sheet regarding HIV screening, click here.

To read more about the Task Force’s recommendation on Hepatitis C screening, click here.

To see the fact sheet regarding Hepatitis C screening, click here.

To read the HHS Action Plan, click here

The Task Force welcomes public comments on both of these draft statements. Comments for the HIV screening recommendation are due by December 17, 2012, and comments for the Hepatitis C screening recommendation are due by December 24, 2012. You can visit both of the recommendation links provided above to voice your opinion on these very important issues!

UNAIDS and Department of State Release Groundbreaking Reports

In the recent weeks, both UNAIDS and the Department of State released groundbreaking reports on improvements in the global fight against AIDS as well as a new PEPFAR (President’s Emergency Plan for AIDS Relief) blueprint for achieving an AIDS-free generation.

On November 20, UNAIDS released its World AIDS Day 2012 report on the global AIDS epidemic, which details much of the progress made in the last few years as well as steps that need to be taken to improve outcomes. According to the report, 25 low- and middle-income countries, more than half of which are in Africa, have seen a 50% or greater drop in new HIV infections since 2001. Furthermore, 1.7 million people died from AIDS-related causes in 2011, 24% fewer than in 2005. The number of people accessing antiretroviral therapy (ART) increased by 63% from 2009 to 2011. Half of the reductions in new HIV infections in the last two years have been among newborn children, indicating that achieving zero new HIV infections in children is a real possibility.

Despite the progress made on many fronts, there is still a lot of work that needs to be done. There were still 2.5 million new HIV infections in 2011, and many of these new infections are occurring in Eastern Europe and Central Asia. Seven million people eligible for HIV treatment still do not have access to that treatment. In 26 of 31 countries with generalized epidemics, less than 50% of young women have comprehensive and correct knowledge about HIV. Other key populations continue to include sex workers, intravenous drug users and men who have sex with men (MSM), where HIV prevalence is much higher than in the general population.

On November 29, Secretary of State Hillary Clinton released the “PEPFAR Blueprint: Creating an AIDS-Free Generation,” which outlines five principles that provide a road map for the United States and its partners to achieve an AIDS-free generation. The five principles are:

1. Make strategic, scientifically sound investments to rapidly scale-up core HIV prevention, treatment and care interventions and maximize impact.

2. Work with partner countries, donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations and multilateral institutions to effectively mobilize, coordinate and efficiently utilize resources to expand high-impact strategies, saving more lives sooner.

3. Focus on women and girls to increase gender equality in HIV services.

4. End stigma and discrimination against people living with HIV and key populations, improving their access to, and uptake of, comprehensive HIV services.

5. Set benchmarks for outcomes and programmatic efficiencies through regularly assessed planning and reporting processes to ensure goals are being met.

During Secretary Clinton’s press event, which AIDS United President and CEO Michael Kaplan attended, she also stressed the importance of reaching out to key populations that are often times discriminated against and victims of structural violence and debilitating stigma, including MSM, sex workers, and people who inject drugs. The blueprint expands on Secretary Clinton’s comments, proclaiming that “success in saving lives also depends on promoting and supporting institutional and social changes, such as ending stigma and discrimination against key populations, as well as people living with HIV (PLHIV); promoting gender equality, including education for girls along with economic opportunities and assets for women; preventing and addressing gender-based violence (GBV) and exploitation which continue to put women and girls at higher risk for HIV infection; and repealing laws that penalize people simply because of their sexual orientation.” AIDS United is pleased to see such a comprehensive plan focuses efforts on populations known to be at higher risk and who continue to be hardest hit by HIV.

To read the UNAIDS press release regarding their report, click here. For the full UNAIDS report, click here.

To watch Secretary Clinton deliver her remarks, click here.

To read the Department of State’s PEPFAR blueprint, click here.

Essential Health Benefits Proposed Rule

Just before the Thanksgiving holiday, on November 20, 2012, the Department of Health and Human Services (HHS) released a proposed rule related to the coverage of essential health benefits (EHB) under the Affordable Care Act (ACA). The proposed rule outlines standards that qualified health plans must meet in providing EHB coverage, as required under the ACA.

HHS also released a letter to State Medicaid Directors giving guidance as to how EHB will be approached under Medicaid expansion.

The rule details how EHB coverage will be defined and implemented are very important for people living with HIV/AIDS and for people living with other chronic conditions. As indicated by HHS when a bulletin on EHB was released last December, the states will be given a great deal of flexibility in carrying out the ACA’s requirements for EHB.

Comments on the proposed rule are due to HHS by Dec. 26, 2012.

Click here for an analysis prepared by Treatment Access Expansion Project and the National Alliance of State and Territorial AIDS Directors (NASTAD) of the proposed rule and the letter to the State Medicaid Directors.

To see the full proposed EHB rule, click here.

Announcements

“New Responses to the HIV/AIDS Epidemic in D.C.” Event

The District of Columbia Developmental Center for AIDS Research (D.C. D-CFAR) is hosting a seminar featuring Dr. Gregory Pappas, a senior Deputy Director of the D.C. Department of Health and leader of the HIV/AIDS, Hepatitis, STD and TB Administration (HAHSTA). Pappas will present on “New Responses to the HIV/AIDS Epidemic in D.C.”

The seminar will take place on Monday, December 3, 2012, from 6:30-8:00 PM at the George Washington University Hospital Auditorium (basement level), which is located at 900 23rd Street NW, Washington, D.C. The event is free and open to the public, and you can register here.


Survey Regarding Safe and Appropriate Access to PrEP for Women in the U.S.

Earlier this year, SisterLove, a reproductive justice organization for women that focuses on HIV/AIDS and is based in Atlanta, met with a group of women advocates from across the U.S. to talk about how to make PrEP (Pre-Exposure Prophylaxis) safely and appropriately accessible to women in the U.S. who want to use it. They have developed this survey to make sure that the views of transgender women, sex workers and active drug users are represented in their discussions.

We invite any and all women to complete this survey by January 1, 2013. Your input is greatly appreciated and will assist SisterLove in this important discussion about the role of PrEP in the lives of women in the U.S. Feel free to pass this survey along to whatever lists, friends or colleagues you think are appropriate.

For more information, please contact Anna Forbes at annaforbes@earthlink.net or (301) 946-4269,(610) 662-1261.


National Black Leadership Commission on AIDS, Inc. Hosts Town Hall Meetings

The National Black Leadership Commission on AIDS, Inc., is hosting multiple town hall meetings in cities across the United States on “Turning the Tide Together: Addressing HIV/AIDS and Health Disparities in Black Communities.” These town halls are free and open to the public. Forums will be held in the following locations: New York, NY, on December 4; Tampa, FL on December 7; Texas on December 14; and New Orleans, LA, and Jackson, MS in 2013 (dates to be determined). Speakers at the New York forum include Ronald Johnson, AIDS United’s Vice President of Policy and Advocacy, who will be speaking on the Patient Protection and Affordable Care Act. Please contact Athena Moore (amooreaka@hotmail.com) for more information regarding the town hall meetings in your area.


Congressional HIV/AIDS Caucus Website Launched

Marking the occasion of World AIDS Day on December 1, the bicameral and bipartisan Congressional HIV/AIDS Caucus launched its new website! The Caucus hopes this forum will assist in continuing the dialogue and dissemination of information among Members of Congress as well as partners in the public. To recognize World AIDS Day and remember  those affected by HIV/AIDS, members of the Caucus delivered one-minute speeches on the House floor yesterday, November 29 at noon. You can visit the new website by clicking here.


‘Tis the Season…for End-of-Year World AIDS Day Reports!

As 2012 comes to an end and World AIDS Day approaches, many HIV/AIDS related organizations are publishing their yearly reports. To read more about the reports, click on the links below.

  • The AIDS Vaccine Advocacy Coalition, AVAC, has published Achieving the End: One Year and Counting, their 2012 report on the state of biomedical HIV prevention research and implementation.
  • The Southern HIV/AIDS Strategy Initiative, SASI, released their updated report The Continuing HIV Crisis in the US South, which highlights 9 southern states that have been hard hit by the epidemic and calls for a “State of the South Task Force.”
  • The Global Health Policy Center at the Center for Strategic and International Studies, CSIS, published Lessons Learned from AIDS 2012: Friends in Need are Friends Indeed, a report on what AIDS 2012 achieved, why the CSIS advisory group “American Friends of AIDS 2012” was formed, and what we might expect from future International AIDS Conferences.
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