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MARCH 8, 2013
House Acts to Avoid Government Shutdown

Undeterred by the threat of a major winter snow that led to federal offices closing on Wednesday, the U.S. House of Representatives passed a new Continuing Resolution (CR) to fund the federal government for the balance of FY 2013 (to Sept. 30, 2013). The bill (H.R. 933) passed on a 267- 151 vote, with 13 Representatives not voting. House Democratic leadership did not support the CR but 53 Democrats did vote “Yes;” 14 Republican Members voted “No.” The current CR expires March 27th and both houses must pass a new CR and the President must sign the legislation by the deadline to avoid a government shutdown.

For most departments, including those that administer all domestic HIV/AIDS programs, the House CR continues the funding levels currently in place. However, there is a catch. Sequestration, a process of cuts mandated by the Budget Control Act of 2011, went into effect on March 1st. The CR does leave sequestration in place for FY 2013, so all programs are now subject to the automatic spending cuts it requires. In a “Report to Congress” released last Friday, the Office of Management and Budget (OMB) calculates the automatic cuts to be 5% for non-defense discretionary (NDD) programs that are non-exempt, which includes HIV/AIDS programs.

The House did, however, act to soften the effects of sequestration for the Defense and Veterans Affairs Departments. The CR includes the full FY 2013 appropriation bills that the House passed for the two departments. The CR also gives the two departments more flexibility on how to apply the cuts than for other departments. The total spending level in the new CR remains at $1.043 trillion before sequestration. The reported total level after sequestration is $984 billion.

Attention now shifts to the Senate. Under the leadership of the new Appropriations Committee Chair, Senator Barbara Mikulski (D-MD), the Senate is expected to take a somewhat different approach, although maintaining sequestration in FY 2013. Senator Mikulski is reported to be adding full appropriation bills (with funding levels higher than FY 2012) for additional departments, including Agriculture, Homeland Security, and Commerce/Justice/Science. Again, this would have the effect of giving those departments more flexibility in applying the automatic cuts. The Senate version may also include provisions that provide additional pre-sequestration funding for key health projects and that give departments “enhanced transfer reprogramming authority” that could allow flexibility in administering the automatic spending cuts. According to a report in CQ. News, Ranking Member Richard Shelby (R-AL) supports the emerging Senate CR. The Senate version of a new CR is expected also to stay at the $1.043 trillion total funding level before sequestration.

The Senate likely will take up the House-passed CR starting on Monday, March 11th, with a floor vote starting on Wednesday to be completed on Thursday. Since both Congressional leadership and the President say they wish to avoid a government shutdown, final action on a new CR is expected before Congress takes its Easter/Passover recess starting March 22nd and well before the March 27th deadline.

The HIV/AIDS community will need to advocate strongly over the next two weeks, beginning next week with the Senate, for a new CR that mitigates the effects of sequestration on HIV/AIDS programs and other vital health care and public health programs, including implementation of the Affordable Care Act (ACA). We should also oppose any amendments that would target the ACA or low-income safety net programs for further funding restrictions. We must tell Congress members what the drastic, indiscriminate automatic cuts will mean for people and communities affected by HIV/AIDS. We must make our voices heard.

Community Discussion Co-Sponsored by AIDS United Highlights CROI 2013 VOICE Findings

By: Charles Stephens, Regional Organizer, AIDS United

Research is the most successful when scientists and community members work together. Innovation requires the best ideas put forth by diverse stakeholders. The urgency of our present moment necessitates that progress continues to keep pace with the epidemic. For that to happen we must insist upon the collaboration of scientists and community members in sharing information, engaging one and other, and mutually committing to doing their part in moving us closer to an AIDS free generation. Certainly this relationship is not always seamless, but it is definitely necessary. Such a collaboration was manifested beautifully earlier this week at a community discussion I attended.

Monday, March 4th, AVAC along with several partners including AIDS United, hosted a community discussion at CROI (Conference for Retroviruses and Opportunistic Infections). The forum was organized to connect local community members with researchers presenting at the conference. Dazon Dixon Diallo, Founder/President of SisterLove, Inc, which is also an AIDS United partner/grantee, and myself, AIDS United Southern Regional Organizer, were a part of the Atlanta-based planning team.

The event was held in downtown Atlanta not far from the conference. We wanted to ensure the space would be convenient to conference attendees and presenters, and accessible to community members. The Loudermilk Center, the space in which the event was held, is frequently used to host events targeting the HIV/AIDS community. It was very well attended, with 60 or more people present, and there was an excellent mix of community members, conference attendees, research advocates, and scientists.

In our work, the announcement of major research findings has a historical feel. Actually, perhaps all of HIV/AIDS work has a historical feel. We understand perhaps better than most, that history isn’t all grand battles and great events but a series of moving pieces and energies that are harnessed to create the magic that is social change. History is how many of us mark our work in the HIV/AIDS realm ….were you in Vancouver in 96?

To read more about Charles’ experience at the community discussion, click here.

CROI: Possible Infant "Cure" but Health Disparities Remain Evident

At the 20th Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta this past week, the announcement of the “functional cure” of a baby who tested positive for HIV in Mississippi captured the attention of the world. The baby, now two and a half, has an undetectable viral load despite not having taken medication in ten months. After being born prematurely at 35 weeks to a mother who tested positive for HIV at the hospital, the infant was also tested for HIV at 30 hours of age. The test results found a fairly low level of virus in the infant, suggesting the infection occurred in the womb. The test results were duplicated five times, giving the researchers working on the case confidence that the baby was actually infected. Dr. Hannah Gay of the University of Mississippi Medical Center started the infant on liquid antiretroviral treatment consisting of three anti-HIV drugs: zidovudine, lamivudine, and nevirapine prior to receiving confirmation of HIV. This is a more aggressive course of treatment than is usual for newborns with infected mothers, who would normally only receive one or two drugs as part of a prophylactic measure. However, after one month of this aggressive treatment regimen, the baby had an undetectable viral load. The baby maintained an undetectable viral load until 18 months of age, at which point the mother and child fell out of care and the child was no longer on antiretroviral therapy. Nearly six months later, the child returned to care and was found to have no detectable viral load and no HIV-specific antibodies. Furthermore, what tiny amounts of viral genetic material remain are unable to replicate.

While controversy and excitement have surrounded this case, it is important to remember that this is a single study that has not yet been peer-reviewed or published. Dr. Deborah Persaud of Johns Hopkins University School of Medicine announced the case at CROI and reported that efforts are currently underway to investigate whether such a functional cure is possible for larger numbers of infants. Until further research including clinical trials has been conducted, Dr. Eric Goosby, U.S. Global AIDS Coordinator, advises that clinicians continue to follow the established guidelines for the testing and treatment of infants.

What is perhaps most unsettling about this case is that the mother of the child had not received any prenatal care whatsoever before arriving at the hospital and giving birth prematurely. If the mother had accessed prenatal care, she would have been tested for HIV prior to giving birth and placed on AZT to greatly lower the risk of transmission to her child. Furthermore, both the mother and child fell out of care for nearly six months, highlighting the need to prioritize retention in care in order to ensure better health outcomes. From AIDS United’s view, it is unacceptable for an expectant mother in the United States today to not have access to prenatal care, and we must continue to advocate for services that may be lacking in rural areas to ensure that all woman have competent and comprehensive access to necessary resources. We must also work to ensure that woman around the world have access to prenatal care.

North Carolina Senate Passes Drug Overdose Prevention Bill

In North Carolina, the state Senate passed a comprehensive overdose prevention bill, Senate Bill (SB) 20. The bill would allow practitioners to prescribe Naloxone, also known as Narcan, to individuals or their families and friends who are “at risk of experiencing an opiate-related overdose.” Naloxone is an opioid antagonist that can reverse the effects of overdose on opiates such as heroin. It also allows people to administer Naloxone under some circumstances, and provides limited protection from prosecution for people seeking medical assistance. It also creates protections for people trying to help others avoid overdose, providing it with part of its short title as a “Good Samaritan Law.” The bill, which enjoys strong Republican support, was passed 50-0 and will move on to the North Carolina House for further consideration.

The issue of overdose prevention is strongly related to HIV/AIDS and has recently become more prominent for HIV/AIDS advocates as it has become clear that many people living with HIV, particularly injection drug users, are strongly impacted by the potential for overdose on opiates. A 2010 paper, “Why Overdose Matters for People with HIV,” from the Eurasian Harm Reduction Network and Open Society Foundations, details several issues that crossover between drug use and HIV/AIDS, including that overdose is a leading cause of death among HIV-positive drug users and that overdose prevention services can also help injection drug users to prevent HIV or to attain additional HIV-related health services. The paper also notes that many of the policies that increase the risk of HIV are also connected to overdose issues. For these and other reasons, helping to reduce the risk of overdose may help lower the risk of HIV.

The North Carolina Harm Reduction Coalition, an AIDS United grantee, has played a key effort in building support for the bill. The strong vote of support from the North Carolina Senate shows that the hard work of advocacy and contacting legislators can pay off when a law has the potential to help people living with HIV.

The text of the law can be found here.


Upcoming HIV/AIDS Awareness Days

Mark your calendars now! March 10, 2013, is National Women and Girls HIV/AIDS Awareness Day and March 20, 2013, is National Native HIV/AIDS Awareness Day. To learn more about these and other HIV/AIDS Awareness Days throughout the year, click here.

The 24th National Week of Prayer for the Healing of AIDS began on March 3rd and will end tomorrow, on March9th, 2013. This is an annual HIV awareness campaign that mobilizes faith communities and highlights the contributions and the impact congregations are making in areas of HIV prevention, testing, direct service, advocacy and community engagement. To learn more about the final activities for the week, visit their website by clicking here.

“HIV Transmission and Prevention of Transmission: Working toward the End of the AIDS Pandemic” Event

The District of Columbia Developmental Center for AIDS Research (DC D-CFAR) is hosting a seminar featuring Dr. Myron Cohen, the J. Herbert Bate Distinguished Professor of Medicine, Microbiology and Immunology and Public Health at the University of North Carolina at Chapel Hill. Dr. Cohen will present on “HIV Transmission and Prevention of Transmission: Working toward the End of the AIDS Pandemic.”

The seminar will take place on Wednesday, March 13, 2013, from 6:30-8:00 PM at the George Washington University Marvin Center – Continental Ballroom, which is located at 800 21st Street, NW, Washington, D.C. The event is free and open to the public, and you can register here.

HRSA’s New Affordable Care Act Webpage

The Health Resource Services Administration’s HIV/AIDS Bureau (HRSA/HAB) has created “Ryan White and the Affordable Care Act: What you Need to Know,” a webpage meant to provide guidance on the key provisions of the ACA for the Ryan White Program. The page is intended to grow as a resource guide as more information becomes available. Click here to view the page.

Petition to the Obama Administration to Commit Resources to Ensure an AIDS Free Generation

On the heels of President Obama’s State of the Union Speech and in advance of the release of the Administration’s budget, the convening groups of the Federal AIDS Policy Partnership (FAPP) and the Global AIDS Policy Partnership (GAPP) posted a petition to the White House website’s “We the People” section. The petition calls on President Obama to fully support funding for an AIDS-free generation. We have 30 days (until March 16th) to get 100,000 signatures to garner a response from the White House!

We ask that you share the petition with your organizations, supporters and grassroots. Some in the community are using the hashtags #endaids, #aidsfreegeneration, and #dontcutnow in social media, and we ask that as you push the petition over your own social media channels you consider doing the same.

You can sign the petition here! Please share this with everyone you know so we can reach 100,000 signatures!

UCHAPS Launches Search for New Board Members

The Board of Directors of the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS) is launching the search for new Board candidates. They ask for your assistance in distributing this Call for Nominations package widely around your professional network and sphere of influence. The information provided includes the nomination process, nomination form, and details about Board Member responsibilities.

The deadline to submit the nomination application is March 31, 2013. If you or anyone interested in a Board position has a question, please contact Kirby Reed directly (kirby@uchaps.org), who will forward the inquiry to the Nominations Committee.

Thank you, and UCHAPS appreciates your help in sharing this Call for Nominations around the community.

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