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HIV Infection Numbers Drop For First Time in Decades, But Not Everyone Benefits

 

For the first time since the mid-1990s, the official estimate of annual HIV infections, or incidence, in the United States has decreased notably. According to a study released by the Centers for Disease Control earlier this week, HIV incidence dropped 18% in recent years, going from an estimated 45,700 infections in 2008 to 37,600 in 2014. This reduction in new HIV infections—the first official one in nearly two decades—is a welcome development at a time when good news in health care is becoming hard to come by with the specter of Affordable Care Act repeal looming in Congress.

The study’s findings had their share of troubling aspects as well. The undeniable progress that was made in the fight against HIV infection in America in recent years was not distributed evenly. The largest amounts of reductions in HIV incidence over the 6-year period covered by the study came from heterosexuals and people who inject drugs, who saw their new HIV infections decline by 36% and 56% respectively. Slightly smaller decreases were also seen among certain age groups of gay and bisexual men, with a 26% drop for gay and bisexual men between the ages of 35 and 44, and an 18% drop for gay and bisexual men between the ages of 13 and 24.

Unfortunately there were several populations who saw their new HIV infections remain stable or increase over the course of the study. The HIV incidence among black gay and bisexual men stayed at the still alarmingly high number of 10,100 new infections at the beginning and end of the 6-year period, while there were increases among Latino gay and bisexual men, and gay and bisexual men between the ages of 25 and 34. Latino gay and bisexual men saw a 20% increase in HIV incidence between 2008 and 2014 while gay and bisexual men between the ages of 25 and 34 experienced a 35% increase in HIV incidence over the same period. Similarly, the South continued to be overrepresented in terms of HIV incidence, as the 37% of the US population that lives in the South accounted for 50% of new HIV infections in 2014.

There is reason for cautious celebration in the results of this study, as any significant decrease in new HIV infections should be lauded. But, with the rise in HIV incidence for portions of the population and a health care system currently in flux, it’s important that we recognize that even more vigilant prevention efforts are needed in the future if we are to maintain and improve upon this progress.

Posted By: AIDS United, Policy Department – Friday, February 17, 2017

Can Love Conquer!!!

AIDS United: A Harm Reduction Compendium

 

As a result of the opioid epidemic, the concept of harm reduction has come into increasing prominence in the United States. Harm reduction is a strategy designed to reduce harmful consequences of drugs, sex, or other risky behavior by focusing specifically on reducing the harms associated with that behavior rather than focusing on the risk or illegality of the behavior. AIDS United has long advocated for harm reduction policies such as legalizing and funding syringe services programs (SSPs) and allowing or even requiring that condoms be available in prison. With the 11th National Harm Reduction Conference hosted by the Harm Reduction Coalition in sunny San Diego just around the corner, this seems like a good time to provide an overview of some of AIDS United’s current harm reduction activities.

Harm Reduction Conference

AIDS United is participating heavily in this year’s National Harm Reduction Conference as a sponsor, as presenters and exhibitors, and as participants. AIDS United staff are leading several pre-conference workshops designed to help syringe service organizations and harm reduction organizers expand their capacity and increase their sustainability in an era of federal funding for syringe services. AIDS United is participating in a host of workshops throughout the conference – including a funders’ roundtable and a session diving into the federal implementation of syringe services funding – as well as tabling in the exhibitor hall for the duration. We will also be offering on-site technical assistance for any programs looking to apply for – or assist their health department in applying for – federal funding for SSPs.

Federal Funding Implementation

AIDS United has continued to monitor the implementation of federal funding for SSPs, and has produced a variety of resources for advocates and CBOs over the last year. In June, we released a webinar explaining the various implementation guidance documents released by the Department of Health and Human Services (HHS), Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), and Substance Abuse and Mental Health Services Administration (SAMHSA) as well as the role Community Based Organizations (CBOs) could play in guiding their jurisdiction’s “Determination of Need” process. A follow-up webinar, examining what we’ve learned over the first year of federal funding availability, can be expected in the new calendar year. This fall, we released a series of fact sheets, including an SSP-101 and fact sheets aimed at CBOs and SSP advocates. We continue to offer capacity building and technical assistance for programs interested in expanding services using federal funds through our CDC-funded capacity building program Getting to Zero and our policy department. Finally, we continue to work with our partners within the Coalition for Syringe Access to build upon the victories won in late 2015.

Funding

The Syringe Access Fund (SAF) is a funding collaborative of Elton John AIDS Foundation, Irene Diamond Fund, Levi Strauss Foundation, Open Society Foundations, and AIDS United. It is the largest private funding collaborative for syringe access in the United States. The Fund is currently in the first year of its 9th funding round, with grantees across the country continuing to offer lifesaving services and critical policy advocacy on behalf of people who inject drugs. The Round 10 RFA, covering 2018-2019, is expected to be released in Fall, 2017. To date, the Syringe Access Fund has provided more than $17 million in grants to syringe services programs.

Policy Advocacy

AIDS United continues to support harm reduction policy responses to substance use, and in July became the first national HIV advocacy organization to publicly endorse Supervised Injection Facilities as an HIV/HCV prevention strategy for people who inject drugs, alongside expanded access to Medication Assisted Treatment, layperson-naloxone distribution, Good Samaritan protections, syringe services programs, and non-abstinence based housing first permanent supportive housing programs. This endorsement, supported by our Public Policy Committee, firmly centers harm reduction approaches to HIV prevention for people who inject drugs. With the opioid epidemic continuing to rage, AIDS United expects to only deepen our commitment to advancing harm reduction responses to this public health crisis.

Posted By: AIDS United, Policy Department – Friday, October 28, 2016

As STD Rates Soar, Prevention Spending Cuts Continue to Loom Large

 

Infectious diseases don’t take breaks. Humanity has plenty of advantages over communicable diseases, but by and large, policy makers and the public have a disconcerting tendency to only pay attention to public health in times of crisis. In the midst of an outbreak, we are prone to take swift and demonstrative action to address whatever problems face us. However, as soon as that outbreak subsides, our reaction is too often to take our foot off the gas and refocus our energy on issues that suddenly seem more pressing.

For over a decade, funding to combat sexually transmitted diseases (STD) has been given the short shrift by Congress and state legislatures that is all too common with regards to health issues. Since 2003, Congress has not provided a single funding increase for STD programs, while, simultaneously, more than half of all state and local STD programs have undergone large budget cuts.

The result of this institutionalized neglect of STD prevention and treatment has been a startling, but not altogether surprising, resurgence in STD rates, with the recent release of a Centers for Disease Control and Prevention’s (CDC) report showing the highest number of combined cases of chlamydia, gonorrhea, and syphilis ever recorded in the United States. Between 2014 and 2015, the number of cases of primary and secondary syphilis, congenital syphilis, gonorrhea, and chlamydia rose by 19 percent, 6 percent, 13 percent, and 6 percent respectively, but those numbers only tell part of the story.

This sharp spike in STD rates over the past year is just the most recent and most pronounced manifestation of a disturbing epidemiological trend that shows no signs of stopping any time soon. Between 2003–the last year that Congress provided a funding increase for STD programs–and 2015, the recorded number of cases of primary and secondary syphilis increased by a staggering 333 percent. During the same period, the number of reported cases of chlamydia rose by 174 percent. The number of reported cases of gonorrhea have gone up by a comparatively low 18 percent, but this modest increase is countered by the severity of antibiotic resistant strains that are becoming increasingly prevalent.

It is not a coincidence that this surge in STD cases has come at a time when the budgets of state and local STD programs are being slashed. Much like our aging roads and bridges, America’s public health infrastructure is woefully underfunded and is being pushed to its breaking point. As Bill Smith, the former executive director of the National Coalition of STD Directors, put it at a congressional briefing on STD prevention back in April, “Our mantra has been to ‘do more with less,’ but now we’re doing less with less. The public’s health is in danger.”

At that same congressional briefing, Dr. Gail Bolan, the CDC’s director of STD Prevention, gave a dour diagnosis for the trajectory of STD infection in the United States if state and local STD programs continue to be underfunded or abandoned. “For those of you who are not clinicians, in most people’s assessment, congenital syphilis is a sentinel event.” Bolan said. “It is a failure of the health care system and it is a failure of the public health system. And in a society that invests as much as we do in our health care and in our public health we should not be seeing this number of congenital syphilis cases in the United States.”

One would think that Congress would immediately react to such a dire warning and would circle the wagons and work to nip this burgeoning STD crisis in the bud. Unfortunately, with the lame duck session quickly approaching, Congress may decide to double down on its neglect of the nation’s sexual health. In the Senate’s current Labor, Health and Human Services and Education Appropriations bill for FY2017, there is a proposed $5 million cut to the CDC’s Division of STD Prevention, while the House version merely continues the flat funding that has led to a 40% reduction in the Division of STD Prevention’s buying power since 2003.

Out of sight, out of mind, is not an acceptable approach for Congress or state and local governments to take regarding any public health issue, much less one with the destructive personal and financial implications of sexually transmitted disease. For the millions of Americans who contract STDs each year, and particularly for populations like men who have sex with men who bear a disproportionate brunt of this burden, what do these proposed cuts in funding say about the government’s opinion of them and their wellbeing? It is hard to interpret a call to slash STD program funding in the wake of this recently released CDC data as anything other than a disregard by elected officials for the health of their constituents and it cannot be allowed to stand. As Congress completes its funding of federal programs for the fiscal year that began Oct. 1, AIDS United will join other advocates in demanding increased funding for STD prevention. The latest surveillance data call for no less from us.

Posted By: AIDS United, Policy Department – Friday, October 28, 2016

WAD 2016

Please see attachment concering our collaboration with IRCHD and IRCHAAN for the upcoming WAD 2016.

PLEASE RSVP ASAP!!!!

 

 

 

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