White House Visits AIDS Action
It’s not often that people living with HIV/AIDS get to sit down and talk with the White House official responsible for implementing federal policy initiatives that directly impact them. But that’s what happened at the AIDS Action Committee on Oct. 19, when Jeffrey Crowley, Director of the Office of National AIDS Policy, participated in a town hall style meeting with about 30 clients of AIDS Action.
AIDS Action President and CEO Rebecca Haag introduced Crowley who gave an overview of the Obama Administration’s National Policy on HIV/AIDS, which was released this past July. The plan — the first ever released by the federal government to coordinate federal, state, and local responses to the HIV/AIDS pandemic — calls for a 25 percent reduction in new HIV diagnoses over the next five years as well as a focus on populations vulnerable to HIV infection, including gay/bi men, African Americans, and Latinos. The three main prongs by which the national strategy plans to achieve this are increased resources directed at reducing new HIV infections; more frequent HIV testing among vulnerable populations; and increased access to treatment.
Crowley then asked attendees what steps the Obama administration could take to better address the impact of the epidemic on their lives. Several clients shared their stories of experiencing stigma and discrimination and how devastating and discouraging it can be. They often fear revealing their status to friends and colleagues for fear of being shunned or ignored. One suggested increased training for medical providers. Another suggested doing public service announcements (PSAs) raising awareness about people with HIV/AIDS. Crowley noted that the PSAs run by the Obama Administration last year were the first to be created by a presidential administration in 15 years.
He referenced the “Greater Than AIDS” campaign aimed at raising HIV/AIDS awareness in the black community, as a great example of outreach to a population that’s vulnerable to HIV infection. Crowley also assured attendees that Obama understood the stigma issue and that’s why he and his wife have been publicly tested for HIV and will continue to talk about HIV in their public appearances.
Another client, noting that he was not comfortable being tested in some medical settings, asked for more funding for places like The MALE Center, which is geared toward reaching out to gay and bisexual men and provides free, on-demand HIV testing during evenings and weekends. He shared his experience of panic and distress when a close friend disclosed his status. He immediately called The MALE Center and the staff helped him through his anxiety, provided a test — which was thankfully negative — and then counseled him on safe sexual practices so he could protect himself and avoid infection.
Other clients talked of the need for more peer support programs, better engagement with faith communities, an almost complete lack of resources for transgender people with HIV/AIDS, more funding for clinical care, tying HIV prevention for women with reproductive health, and the need for sexuality education in schools.
One also pleaded for an end to “sanitized” prevention messages aimed at gay men. Crowley said that Obama was sensitive to the need for better outreach and prevention but also said that there was only so much the federal government could do. The private sector, Crowley said, needed to engage in developing relevant prevention messages and campaigns.
Before the meeting with clients, Haag hosted a luncheon for Crowley and a dozen public officials and community leaders. There, he talked about how the Affordable Care Act (the national health reform law signed by President Obama March 23), will impact people with HIV/AIDS. Most notably, the law now prohibits health insurers from canceling coverage to children who are living with HIV or AIDS; insurers can no longer impose a lifetime cap on benefits; and the law is currently phasing out the Medicare Part D prescription drug “doughnut hole.”
Lunch attendee Robert Greenwald, a member of the President’s Advisory Council on HIV/AIDS and a professor at Harvard Law School, noted that thanks to the ACA, approximately 80 percent of the people with HIV in the United States will be eligible for Medicaid by 2014.That’s when low-income individuals who are diagnosed with HIV will become immediately eligible for Medicaid health care benefits. In 48 states, people who are HIV positive are not eligible for such benefits until their HIV progresses to an AIDS diagnosis. (Massachusetts is one of the two exceptions that already provide early eligibility to Medicaid for people with HIV. In the early 1990s, the AIDS Action Committee policy department, under Greenwald’s leadership, pushed for an expansion to the state’s HIV coverage under the state’s Medicaid program. Early access to health care for people who are HIV positive is one of the reasons why health outcomes for people with HIV/AIDS in Massachusetts have long been among the best in the nation.)
Lunch attendee Kevin Cranston, Director of the Division of Infectious Diseases of the Massachusetts Department of Public Health, talked about how other states might be able to learn from the ways that Massachusetts has been able to keep people with HIV/AIDS eligible for health care by creatively applying federal and local dollars to public health insurance programs.
Others noted how the full array of services provided to people with HIV by AIDS service organizations such as AIDS Action — which includes assisting clients with services not directly related to health care, such as housing and legal services — could become a model of care for people living with other chronic diseases such as diabetes and asthma.
Other lunch attendees included Cheryl Bartlett, Director of Chronic Diseases of the Massachusetts Department of Public Health; Dr. Nancy Norman, Medical Director of Boston Public Health Commission; Dr. Michael Wong of Beth Israel Medical Center and chair of the AIDS Action Board of Directors; Jonathan Scott, CEO, Victory Programs; Douglas Brooks, Vice President of JRI Health and member of President’s Advisory Council on HIV/AIDS; Dr. Barbara McGovern; David Waters, CEO of Community Servings; Dr. Bisola Ojikutu of Harvard Medical School and MGH; Bill Walczak, Executive Director Codman Community Health Center; John Gatto, Senior Vice President of Programs at AIDS Action; and Renee Markus Hodin of Community Catalyst.
To learn more about the AIDS Action Committee, please visit www.aac.org.
Cross-posted at BayWindows.com.