May 8, 2012
The eighth in a series of articles about the Road to AIDS 2012, a 17-city tour that seeks to define the state of the U.S. epidemic and that leads up to the International AIDS Conference in Washington, D.C., in July 2012. The seventh installment reported on the Houston meeting.
Participants at a New York town hall meeting marked New York City's successes battling the HIV/AIDS epidemic but raised questions about whether other parts of the country would ultimately catch up.
"We've come a long way," said Monica Sweeney, M.D., assistant commissioner of the Bureau of HIV Prevention and Control in the city's Department of Health and Mental Hygiene. In the past, hundreds of babies were born each year with HIV, but "in the last year of data, there were three babies born positive with HIV in New York state," she added.
But some town hall participants living with HIV lamented the fact that New York state is so far ahead of other parts of the country in terms of HIV/AIDS care and treatment that they feel their health will suffer if they ever relocate.
"I came here in 2004 for services, and I have 30 or 40 friends from Florida, Atlanta, Detroit, Texas, Maryland and other states," one audience member said. He and his friends share a common fear: "If we're anywhere else, we may not receive care," he said. "We love New York, but a lot of us want to go home. I can't go somewhere else because of fear that services will be cut."
However, there is evidence that other parts of the country will improve their handling of the epidemic, panelists pointed out. For example, the U.S. Department of Health and Human Services' Office of HIV/AIDS Policy has allocated (pdf) $14.5 million each year for the next three years to help Southern states build an effective response to HIV, said panelist Marsha Martin, director of the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS). The Patient Protection and Affordable Care Act may also provide some relief because it establishes essential health benefits, or a basic set of services that people will be guaranteed under health-care reform.
Of course, the Affordable Care Act faces its own challenges. That was another topic addressed during the town hall meeting, which was attended by 65 local residents, many of them PLWHA. Not only will the Supreme Court be ruling on whether parts of the law are unconstitutional, but several Republican presidential candidates have vowed to dismantle it should they get into office.
"We need to call elected officials and urge them to make sure the Affordable Care Act stays in place," said panelist Ed Shaw, chair of the GMHC's consumer advisory board and the New York Association on HIV Over Fifty. Martin agreed, saying, "If you want information around HIV in your community and funds to support it, it's time the entire HIV community starts to vote for HIV-related causes."
The conversation also touched on areas in which New York's HIV response can use improvement. For example, earlier screening would lead to earlier diagnoses and better outcomes. "In New York City, men show up late and have concurrent HIV/AIDS diagnoses in the first year and a higher death rate," said Martin. The groups most affected in New York--the MSM, minority and transgender communities--also are still dealing with stigma, an issue that exists across the country.
The process of bringing HIV into the realm of routine medical care will help with that stigma, said panelist Blayne Cutler, M.D., director of New York City's Bureau of HIV/AIDS Prevention and Control. With HIV care and treatment currently taking place separately from other conditions, people are more likely to treat people living with HIV differently. "Many policies put in place have stigmatized HIV," Dr. Sweeney said.
Individuals can also play a large role in combating stigma. When it comes to the National HIV/AIDS Strategy, "people often look to government, but we need to ask, 'What can I do?' " said Dr. Cutler.
Other panelists and participants at the town hall meeting were Marcella Tillett, secretary of the NYC HIV Prevention Planning Group and a member of the UCHAPS steering committee; Sam Rivera, chair of UCHAPS; and Janet Weinberg, GMHC's chief operating officer. The event was held at GMHC and moderated by A. Toni Young, executive director of the Washington, D.C.-based Community Education Group.
Several participants noted that individual responsibility is also a key component of ending the epidemic. "I am responsible for my health. It takes two people to be unsafe and one to be safe," Dr. Sweeney said.
The entire Road to AIDS 2012 tour is a joint effort between the Washington, D.C.-based Community Education Group, the Urban Coalition for HIV/AIDS Prevention Services, pharmaceutical company Merck and AIDS 2012. The Road to AIDS 2012 will seek community input in cities across the country. That input will be shared at AIDS 2012 in Washington, D.C., when the International AIDS Conference is on American soil for the first time in more than 20 years.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.