June 12, 2012
The eleventh 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 tenth installment reported on the Denver meeting.
Participants at a town hall meeting May 9 discussed the successes Seattle has had in fighting the HIV/AIDS epidemic, but complained about the complacency among some community members who aren't voicing their needs.
"We've been so incredibly lucky and we're on the cusp of sharing that luck with others through the Affordable Care Act," said panelist Jesse Chipps, planning council administrator for the Seattle HIV/AIDS Planning Council. "But I worry about people who are getting what they need and because they're getting what they need, they're not speaking out."
An audience of 25 participants listened as panelists described the Seattle area's success in getting people with HIV/AIDS identified and into care.
King County, where Seattle is located, has a higher-than-average number of HIV-positive people with an undetectable viral load, said Chipps. That's important since people with an undetectable viral load are less likely to transmit HIV.
Participants also discussed how Seattle residents living with HIV/AIDS have experienced a more focused response than people living in other areas. "I moved here from a place where you couldn't get a legislator to say HIV out loud," one audience member said. "[Here] your insurance and copays are covered. Your access isn't a huge issue unless you live in a rural community. This is an amazing place."
One audience member who described himself as a physician expressed confidence that Seattle will continue to perform well when it comes to the epidemic. "I feel Seattle is nicely situated to handle the National HIV/AIDS Strategy and the Affordable Care Act," he said. "But it will be more difficult in rural areas and the southeast because they have significantly fewer resources."
Panelists also debated ways to get more community members involved in the fight against the epidemic. "Do we need to go back to grabbing people and going to community meetings?" asked panelist B.J. Cavnor, director of public policy and advocacy at Lifelong AIDS Alliance in Seattle. "Can we find a way to engage new media and social media and reach out to people who are not here?"
Some groups remain less likely to receive adequate care, "particularly minority and disenfranchised communities," one audience participant said. Several reasons were given for the disparity, including a lack of minority physicians and healthcare providers in the Seattle area and stigma within the Black community. "We think homophobia is a substantial contributor in the Black community because families don't want to accept it," said one audience member. Homophobia often interferes with people recognizing their risk and getting tested, often leading to a late diagnosis, participants said.
One audience member said disparities exist because there is too much focus on HIV/AIDS as a public-health issue and not enough focus on the disease as a social and cultural issue. "HIV is a social-cultural disease. It is transmitted through relationships," she said. HIV discussions also tend to be divisive, with different communities fighting for resources, she continued. Unless the HIV/AIDS community starts focusing on community building and addressing the social-cultural factors, "we will see the same people having the same conversations 10 years from now," she said.
Other panelists at the two-hour meeting included Jake Ketchum, program manager at Seattle Area Support Groups, and Renee McCoy, assistant director of prevention education at Lifelong AIDS Alliance.
As far as what town hall participants wanted the world to know about Seattle's HIV response, there was a consensus that Seattle has done an impressive job in meeting the HIV crisis head-on, but the response "could always be better," Cavnor 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 health and wellness.