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News & Notes

January/February 2000

NYC Housing Victory
HOPWA Swap, Continued
Circumcision and AIDS
Prevention Neglected
Ticket To Work
Communities Unite Against AIDS
New GMHC Executive Director
Dentists' Duty to Treat
Gay Victory in Vermont
Anemia Awareness Campaign
AIDS Acitivist Honored

New York City Housing Victory

HIV-infected New Yorkers in need of shelter scored a victory recently, when a state court ruled that Local Law 49 means what it says.

The suit was brought by the AIDS service organization Housing Works on behalf of two of its clients. Housing Works argued that the law's requirement that the Division of AIDS Support and Income Services (DASIS) provide "medically appropriate housing" means that DASIS clients who request it must be provided with shelter for the night. The city contended that DASIS had 24 hours in which to meet shelter requests.

Ruling in favor of Housing Works and homeless people with AIDS, Justice Emily Jane Goodman ruled that "a night on the streets ... is medically inappropriate."

HOPWA Swap, Continued

In another victory on the housing front, the federal Department of Housing and Urban Development has once again shot down the Giuliani administration's attempts to cut back on the city's funding of housing for people with AIDS. As reported in the November 1999 Body Positive ("Housing Shell Game in New York"), the city had proposed a complicated scheme of redirecting $25 million of federal HUD money received under the Housing Opportunities for People with AIDS (HOPWA) program into case management services at DASIS and replacing it with city tax levy dollars ... but without the controls attached to the HOPWA funds. AIDS organizations and their supporters on the City Council successfully fought back the proposal, and HUD refused to give the city the required approval for the redistribution of the funds.

Unfortunately, it didn't end there. The Giuliani administration opted to ignore HUD's rejection of the plan and included it in the new HOPWA Proposed Consolidated Plan anyway. But the end run didn't work. HUD nixed the plan again, essentially saying it will not allow New York City to use federal AIDS housing money to take the place of city funds.

Male Circumcision and AIDS Risk

Analysis of nearly forty studies conducted in Africa over the past decade suggests that male circumcision may reduce the risk of HIV infection by at least half, according to a story in the Boston Globe in November.

According to Stephen Moses of Canada's University of Manitoba, "The evidence is not 100 percent consistent, but more and more studies are out, and they show that men who are not circumcised are at least two times more at risk of infection than men who are circumcised." The reason is that the foreskin is susceptible to tearing and bleeding during intercourse, and it traps potentially harmful body fluids.

More than 2 million people die each year from AIDS in Africa, where the disease is primarily spread by heterosexual contact and mother-child transmission. Depending on the country, twenty to eighty percent of men are not circumcised. Circumcision may be one of the most promising and low-cost methods yet suggested for slowing the rate at which the epidemic is sweeping the African continent. Fearful of offending cultural sensibilities, many international organizations and healthcare workers have been reluctant to push for widespread circumcision. Their fears may be unfounded, however, say some experts. They point out that ethnic groups that do not circumcise their men generally do not attach the same deep significance to the practice as groups that do.

Epidemiologist Robert Bailey of the University of Illinois at Chicago, who conducted the analysis of existing studies, says that research supporting an HIV-circumcision link has been met with resistance. "No one wants to be first to come out with a statement in support of male circumcision," he says. "In the U.S. and Europe there are big anti-circumcision movements now, so people don't want to promote something in Africa that is discouraged here."

Prevention Neglected in Major Population Centers

Drug-injection-related AIDS continues to spread in the absence of syringe exchange programs, and many states and cities with the highest rates of injection-related AIDS do not have these programs, according to a new analysis by the Dogwood Center of Princeton, New Jersey.

"Four of the ten states with the highest rates of IV-drug-use-related AIDS do not allow needle exchange programs. None of the states provide adequate needle exchange," says Dawn Day, Ph.D., Director of the Dogwood Center and the study's author.

The study is based on a special tabulation of most recent data -- through 1998 -- obtained from the Centers for Disease Control and Prevention. Injection-related AIDS cases include persons who inject drugs and their heterosexual partners. According to the CDC, half of all new AIDS cases start with sharing syringes.

"New York, which leads the nation, historically has had the largest concentration of heroin users. Needle exchange programs in New York City have reduced the per capita HIV rate. But the number of exchange programs is completely inadequate to stop the spread of HIV," says Day.

The spread of HIV through shared syringes has increased for two reasons. First, the price of heroin has fallen and purity increased, making addiction more rapid and less expensive. Second, medical advances in AIDS treatment mean persons who inject drugs and are infected with HIV/AIDS are living longer, and continuing to share needles.

"For effective AIDS prevention, substantial expansion and federal funding of needle exchange programs are urgently needed," says Day.

Ticket to Work

More good news for people with HIV and AIDS: President Clinton has signed into law the Ticket to Work and Work Incentives Improvement Act, which essentially means that people with disabilities will no longer be forced to choose between their health and their livelihood.

Under the new law, which passed Congress with strong bipartisan support:

  • State Medicaid programs will be allowed to cover working people with disabilities who are able to continue working only because they are receiving medical treatment.
  • States can let workers with disabilities purchase Medicaid, even if their income is over $20,000 per year.
  • Medicare recipients who go back to work are entitled to receive Part A coverage at the subsidized rate for up to 99 months, more than twice as long as before passage of the bill.
  • Some states will be able to launch demonstration programs extending Medicaid coverage to disabled individuals who need medical care in order to continue to work.
  • Nonprofit and private providers, not just state agencies, will be eligible for compensation for vocational and rehabilitation services they provide to people receiving federal disability benefits.

African-American Faith Communities Unite Against AIDS

In late October, national and local leaders gathered in Washington, D.C., for a Gospel Concert Against AIDS. The free concert was a joint venture among several HIV/AIDS organizations, local churches, corporations, community groups, and government agencies. It brought together clergy and national figures such as Sandy Thurman, White House Director of AIDS Policy, and Donna Christensen, leader of the Congressional Black Caucus's Task Force on Health. Al Roker of NBC's Today Show and prominent AIDS activist Mary Fisher also participated, as did renowned gospel groups and Broadway stars.

The goal of the event, according to the D.C. Comprehensive AIDS Resources and Education Consortium, was to increase the number of African-American churches active in combatting HIV/AIDS. AIDS is now the leading cause of death for African-American men and women between the ages of 25 and 44. Although African-Americans make up approximately thirteen percent of the nation's population, they accounted for 56 percent of all new HIV infections in 1998. Washington, D.C., has among the highest infection rates in the nation.

Among the supporting organizations was the Dwayne S. Brown Foundation, an organization founded by William Beale in honor of his gay son, who died of AIDS-related complications. Beale, who is active in PFLAG -- Parents, Families and Friends of Lesbians and Gays -- has worked for months with other local families and PFLAG to launch "For Those We Love," a support group for African-American families and friends of gay, lesbian, bisexual, and transgendered people.

New GMHC Executive Director

New York's Gay Men's Health Crisis has announced the appointment of Ana Oliveira as its new Executive Director. Oliveira thus becomes the first woman, the first Latina, and the first lesbian to head the agency.

Oliveira's appointment comes after a year of unprecedented turmoil in the nation's oldest and largest AIDS service organization, and less than a week after the announced resignation of her predecessor, Dr. Joshua Lipsman. Lipsman assumed the Executive Directorship in January 1999, at a time when GMHC was dealing with several years of declining revenues and mounting expenses. Staff and services were being cut and cut again, and the agency was saddled with an extremely restrictive lease on a large building it could no longer occupy to capacity. His tenure was marked by controversy and charges of overspending and mismanagement.

Before taking over as Executive Director, Oliveira had been serving as the agency's Associate Executive Director. A Manhattan resident born and raised in Brazil, she joined GMHC in 1996 as Director of Women's Educational Services and later served as Managing Director for Program Services, where she oversaw the integration of services throughout the organization. Before coming to GMHC she worked at Samaritan Village, the Osborne Association, and El Rio. She has an M.A. in Medical Anthropology from the New School for Social Research in New York and is a member of the New York City HIV Planning Council.

Oliveira's first official act was to ask Ronald Johnson, GMHC's Managing Director for Policy, Communications, and Community Relations, to serve as Associate Executive Director and her second in command. Johnson joined GMHC in 1997 after having served as Citywide Coordinator for AIDS Policy in the Office of the Mayor of the City of New York. Johnson is a Brooklyn resident who received his undergraduate degree at the City College of New York and pursued graduate study at Harvard University. He also serves on the Presidential Advisory Council on HIV/AIDS.

In a joint statement, Board of Directors co-chairs Dr. Marjorie Hill and William McCarthy said, "We all need to be reminded that AIDS is not cured and that the epidemic is not over. Although the epidemic is eighteen years old, there are nearly 40,000 people newly infected with HIV each year in the United States. We must renew our prevention messages to reach young people, especially young gay men, women, and communities of color. Despite the incredible medical advances over the past three years, people with HIV continue to need treatment and care. We must continue to press the federal, state, and city governments to do more. Along with others in this country, we must address the global AIDS catastrophe. Ana Oliveira's unique talent and intelligence are the right qualities for facing the challenges of HIV/AIDS into the new millennium. The Board is grateful for the stability, history, and continuity that she brings to this position."

Dentists' Duty to Treat

"Dentists are often the first to notice the clinical changes that signal the onset of symptomatic HIV disease, making them vital to helping HIV-infected people maintain good health. Yet too frequently the relationship between the dentist and the HIV-infected patient is adversarial.

"Patients hide their status, even when they know they are withholding information important to their care, because of discrimination and rejection experienced with other dentists. In turn, this mistrust and lack of candor makes caring providers feel frustrated and abused."

So says David I. Schulman, J.D., in "The Dentist, HIV and the Law: Duty To Treat, Need To Understand" in the July 1999 Journal of the California Dental Association.

The article is a reprint of a similarly titled article Schulman wrote in 1993, updated to reflect the Supreme Court's 1998 decision in Bragdon v. Abbott denying a dentist's claim that he had a right to refuse to treat a person with HIV because of the risk of infection that she posed.

The article stresses that "disability right laws require that overly broad generalizations about disease be set aside in favor of individually based evaluation." It goes on to say, "Dentists can't refuse to treat all HIV-infected patients. For instance, asymptomatic HIV patients should never be refused care merely because they have HIV, because asymptomatic patients, by definition, present no clinical symptoms that might be beyond the scope of a dentist's competency and training."

Gay Victory in Vermont

In a landmark decision, the Vermont Supreme Court on December 20 ruled in favor of three same-sex couples who had challenged the constitutionality of the state's marriage laws. The court concluded that statutory benefits and protections of marriage must be extended to same-sex couples, and it directed the state legislature to remedy the discrimination.

Holly Puterbaugh and Lois Farnham, one of the plaintiff couples, cheered the ruling, noting, "We'll be celebrating our 27th anniversary together in October. We look forward to the time when we can finally make it official." Stan Baker and Peter Harrigan of Shelburne and Nina Beck and Stacy Jolles of South Burlington joined Farnham and Puterbaugh in challenging the state's refusal to grant them civil marriage licenses.

Susan Murray, co-counsel for the plaintiffs, stated, "It's really a win-win situation for everyone. The court's decision will provide added security and protection to same-sex couples and their families without taking anything away from anyone else."

"This is a legal and cultural milestone," added Mary Bonauto, co-counsel for the plaintiffs and Civil Rights Director at New England-based Gay & Lesbian Advocates & Defenders. "The court recognized that same-sex couples need and deserve the same legal rights and protections other people take for granted. The court's decision paves the way for more secure families and stronger communities."

Same-sex couples in Vermont will now be eligible for the protections of a wide variety of laws that recognize the relationship of married partners. They will be able to inherit from one another without a will, for example, make medical decisions for an incapacitated partner, transfer property to each other without tax consequences, and take time from work to care for each other in the event of illness. A survivor will be able to bury his or her own partner, and same-sex couples can be treated as an economic unit for tax purposes. In the event that same-sex partners break up, they can seek an ordered division of property under law. The plaintiff's third attorney, Beth Robinson, explained, "These types of legal protections are extremely important to same-sex couples and the families they form. We can now declare who is our next of kin."

The parties filed their lawsuit in the Chittenden County Superior Court in July 1997, after each of the three couples was denied a marriage license by their local town clerk. The trial court dismissed the case in December 1997, and the plaintiffs appealed to the Vermont Supreme Court. That court heard oral argument in November 1998, and interested parties from all over the country submitted amicus briefs. In its ruling, the Vermont Supreme Court suspended the case and retained jurisdiction in order to ensure that the legislature crafts an appropriate response.

Since the Vermont court based its ruling on the state rather than the federal constitution, the decision cannot be appealed.

Anemia Awareness Campaign Targets African-Americans

Former U.S. Surgeon General Dr. Joycelyn Elders has joined with The Balm In Gilead and the National Minority AIDS Council, two of the nation's leading AIDS organizations, in a national campaign urging African-Americans living with HIV to see their healthcare providers about anemia. The campaign includes print and radio public service announcements and advertisements featuring Dr. Elders, a toll-free number for more information [(888) 321-AIDS], and two websites for further information online -- and

"The AIDS epidemic is having a devastating impact on African-Americans," said Dr. Elders, who served as U.S. Surgeon General from July 1993 to December 1994. "At the same time, the qualify of life for people living with HIV is being compromised by HIV-related conditions such as anemia. As many as 95 percent of people living with HIV will develop anemia during the course of their disease, and we want them to know they don't have to feel tired all the time. Treatment options are available that can dramatically improve the way they feel."

Anemia is an abnormally low level of red blood cells common in people with HIV/AIDS and its treatments. It can be caused by the virus itself or by treatments that suppress the bone marrow, among other factors. It can be diagnosed by a routine red blood cell count.

AIDS Activist Honored

At its 1999 annual fall convocation, Trinity College of Hartford, Connecticut, honored alumnus Patrick J. O'Connell, founding director of Visual AIDS and pioneer of the international "Day Without Art" and the red-ribbon campaign, for his accomplishments.

The November 12 convocation, "The Art of Courage," celebrated individuals who have made outstanding contributions to the arts and "demonstrated courage by pushing the limits of æsthetic conventions, or overcoming resistance or personal hardship, or giving shape to ideas contrary to the social and political mainstream."

"In founding the uniquely effective arts organization Visual AIDS, Patrick O'Connell created an instrument that brought immediate attention to the disease and the struggle to contain and cure it," said Trinity College President Evan S. Dobelle. "Patrick has given a proud, strong, articulate voice to the millions of patients and caregivers worldwide who have had to endure the indignities and suffering of this catastrophic disease."

Back to the January/February 2000 Issue of Body Positive Magazine

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This article was provided by Body Positive. It is a part of the publication Body Positive.