Hey, folks living with and/or working in the field of HIV -- not to mention family, friends, and allies! You need to call your senators now -- especially if they're Republican -- and ask, beg, plead, demand, and implore that they fund the Housing Opportunities for Persons with AIDS (HOPWA) program at HIV/AIDS advocates' requested $410 million for fiscal year 2020.
Why is this so important? The main reason, explains Lauren Banks Killelea, public policy director at the National AIDS Housing Coalition, is that HOPWA is hugely important to keeping some 55,000 low-income households containing a person living with HIV stably housed, funding both direct housing programs and rental assistance. It also provides about 60,000 households with supportive services like housing counseling and services navigation, plus transportation to and from doctor and other important appointments. This is hugely important for people living with HIV/AIDS in rural areas or in certain cities with weak or no public transit.
Numerous studies have found that being homeless or unstably housed has led to poor health outcomes in people living with HIV -- and that the opposite, stable housing, has led to such positive outcomes as taking one's HIV meds regularly and achieving viral suppression (being undetectable).
"There's been so much talk about the president's plan to end HIV," says Killelea, "but you can't do that if you have people who are homeless, or sleeping on a cousin's sofa and scared to pull out their HIV pills [for fear of disclosure]. We have to make sure that people are housed, so that they can be healthy -- and that seems to be lost on the Trump administration" -- which has asked for HOPWA cuts -- "and on the Senate."
On the Senate, too? Yes. The Republican-led Senate, in recent years, has proposed flat-funding HOPWA, while the House has routinely proposed hikes -- and thankfully, the House has won out in the two-chamber reconciliation process, resulting in HOPWA funding going from $330 million to $393 million in recent years. But this year, the Senate is actually proposing a massive $63 million cut to HOPWA, which might mean that two-chamber reconciliation, likely to happen in November, might lead to HOPWA funding staying flat -- or, worse, going down.
And why is this especially bad news? Because in recent years, HOPWA funding has been phasing in a redistribution of goodies based on the recent HOPWA Modernization Act. That means that HOPWA no longer counts all people with AIDS in a certain area, including those who've passed, as it once did, but instead counts all those living with HIV. And that's meant a loss of money for traditional AIDS hotspots like New York, California, Miami, and Atlanta and more money for more newly hard-hit places like midsize southern cities.
In other words, those HOPWA increases of recent years have played a big role in offsetting cuts taken by New York, California, etc. And they'll feel those cuts even harder next year if HOPWA overall is flat-funded -- or decreased.
According to Kathie Hiers, who heads AIDS Alabama, even if the House and Senate meet halfway and push through a HOPWA cut of just $23 million, her agency -- which funnels federal funding to HIV agencies throughout the state -- could lose $250,000 of the $2 million they currently receive.
"It would be very painful," she says. "We use a lot of that money for long-term rental assistance, [so cuts] might make some people homeless -- in Alabama and a lot of states. It's ironic, because you're not going to end the epidemic if you don't pay attention to the structural barriers."
Hiers says she's had the impression that the current top brass at the Centers for Disease Control and Prevention, charged with HIV prevention nationally, were not even aware that there was a federal HIV/AIDS housing program. And she says that when she recently got on the phone with her senator, Richard Shelby, a Republican, "protecting HOPWA was the only thing we asked of him -- that's how important it is."
Now it's your turn to do the same -- especially if your senator is a Republican. Whether you're living with HIV and/or work in the field and see the big picture, tell your senator's staff when you call what HOPWA means to you. That it's allowed you to have (or keep!) your own apartment, take your meds in private, and stabilize your health -- or that it's taken x number of clients living with HIV off the streets and into not only stable housing but the all-important services that accompany it, such as transportation and case management.
"I'm more worried than usual," stresses Killelea. "We need to be scaling up HOPWA, not cutting it back. We have to put pressure on the Senate to back off."
Find numbers for your senators here.