Friday, April 06, 2018

Diseases Don’t Play Politics

Diseases are bipartisan, they don’t care if you are Republican or Democrat, liberal or conservative and if you give them an opening they will take advantage of it.
Fenway Health
February 2018

This week, President Trump released a proposed budget that, if enacted, would sharply reduce global and domestic spending for HIV care and prevention. It would also reduce access to Medicaid, and move categories of healthcare spending, such as federal investment in community healthcare centers, from mandatory to discretionary spending.

The budget would eliminate AIDS Education and Training Centers (AETCs) and Special Projects of National Significance (SPNS), which are run under the auspices of the Ryan White HIV/AIDS Program. The education centers and special projects program assists with rapid response to outbreaks of disease. When nearly 200 people were diagnosed with HIV in rural Scott County, Indiana over a 15-month period in 2014-15, the Midwest AIDS Education and Training Centers provided in-depth training to doctors and care providers in the area and helped get those newly diagnosed with HIV into immediate care.

The education centers and special projects program are also central to pioneering and evaluating innovative HIV care models that improve access to and retention in care for vulnerable populations disproportionately burdened by HIV, such as gay men and transgender women, particularly gay men and transgender women of color.

“The proposed cuts in domestic HIV prevention and treatment would undermine the dramatic progress seen since the implementation of the National HIV/AIDS Strategy,” said Sean Cahill, Director of Health Policy Research. “We urge Congress to reject these proposed cuts and maintain the bipartisan support that HIV prevention and treatment have traditionally received.”
Any disease you need to stay on top, if you let down your guard you are going to find yourself in the middle of an epidemic.
“It’s impossible to overstate the deadly impact these proposals could potential have,” Cahill added. “We have been lulled into believing that HIV and AIDS is no longer a concern globally thanks to the scale up of treatment. But these advances mean nothing if you’re cut off from life-saving medicine.”

The proposed budget would also eliminate the expansion of state Medicaid programs that occurred under the Affordable Care Act. Expanding state Medicaid programs contributed to dramatically reducing the rates of healthcare uninsurance among lesbian, gay, bisexual, and transgender (LGBT) people. The CDC and the Kaiser Family Foundation estimate that following implementation of key elements of health care reform the percentage of PLWH who lacked any kind of health insurance coverage dropped from 22% in 2012 to 15% in 2014. The percentage of PLWH who received their health insurance through Medicaid increased from 36% in 2012 to 42% in 2014. Medicaid expansion played a major role in expanding access to insurance for PLWH.
The Daily Beast reported…
Three-hundred thousand deaths per year.

That’s the human cost of President Donald Trump’s proposal to cut more than $1 billion cut from global HIV funding in 2019, a 20% reduction from current levels, according to a report by the ONE campaign. And it comes just when American-led efforts are paying off, and the global tide of the epidemic appears to be turning.
In a report Fenway Health said…
For decades now, researchers and activists have promoted adding sexual orientation and gender identity (SOGI) questions to federal surveys to capture health and demographic data about LGBT people. Under the Obama Administration the number of federal surveys and studies measuring sexual orientation increased to; seven of these also measured gender identity or transgender status. SOGI data are now included in many public health surveys, such as the Behavioral Risk Factor Surveillance System (SOGI questions) and Youth Risk Behavior Survey (sexual orientation (SO) question), the National Health Interview Survey (SO), the National Survey on Drug Use and Health (SO), and the Health Center Patient Survey (SOGI). Several other surveys are now collecting SOGI data that examine social determinants of health, such as the National Crime Victimization Survey (SOGI), which collects data on intimate partner violence, and the National Inmate Survey (SOGI), which collects data on sexual assault in prison as mandated by the Prison Rape Elimination Act.

The collection of population-level data is important to better understand the experiences of LGBT Americans. LGBT people, especially Black gay and bisexual men and transgender women, experience a disproportionate burden of bias-motivated hate violence. On a per capita basis, LGBT people are more likely to be targets of hate crimes than any other group in America.18 Bisexual women and men, and lesbians, are more likely to experience intimate partner violence than heterosexual women and men. Gay men are 11 times as likely as heterosexual men to be sexually assaulted in state prisons. Bisexual men and transgender people  are 10 times as likely to be sexually assaulted in state prisons as heterosexual men.
Research needs data! Without data you don’t know what to target your effort, you might be targeting the wrong area for it to be effective. Without data funding is hard. When we were trying to pass the gender inclusive non-discrimination law the top question from the legislators were how many trans people are in Connecticut and the same is true for funding for HIV/AIDS healthcare.

Cutting funding to Planned Parenthood will also cut testing for HIV/AIDS which in turn will increase the spread of AIDS. In many areas Planned Parenthood clinics are the only place where you can get tested for AIDS and many times at no cost to the patients.

The Daily Beast article ends with…
Are we really going back to the Eighties, when HIV/AIDS was a “gay disease” and Reagan White House officials joked about it? Trump himself seems trapped in the decade – making comments about Haitians having AIDS, for example. Is that what this is all about? Is that the reason for the slashing of effective health programs here and abroad?

And if not, then what is it?
People this is important, you might think that this doesn’t affect me because I don’t have AIDS but if the disease take roots in the general population it will affect you. The blood supply might be in danger because of not enough AIDS free donors, if the disease moves out of the marginalized community it could become an epidemic.

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