David's POZ Blog

Last year, the Bush Administration's PEPFAR bill was to have eliminated the HIV travel ban. The bill was signed into law. But that wasn't the end of the ban.

The final step in removing the policy of excluding those with HIV required the Department of Health and Human Services  to remove HIV from its regulation listing "communicable diseases of public health significance." (42 CFR 34.2(b).) That's not what happened.

On April 10, 2009, HHS forwarded regulations to the Office of Management and Budget (OMB) for review. As of now, visitors to the U.S. will still be asked whether they have HIV. They will then be asked to sign the following certification:



I certify that:

    a) I do not currently show symptoms indicative of an active AIDS-related condition that is
contagious or that requires urgent treatment.

    b) I am aware of, understand, and have been counseled on the nature and severity of my
medical condition. I am also aware of and have been counseled on the communicability of my
medical condition, including the fact that I must not donate blood or blood components.

    c) I am knowledgeable of the routes of transmission of HIV, including sexual contact, sharing needles, and blood transfusions, and understand that I must avoid these activities to minimize the danger of transmission of the infection to any other person in the United States.
  
    d) If I have been prescribed antiretroviral drugs, I have access to an adequate supply for my
anticipated stay in the United States.

    e) I possess sufficient assets or insurance, acceptable in the United States, to cover any medical care that I may require in the event of illness at any time while in the United States. Therefore, I will not create any cost to the United States, or a State or local government, or any agency thereof, without the prior written consent of that agency.
   
    f) I am seeking admission solely for activities that are consistent with B-1 (business visitor) or B-2 (visitor for pleasure) nonimmigrant classifications.
  
   g) I understand that I am not eligible to seek admission under section 217 of the Immigration and Nationality Act, which allows some visitors from specified countries to be admitted without visas.
  
    h) I understand and agree that no single admission to the United States will be for more than 30 days.
  
     In signing below,  I understand that I am waiving the opportunity to apply for any extension of nonimmigrant stay (except under the appropriate circumstances, at its discretion the Department of Homeland Security (DHS) may grant an additional period of stay before satisfactory departure), a change of nonimmigrant status, or adjustment of status to that of permanent resident (except in asylum cases), whether filed affirmatively with DHS or defensively in response to an action for removal. I understand and agree that any failure to comply with conditions of admission will result in a permanent inability to apply for the benefits of this provision.

___________________
(Applicant's Signature)


At first glance, the procedure doesn't seem so bad; it merely asks if you are positive,  and if you disclose the truth, that you assure the government that you'll exercise a little caution, right?  But why are we asked about HIV at all? And who reviews these forms after they are submitted? Can  HIV+ travelers still be banned from entering the U.S.? 

The simple fact is that we are still being subjected to institutional scrutiny, and there are no guidelines or limits to the authority of the immigration agents who review the disclosure forms. You can still be excluded  from the U.S.because you have HIV. 

Has Obama betrayed us? Why are there still any HIV+ travel restrictions? One can only conclude that our government still assumes that there are a significant number of HIV+ men and/or women who might spread HIV through carelessness or worse, intentionally. It assumes that we can't be trusted.
As a result, no U.S. Government agency has published a definitive rule that prohibits itself or its employees from excluding HIV+ visitors.

This isn't the first time that America has marginalized a suspect minority. In 1944,  In Korematsu v. United States,  the U.S. Supreme Court agreed that it was perfectly fine and dandy to relocate Japanese-Americans to protect the country from saboteurs and spies for the public good. Despite much criticism, including a "proclamation" by President Gerald R. Ford in 1976 that the segregation of Japanese-Americans was wrong, Korematsu remains the law today.  

So what can we do about it? Do the numbers support this de facto AIDS apartheid? Is it fair to assume that we are a public health risk? Uncle Sam seems to think so. Unfortunately, and unless our voices are heard, he'll keep pointing a finger of suspicion and stigma at all of us.



David H Weiss is an attorney admitted to practice before the Courts of the State of New York and the United States. He has been living with HIV for almost 30 years. His website, which is desperately in need of an update, can be viewed at DavidWeissNY.com

People living with HIV could soon monitor their own condition at home using a hand-held device, similar to ones used by diabetics .

Scientists at three of London's largest research centres have been granted £2m to develop a hi-tech, finger prick blood-testing gadget.

The device's tiny mechanical sensors - microcantilever arrays - measure HIV levels to warn of impending flare ups.

A display then alerts the user if there is any need for them to visit a doctor. 

It would be very useful if HIV patients could check their own viral measures Lisa Power of the Terrence Higgins Trust

Investigator Dr Anna-Maria Goretti, an NHS consultant and co-investigator based at the Royal Free Hospital, said: "If patients neglect to take their treatments or need prompting to see their GP the device will provide a simple way of letting them know. "It will really empower HIV patients to keep a close eye on their health and their treatments." Read the rest of the article at Self-monitoring

 When properly used, the ability to test your own viral load makes sense for most of us, although I'm sure that there that will always be a few of us who become obsessive about it or break out the test kit after every episode of "True Blood".  Not that I want to shill for the medical profession, but it shouldn't replace working with your doctor.

Like so many of you, I have experienced abuse by the private health care industry in America. The following is a summary of  the complaint to the New York State Attorney General, Andrew Cuomo, that I have drafted and will send shortly:

"I am a 58 year-old attorney living with HIV. My wife and I subscribed to Health Net last year and my coverage was renewed this year by COBRA election  after we divorced.  Health Net states that my coverage has been in effect this year since 3/7/09, but they are still not paying for my medication, Atripla, a claim for which was submitted by my pharmacy and rejected by Health Net. It appears that Health Net is playing the float by requiring patients to pay for their medications in advance and submit claims to Health Net for reimbursement. In effect, the HMO gets paid for twelve months but only provides services for eleven.  This is the second year in a row that they have done this. Kindly assist."

My experience with Health Net is hardly unique. In September 15, 2008, for example
Health Net agreed to a multimillion-dollar settlement over allegations of unfair claims handling and policy cancellations, according to the California Department of Insurance. The Woodland Hills, California, health care insurer was required to pay $14.2 million in billed medical charges and  waive $7.2 million in insurance premiums and possibly pay a $3.6 million penalty to the state. The company was also required to reinstate health care coverage for 926 consumers whose policies were canceled during the past four years and prevent improper rescissions going forward, according to the California regulator's statement.

The worst HMOs are fly-by-night operations with little knowledge of health care. In order to maximize profits they exclude sicker patients from enrollment, ration care through inconvenience, impose burdensome micro management of clinical decisions by nonmedical staff. In the worst cases they deny expensive care that would be beneficial for their enrollees. The profits go to the executives and stockholders, not the patient care.

When will our legislators fix the health care system? WILL they fix it?

It now appears that the U.S. government will limit prosecutions of medical marijuana sellers in those states where medical marijuana can be legally purchased:

U.S. Attorney General Eric Holder said federal agents will now target marijuana distributors only when they violate both federal and state laws, a departure from the policy of the Bush administration.

It's not seen by many as a move by the Obama administration toward the legalization of marijuana. Obama's dismissal of legalization in the recent "town hall" discussion makes that clear. However, it could end much of the confusion among state and federal authorities dealing with the mishmash of laws in which cultivating, using and selling pot for medical purposes is allowed by states but outlawed by the federal government. "This signals, in my mind, a true kind of federalism," said Jody Armour, a law professor at the University of Southern California. "The federal government is allowing states to take chances, to take experiments and see what happens."

California is one of 13 states that allows medical use of marijuana. Over the past 2 1/2 years, the federal Drug Enforcement Administration has raided at least 80 dispensaries in California, the majority in the Central District that extends from the Central Coast down to Orange County and includes Los Angeles. Yet criminal charges have only been filed in several of those cases against the biggest distributors accused of breaking both federal and state laws, said Thom Mrozek, spokesman for the U.S. attorney's office in the Central District of California.

"What we have done in all of our narcotic cases is to focus on large-scale traffickers," Mrozek said. "In terms of what happens in the future, the federal government will continue to enforce federal narcotics law."

(read the rest of the article on Yahoo at  Medical Marijuana )

If you haven't already read the article, California Democratic state assemblyman Tom Ammiano introduced legislation last month that would legalize pot and allow the state to regulate and tax its sale -- a move that could mean billions of dollars for the cash-strapped state. Pot is, after all, California's biggest cash crop, responsible for $14 billion a year in sales, dwarfing the state's second largest agricultural commodity -- milk and cream -- which brings in $7.3 billion a year, according to the most recent USDA statistics. The state's tax collectors estimate the bill would bring in about $1.3 billion a year in much needed revenue, offsetting some of the billions of dollars in service cuts and spending reductions outlined in the recently approved state budget.

Manila Market 

The following is my recipe for perfect chicken soup. The salt may harden your arteries, but you'll die with a smile on your face.

Ingredients:

1 lean chicken, cut into quarters
2 medium sized white onions, diced
4 cloves garlic
2 large carrots, sliced
5 stalks of celery
3 medium to large potatoes, diced
1 chicken bullion cube
12 or so bay leaves
2 tbsp black pepper corns
a generous amount of chopped parsley
salt and pepper to taste
1 good friend
1 bottle red wine
1 large bag of Chitos

Instructions:

1. Drink the wine with your friend.
2. Saute the onions in two or three tablespoons of oil until soft.
3. Throw everything in the pot except the Cheetos, potatoes, parsely and friend. Add water to cover.
4. Make love to your intoxicated friend, or walk the dog if your friend is too buzzed. .
5. After 30 minutes, add the potatoes.
6. Simmer for an hour or so. When it’s tender, remove the chicken skin and bones. If you are too hungry to wait, eat the Cheetos.
7. Add the parsley and stir..
8. Eat.

This Monday marks the beginning of the year of the Ox. Perhaps not coincidentally, President Obama was born in the year of the Ox in 1961.

As I have little or no knowledge of how the Chinese Zodiac works and what it all means, I Googled the year of the Ox, and what it might bring for The Prez this year.

According to various sources on the Web, Obama can look forward to a year of slow but steady progress and developments that will be recognized and achieved with much authority. That sounded like a reasonable forecast, so I looked up my own forecast for the year as someone born in the year of the Tiger. The results were less than promising.

I liked the general descriptions for Tigers: we are said to be sincere, generous and very affectionate. We also possess a great sense of humor (hah!). We Tigers are said to like people (for lunch?), involvement,and dedication to humanitarian causes. We seek out adventures (!!!), and at certain points in our lives, we will be very rebellious.

Then came the bad news: evidently, logic does not appeal to Tigers. Tigers want to be comforted, and we will listen sincerely to the advice you give, and then do exactly as they please.

While Tigers are said to be romantic, passionate, and playful, it is also said that we are extremely jealous and possessive. If they do not learn to control their emotions, they could cause themselves much trouble. The lives of Tigers are full of emotional situations, but we love it that way (groan.)

If the CZ has any merit, roughly 500,000,000 of us - one twelfth of the six or seven billion people living on this planet - are out of control.

Sounds like a lot of Oxpoop to me...

After a long night out abusing my aging body at the local New Year's Eve shindig I was thinking about how I'd begin my blog for 2009 when I read the following on Digg.com, which linked to a video on CNN.com. It is therefor with tongue firmly held in cheek (and in admittedly questionable taste) that I've reposted this one, which is definitely hard to beat:

"A naked intruder, Michael Dick, was scared away by the 88 year-old woman whose home he invaded. The woman yanked Dick's testicles to fight him off".

http://edition.cnn.com/video/?JSONLINK=/video/crime/2008/12/31/or.naked.intruder.kptv

Happy New Year!

Okay, I admit it: I haven’t been blogging much lately. Why? I've gone to the dogs! I was never much of dog person, but I suddenly find myself surrounded by them. Twelve, to be exact. Four of them are grown, three others are six months old, and five of them are four week old puppies. None of them has HIV (or CIV, if there is such a thing).

Twelve dogs. Forty-eight legs. Fiftty two if you include mine and Eva’s. Twelve dogs might seem excessive, but here on Boracay Island (in the Philippines) living with a pack of dogs seems to be quite common. I won’t bore you with a long discourse on the merits of dog ownership, but watching the puppies grow has been almost as good for my immune system as the meds we all depend on, and I’d wager that my T-cells are WAY up there now. Highly recommended!

So is this the end of “Wishihadacat”? Has the world’s longest-living hetero HIV&HCV survivor really gone over to the dark side? We'll see.

On a (slightly) more serious note, the warm climate here has done wonders for my 58 year old
body. The dry skin that used to plague me during the New York winters is no longer an issue, and the neuropathy in my feet (courtesy of DDI) has all but disappeared.

While much of my present good health is undoubtedly due to the climate here, the most significant change in my life has been Eva, my poz GF. We've now been together since August, and suffice it to say that having a partner who does not fear my HIV has been the best thing that has happened to me in years. Not all of us are that fortunate, but I am grateful that she is now in my life. As much as I did like life in the Big Apple, I like it here more.

To be sure, life abroad isn't all mangos and monkey business. Like all of us with HIV, I am tethered to my meds, and it's a rare day that I don't have some concern about or my future. But call it faith or good fortune, I know that I'll keep on keeping on.

Now if only those %*&$#@! dogs would stop eating my flip-flops...