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HIV Is Not A Crime - Or IS IT?

| 24 Comments
I wanted to alert you to a piece I wrote that ran a few days ago in Huffington Post Gay Voices Blog. The Blog deals with HIV Criminalization Laws in the US.  A summary and a link to the full article in Huffington Post appears below.


HIV Is Not a Crime, is a compelling, powerful, and tragic film about the criminalization of HIV in America, created by POZ Magazine founder Sean Strub.  HIV Is Not a Crime is a shocking film that asks some basic questions we all need to think about. 

Do you think people living with HIV should have to register as sex offenders? Do you believe people living with HIV should be sentenced to 25 years in prison for a sexual act that did not result in transmission of the HIV virus?

Would the fact that an individual did not disclose his or her HIV-positive status change your answer? Do you think someone living with HIV should be virally defined as a second-class citizen with fewer rights and more legal liabilities than someone who is either uninfected or is unaware of his or her status HIV status?

HIV is not a crime. Or is it?

Thirty-four states and two U.S. territories have laws on their books that state that if a person living with HIV has sexual relations without prior disclosure of his or her HIV-positive status, then that person is committing a crime. Some laws permit sentencing a person living with HIV to jail (for up to 25 years) for having consensual sex with someone who is HIV-negative (or does not know his or her HIV status) without prior HIV disclosure -- often even if a condom is used and no HIV is transmitted.

Prosecutions against HIV-positive individuals have occurred in at least 39 states (some states have used non-HIV-specific laws for sexual assault), invoking a spectrum of charges including attempted murder, sexual assault, and assault with a deadly weapon. Yes, ignorance has led to defining blood, semen, vaginal fluid, vomit, and saliva of people living with HIV as "deadly weapons" by the courts -- and has even led to claims of "bio-terrorism" -- even though HIV is now considered a chronic manageable disease. In five states alone more than 500 people have been charged under these laws.

Shocking right?

For the full article please go to:

http://www.huffingtonpost.com/eric-sawyer/hiv-criminalization_b_1158255.html

Thanks,
Eric

Promoting Treatment as Prevention

| 1 Comment
I think the most compelling part of Regan's blog ("Not Drinking the PrEP Kool-AIDS") is her comparison of the recent PrEP studies to HPTN 052 - which I think is unquestionably on the money and it clearly shows that the way forward to get the HIV epidemic under control is to de-stigmatize HIV, normalize testing, rapidly scale up test and treat, and scale up/roll out better first line treatments universally.

This paragraph says it clearly:

HPTN 052 suggests that if we could achieve universal testing and access to care for all people living with HIV, we could reduce individual viral loads around the world and therefore lower the global "community viral load." By doing so, we could reduce the overall potential HIV transmission risk around the world significantly. If we could test and treat every positive person--and, admittedly, there are many significant issues to address in order to make universal access feasible, not the least of which is the challenge of paying for ARVs for tens of millions of people for the rest of their lives or until there is a cure--would we really need PrEP? Would we really need to give medications to people who don't have a disease?
Sure there are scenarios where oral PrEP makes sense and these scenarios make adding oral PrEP to the HIV prevention tool-kit justifiable. But I do not think we should be promoting oral PrEP widely -- as it is already is being promoted -- as it is driving people to MDs offices in NY to request "the pill to prevent HIV" and (this is according to a friend who is an HIV MD) having them ask telling questions like: "Oh insurance won't pay for it and it's so expense - I can't afford that every month - since I usually only have sex on weekends - can I just take it Friday and Saturday nights?"

If someone did a study that showed a shot/a pill of penicillin before having sex with ten people infected with "the clap" resulted in a 63% less likelihood to catch gonorrhea, would we be promoting daily penicillin shots/pills as an intervention to prevent transmission of gonorrhea? I think not.

I believe we need to promote campaigns to de-stigmatize HIV, promote the normalization of HIV testing, rapidly scale up test and treat, and aggressive scale up/roll out better first line treatments universally and make the point to governments that you can pay now to get HIV under control and stop transmission while treating those already infected (through wide spread roll out of test and treat); or you can continue to treat only part of those HIV infected and let those not on treatment (many of whom do not know they are infected) continue to infect others, creating an ever expanding number of HIV infected people and an ever increasing financial burden on the health care budgets.

Let's spend our energy promoting treatment as prevention for the HIV infected, I think it makes a whole lot more sense.

(This is my personal opinion and not the position of any organizations I have founded or work for.)

It is unbelievable that the ADAP waiting list for HIV medications has now grown to over 6,000. Year after year the AIDS Drugs Assistance Program requires specific annual Authorization and Appropriations Bills and successful legislative action. The Congress has year after year voted to pass the reauthorization and appropriation bills but also basically flat funds the program, while the prices of all AIDS medications rise. The number of US citizens who need access to ARVs through the program continues to grow.

Annual reauthorization has set the precedent for continued funding, yet this hard fought for safety net for the working uninsured poor remains perched on the edge of a cliff waiting for the program reauthorization efforts to fail and send thousands of PLWHIV into harm's way.

It is time we stand up and demand the Congressional leadership to transition the ADAP program into the category of an entitlement program. As an entitlement program (like Medicare and Medicaid) the Federal and State Governments would be required to fund the ADAP Program based upon the level of need, not based upon a negotiated appropriation bill amount, or a continuation of last year's funding level. Like Medicare and Medicaid anyone who meets the eligibility requirement would be provided ADAP services.

Some are saying - impossible - this is a heavy lift but consider recent scientific evidence on Treatment as Prevention.

Treatment as Prevention long term research has proven that providing anti-retroviral medications reduces the viral load and infectivity of individuals whom are compliant with treatment. Studies by Julio Montaner in British Columbia have shown that providing free access to every person living with HIV and access to harm reduction services can lead to dramatically reduced rates of new HIV infections Province wide.

Treatment as Prevention research proves that providing access to ARVs reduces the global public reservoir of entire communities, leading to lower HIV transmission rates, thus providing a public health benefit.

The recent increase of nearly 2,000 in the last month to the ADAP waiting list makes it time to step forward with this demand. We are about to hold the annual AIDS Watch advocacy effort targeting Congressional Leadership on HIV. We must change the ask away from the same old process of begging crumbs from the table of Congress and hoping for a short term fix to win enough funds to provide a years relief for the ADAP funding crisis. It is time to demand a systemic fix, transitioning ADAP to an entitlement program where the fund must be provided by States and the Federal Government to meet the level of need, ensuring that everyone who qualifies for the ADAP program gains access. This battle won't be won immediately, so we will still have to ask for a short term emergency funding to eliminate the ADAP waiting list. This would solve the problem long term when won.

I similarly think the AIDS Community must return to the demand we ACT UP Founding Activist championed in the 1980's - that being CURE AIDS NOW!! And return to the demand for research funding to FIND A CURE FOR AIDS. The AIDS CURE Project is leading this renewed effort and their work must be supported.

Will you join me in a conference call this Friday at 12 Noon EST to discuss adding this to our community demands? And if NAPWA, NMAC and other National Advocacy Campaigns like C2EA, Health GAP and leading ASOs like amfAR, GMHC, Housing Works, APLA, SFAF, CAF, will join ACT UP in bring forward this demand, hopefully it can be a priority demand, perhaps even during next week's AIDS Watch.

ACT UP is planning a Late Spring ACT UP Anniversary Action which will highlight the demands expressed above. I hope to talk to you Friday at noon. A free conference call has been set up to discuss this proposal:

Free Conference Call
Conference Dial-in Number: (605) 562-3000
Host Access Code: 718007*
Participant Access Code: 718007#

What's All the Noise About PrEP For?

| 2 Comments

As someone who has been on ARVs since 1987, let me tell you they are not something that you want to take for the rest of your life just so you can have bareback sex.

I can see a value in PrEP for certain individuals, like women in discordant couples whose husbands won't use condoms, and sex workers or drug users who binge frequently and continually have to take multiple courses of PEP annually; but to talk about it as a widespread general prevention tool is crazy.

I have peripheral vascular disease, neuropathy, cardio-vascular disease, arthritis; I have had a hip replacement due to a vascular necrosis, seen times when I had to take Imodium daily as a prophylaxis for diarrhea, etc. - all as a result of the side effects of long term ARV use; are there similar side effects from the use of clean needles and condoms? I don't think so!

Who will pay for lifelong use of ARVs as a prophylaxis for HIV? Certainly not insurance companies, who often won't even pay for ARVs for People Living with HIV, without expensive prescription drug specific add-ons. Governments won't pay for ARVs for all of the people living with HIV who live in their own countries, so count governments out. We all know drug companies won't provide them for free or for reasonable prices - so stop dreaming!!

And the comparisons to hep B or HPV vaccines are apples and oranges comparisons; we are not talking about a cheap one time vaccination or once every five years vaccination here, we are talking about thousands of dollars of annual drug expenses for life.

We can talk about Treatment as Prevention - Treating HIV positive individuals so they survive HIV, so their viral load goes undetectable (rendering them less infectious) and so the global viral reservoir of HIV virus is reduced - this I support with all my heart! But all this noise about PrEP??

I think we would be better off using all this air time and hype to promote the AIDS Cure Project - to call for investing in the development of collaborative research for a cure or for effective vaccines or microbicides.

Even if PrEP works, no one is going to be able to afford it; not unless the price is pennies a day; and what healthy person would want to take ARVs for life with the horrible side effects that now exist from ARVs. Dosing the water supply with ARVs is not the answer - a cure is!!

Malawi Gay Men Sentenced to 14 Years

| 1 Comment
Here's a press release from UNAIDS:

UNAIDS expresses serious concern over ruling in Malawi

GENEVA, 20 May 2010 - UNAIDS is greatly concerned about the guilty verdict handed down by a magistrate court in Malawi against Steven Monjeza and Tiwonge Chimbalanga.

The two men were arrested in December 2009 by police officials on charges of engaging in "indecent practices between males" and "unnatural offenses." Both men were subsequently detained for nearly five months, despite several applications for bail and concerns about their health. They were each sentenced to 14 years of imprisonment and hard labour.

UNAIDS considers the criminalization of individuals based on their sexual orientation as a setback for human rights that threatens public health gains in the AIDS response. Criminalizing sexual behaviour drives people who engage in same-sex relations underground and hampers HIV-related programmes aimed at addressing their needs.

More than 80 countries have legislation prohibiting same-sex behaviour. UNAIDS urges all governments to ensure full respect for the human rights of men who have sex with men, lesbians and transgendered people through repealing laws that prohibit sexual acts between consenting adults in private; enforcing laws to protect these groups from violence and discrimination; promoting campaigns that address homophobia and transphobia; and ensuring that crucial health needs are met.

Eric Sawyer's comment:

When are we going to start organizing a global campaign to de-criminalize same sex love? It is crazy that with so much hate and violence and in the world that two men are sentenced to 14 years of hard labor for loving each other.

These laws and the hatred and discrimination gay men, lesbians, bi-sexuals, trans-gendered people, transexuals, MSM and all related variations face must change; we must ban together with our friends and fight for our human rights! Laws, norms, religious teaching and social mores won't change by themselves! ACT UP! FIGHT BACK! FIGHT FOR OUR RIGHTS!

I am listening to the President, Democrats and Republicans all talking a lot of shit about health care reform! They are all such sell outs and are so far into the pockets of insurance companies that they can not say anything that is not about health insurance.

The health care debate should not be a discussion of mandated health insurance plans, it should be about access to health care. Trying to design a good mandated insurance program is an oxymoron, insurance companies won't change - the involvement of health insurance companies in the health care equation is the largest part of the problem with the health care system in America.

President Obama needs to man up and tell insurance companies to go away!  President Obama needs to find some balls and tell insurance companies to get lost! We don't need them sucking 30% of every dollar out of the health care delivery system in the USA!

President Obama needs to listen to what every health economist in the country, and what every public health expert that does not have a pay check coming from the insurance company has said; they all say "ONLY A SINGLE PAYER NATIONAL HEALTH CARE SYSTEM FOR ALL WILL SOLVE THE HEALTH CARE CRISIS IN THE USA!!"

At a minimum the the President needs to say loud and clear that every American deserves the option to opt into a new and improved National Medicare System!!

No American deserves to be mandated to buy health insurance so that their Insurance Company can then steal one third of every dollar from them that they are paying for their health care.

 We need a national improved single payer health care system for all!

Running in the Olympic Torchbearer Relay

| No Comments
van_2010_logo.jpgJanuary 20th, 8am in Calgary I will be carrying the Olympic Torch in the Olympic Relay as the flame crosses Canada toward the Vancouver Winter Games.

I am representing people living with HIV, UNAIDS & UN Plus as part of the UNAIDS/Olympic Committee's HIV Awareness Campaign.

I will provide a link to the Press Release once cleared to explain the purpose of my involvement later in the week.

If you want to watch me run, tune in online tomorrow at 8:00am MST.

Here's the link to the webcam:
http://www.ctvolympics.ca/torch/follow-torch/index.html
Let's Celebrate the Ending of the HIV Travel Ban Restriction; but let's also remember one of the USA's darkest periods of HIV persecution - so it does not happen again!

While there is great cause to celebrate the ending of the HIV Travel Restriction Ban today (South Korea also lifted their similar ban on January 1st) let us not forget the that this HIV travel ban also caused one of the darkest periods of forced imprisonment, discrimination and violation of the human rights of people living with HIV by own country.

The event that I am referring to is the operation of the Guantanamo Bay HIV Detention Camp at the Guantanamo Bay, Cuba Naval Base during the years 1991 - 1993. This was at the same US Navy Base were "terrorist" have been detained by our government post 9/11.

As you likely know the US HIV Travel and Immigration Ban which was passed in 1987 was largely the "brain child" (and I note the irony of the use of the word brain) of Jessie Helms. The US government was one of the first countries to pass an HIV Travel Ban. It was not completely a surprise to people living with HIV like myself at the time because there were discussions happening both within government, the public health arena and even in the press about creating HIV Quarantine Camps for all people with HIV.

Many people have speculated that the rapid institution of a US HIV travel restriction, and the domino effect replication of the ban in dozens of countries were an over reaction to HIV fear and the fact that little was known about HIV. Most restrictions on the entry, stay and residence of HIV-positive people were put in place in the 1980s when fear, ignorance and prejudice dominated many responses. For those governments that have such restrictions they represent the governments' attempts to prevent the spread of HIV and to avoid possible costs of treatment and care related to HIV. They likely were also fueled by homo-phobia, drug-phobia and racism since most of the early case of HIV were in drug users, people of color and gay men.

The US government operated an HIV detention camp for HIV positive Haitian Refugees seeking asylum in the US. Supporters of President Aristides were fleeing violence from anti- Aristides forces after President Aristides's government had been over thrown by a military coup. Because of the US Congressional HIV travel ban and the high HIV prevalence rates in Haiti, the refugees coming to the US in boats were rounded up by the Coast Guard and US Navy and transferred to US Navy Supervision at the Guantanamo Bay Naval Base (A.K.A. Gitmo) . At Gitmo they were tested without Voluntary Testing and Counseling Procedures and if the refugee was HIV positive (s) he was informed of such by loud speaker announcements and told they were unable to leave the camp, as the US Travel and Immigration Ban prohibited their entry into the US. Negative Haitians were told to report to the parole office and were granted humanitarian parole and political asylum.

What is more disturbing is that detainees were housed in prisoner of war conditions; housed in cinder block huts with sheet metal roofs with no running water, no kitchen, no bath rooms. Bath room facilities were public communal out houses and the showers were cold water hoses hung over the rafters of one of these huts. Instead of kitchen detainees were feed in and mess halls settings.

Detainees including pregnant women and people living with full blown AIDS were denied medical care; detainees were also denied legal counsel, or the right of appeal for their "detention decisions."

When some detainees decided to stage a hunger strike to protest their treatment the hunger striking detainees were hand-cuffed together and placed in 5 feet deep pit in camp yard in mid-day sun.

The Congressional Ban made it politically difficult for Clinton to use an Executive Order to close the camp and made it necessary to use a legal challenge to declare the detention camp a violation of International Human Rights Treaties and to seek a court order that the camp be closed for humanitarian purposes. Public pressure had to be brought upon the Clinton Administration also to force them to not keep the court case tied up in legal appeals indefinitely.

A partnership approach of civil society non-governmental organizations, law firms and legal assistance programs, activist groups, religious leaders, and people living with HIV, friendly politicians, celebrities, and media organizations came together to mount pressure to force a positive outcome. It was thought that multi-pronged approaches lead by multi-faceted stakeholders in the areas that they knew best, would be the most effective approach - given the circumstances surrounding the camp.

Social workers banned together with international human rights organizations and activist. Inspections of the camp including interviews with detainees were demanded by and organized with the help of political activist like Jessie Jackson who made public calls for inspections in the media.

Once the conditions of the camp were documented celebrity supporters of HIV and Social Justice Issues like Susan Sarandon, Tim Robbins, and Jonathan Demme used their star power to go on shows like Oprah to draw public outrage to the existence of the camp.

Activist organizations, ACT UP NY, AIDS Service organizations, AIDS funding groups like BC/EFA, joined governmental Official like the late Dennis de Leon, former NYC Commissioner of Human Rights, and members of the clergy formed social justice coalitions to organize press conferences, demonstrations, civil disobedience actions, pickets and media appearances.

Some of the most notable of these include a public rally and civil disobedience on Fifth Avenue in front of the passport offices where Susan Sarandon, Jessie Jackson, Jonathan Demme, dozens of clergy members and the heads of AIDS organizations and Activists got arrested to draw attention to the need to close the camp. Susan Sarandon and Tim Robbins were banned from the Oscars for using the presentation of an award to criticize the existence of the camp; and a huge press conference at the International Conference on AIDS in Berlin and a mass petition drive at the conference all help pressure the Clinton Administration to back away from defending the camp's operation.

Eventually the US Federal Court found the camp to be in violation of three International Human Rights Treaties and ordered the camp closed; the court also ordered the detainees be given emergency medical paroles and admittance in to the US, regardless of their HIV Status. Mayor David Dinkins of NYC offered full access to the detainees to all services offered to NYC Citizens in the public safety net system

The outcome of the Federal Law Suit, coupled with the fact that the Clinton Administration really did not support the concept of the camp (but did not want to spend the political capital to close it), gave the Clinton Administration a way to close the camp with out Congress having an ability to prevent it.

According to UNAIDS, there are still 57 countries, territories, and areas impose some form of travel restrictions to the entry, stay and residence of people living with HIV based on their HIV status; 6 countries that require declaration of HIV status for entry or stay, resulting, for people living with HIV, in either a bar to entry/stay or the need for discretionary approval (including through granting waivers); 6 countries deny visas for even short term stays; and 24 countries deport individuals once their HIV-positive status is discovered. Thus the world has a long way to go to match the 110 countries, territories and areas which have no HIV-specific restriction on entry, stay and residence.

There are also a larger number of laws on the books today that discriminate against people living with HIV and people most at risk for HIV, due to the discriminatory nature of these laws, the second class citizenship that the laws relegate these populations too, and the lack of social protections these laws cause. By this statement I am referring to laws that criminalize the transmission of HIV; laws that criminalize same sex consensual sexual relations; laws that criminalize drug possession and drug use; and laws that criminalize sex work. Laws that relegate women and girls to second class citizenship in some countries and laws which categorize children in general as possessions of their parents are also discriminatory and work counter productively to the scientific practices to prevent and fight HIV. But this should be another blog entry.

We still have a long way to go before people with HIV enjoy their human right to mobility, to equal protection under the law. But at least now, with regard to travel in the US and South Korea, people with HIV have a little more freedom.

Now we must keep the pressure up so that all the remaining 57 countries are forced to remove their HIV travel bans as well!

Dennis deLeon, R.I.P.

| 2 Comments
This is my first blog for POZ and I write it with extreme sadness; you see I just learned about the loss of one of the HIV movement's unsung heroes: Dennis deLeon, President of the Latino Commission on AIDS and well-known AIDS activist. Dennis died on Monday, December 14, at age 61.

Dennis learned he was HIV positive in 1986, and in 1993 he disclosed his HIV status in a New York Times Op-Ed entitled, "My Hopes, My Fears, My Disease." At the time he was the New York City Commissioner of Human Rights, appointed by Mayor David Dinkins.

In that editorial Dennis wrote: "For four years, I have been torn about when and how to say publicly that I carry H.I.V., the virus that causes AIDS. There were always too many compelling reasons not to say anything. Every such excuse started with the word "fear" -- fear of employment discrimination, fear of the politics of AIDS, fear of becoming a pariah."

He continued, "Given all of these reasons for not being public about the disease, why come out? ..." "The simple answer is hope. If more people proclaim their H.I.V. status, we will change the way society treats persons with the virus. My hope is not based on any expectation that discrimination will end tomorrow but on a sense that it is good to show society that people with H.I.V. are leading productive lives and will tenaciously resist attempts at exclusion."

I first met Dennis when he was the Deputy to the then Manhattan Borough President, David Dinkins. If memory serves me right it was 1988 or early 1989. I was representing ACT UP in discussions with the Office of the Borough President for his public support as we were trying to change NYC policies in order to expedite access for New Yorkers living with HIV to the safety nets of Medicaid, income maintenance payments, Food Stamps and rental assistance.

We approached the meeting with Dennis tentatively, not sure how he or Dinkins would respond, but hopeful that they would ally with our position. Dennis's response was terrific; he responded to our request from the perspective of a Human Rights advocate and social justice lawyer, not as a government official who was concerned about the costs to the city budget or setting a special precedent.

Dennis immediately demonstrated that he recognized and supported the urgent need for immediate access by people with HIV to the city's safety net. After we had explained why we were there, he literally stood up, took off his suit jacket, rolled up his shirt sleeves and sat down to help us hammer out a strategy to win approval for our proposal.

That began a long term personal and professional collaboration between Dennis and me that lasted for many years. On a personal level, he assigned an attorney from the Human Rights Commission staff, after he became the NYC Commissioner of Human Rights, to investigate the cancellation of my surgery by a NYC physician after I had told the doctor that I was HIV positive. (The Human Rights Commission eventually levied sanctions against the surgeon and his hospital.)

Not too long after, the ACT UP Housing Committee, led by Keith Cylar, Charles King, Ginny Schubert and me, started Housing Works, Inc. We recruited Dennis to our Board of Directors and he eventually became our Board Chair. Dennis helped guide Housing Works from 1990 to 1996. (Housing Works is currently the largest US provider of housing, medical care, advocacy and services to homeless and formerly homeless people with HIV.)

Dennis was also instrumental in the AIDS communities' efforts to close the HIV detention camp at Guantanamo Bay, Cuba. As the Commissioner of Human Rights he represented NYC on a committee to organize a high profile press conference and rally calling for the closure of the camp by the Clinton Administration. He also took part in the ACT UP organized related Civil Disobedience Action during which over 40 people were arrested, blocking traffic on Fifth Avenue in front of Rockefeller Center where the US Passport Offices were housed. Among those arrested that day were Dennis deLeon, Jessie Jackson, Jonathan Demme, Susan Sarandon, a dozen clergy members, the leaders of numerous AIDS service providers and me.

We eventually won the closure of the HIV detention camp, through a combined strategy that involved community organizing, a high profile publicity campaign and a legal challenge of the existence of the camp in US Federal Court system (the camp was ordered closed by US Federal Judge Sterling Johnson who ruled it was in violation of three International Human Rights treaties). Subsequently, Dennis played the role of chief liaison with the NYC government in helping to facilitate the enrollment of the detainees into the city social service system to provide the detainees access to safety net benefits.

Dennis eventually went on to become the President of the Latino Commission on AIDS (LCOA). The National Minority AIDS Council (NMAC) said of Dennis: "deLeon built LCOA from a two person operation into a major national AIDS organization addressing the disproportionate impact of HIV/AIDS among Latinos through advocacy and education programs. He helped lead the call for a National Latino AIDS Agenda, and in 2007, joined NMAC and seven other national minority AIDS organizations to work collectively as the National People of Color HIV/AIDS Working Group (POC). Together, the POC ensures that federal HIV- and health-related policies and the upcoming national HIV/AIDS strategy address the needs of underserved communities - and communities of color in particular - which have been hardest hit by the AIDS epidemic since it began."

Dennis was many things to many people. He was a loving partner to his companion of 32 years, Bruce Kiernan; he was a mentor to many in the HIV and social justice communities; he was a leader and an inspiration to people living with HIV. I always considered Dennis a great friend and a perfect gentleman. The world is a better place because Dennis deLeon walked among us!

Rest in peace my friend!
- Eric Sawyer


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