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The Stigma of Sandy: Sound Familiar?

| 1 Comment

"People who didn't evacuate are stupid... careless... a danger to others..."

Ringing any bells?

They were in denial... selfish... thought they were invulnerable.

Here we go again.

Prevention justicians, you know it goes deeper than that.

We've learned that blaming or shaming people for individual behavior that can lead to HIV infection won't get us out of this epidemic.

Blaming, shaming or defaming those who were in the path of Hurricane Sandy takes the spotlight away from where it needs to shine brightest: on the policies that have led to the non-creation or non-implementation of plans to safeguard a warming coastline while resources go to making NYC a playground for the wealthy... on the relentless perfect storm of discrimination, inequity and greed that fuels the vulnerability of people of color, queers, disabled people and immigrants not only HIV infections but further marginalization in the face of a natural disaster... and on the submerged histories of economics and politics that isolated the poor, the elderly and disabled in remote locations like Far Rockaway that are easily cut off from resources.

Have you ever lived in a shelter? If not, perhaps you wouldn't be eager to go off to one, sight unseen, cut off from friends and family. And if you have, you may be even LESS eager to go, especially if you are HIV positive, queer, gender non-conforming, sick or in pain, or elderly. People are resourceful in order to survive in shelters, but it's not easy - check out this report from Queers for Economic Justice to learn more.

Did you ever try to get an elderly parent or grandparent to try to do something they don't want to do, let alone go to an unfamiliar shelter to sleep on a cot? Um, it can be pretty hard. But now how do you feel about political leaders calling your elders stupid and selfish?

It just doesn't sit right-  and it shouldn't.

But it's instructive - policies taken on by elite city mayors and at other levels of government have put the housing and resources needed by elderly and people with chronic illnesses and disabilities in the path of big-profit developers and money-making schemes for decades - leaving us ill-equipped (no pun intended) when natural disaster gets layered on the struggles to make it by day-to-day.

It's not our Grandma's fault, but blaming other Grandmas who don't look like us is awful easy when times get tough.

This situation isn't going away any time soon. Up to 40,000 New Yorkers may be in need of housing - layered on top of an already strained system for housing support decimated by misguided policies and cuts - and this city is just one of the areas in need. So get ready for another surge of blame as clean-up begins. As noted in the New York Times:

Word that some may have to leave their homes permanently caused further confusion and fear, particularly in public housing complexes heavily damaged by the storm.

At the Hammel Houses, a public housing complex in the Rockaways, saltwater stains from the storm surge were visible above first-floor windows, which like many in this part of New York City were all dark.

"They tell us we might evacuate," said Gloria Evans, 47, who has lived at apartment 1B at the houses since she moved there 26 years ago as a new mother.

"Are they going to help us? They can't just move everyone out and have no place to put them," she said.

We've asked you to consider donating to CAAAV Organizing Asian Communities (also known as Committee Against Anti-Asian Violence), one of the groups at the forefront of community-based storm relief. CAAAV focuses on institutional violence that affects immigrant, poor and working-class communities such as worker exploitation, concentrated urban poverty, police brutality, immigration detention and deportation, and criminalization of youth and workers.

And as such, the guidance in their report-back from yesterday points an important way forward, even as digging out is in progress:

‎It is our responsibility to make sure that when the next disaster strikes (and there will be more), we have made the choices as a City to 1) ensure equality in distribution of services, 2) push for infrastructure rebuilding that is not bigger and better but that considers the new world we live in around climate change, and 3) build political power based on values of collective well-being and fairness.

It's imperative to listen to the voices of those who are living with the aftermath of Sandy, just as it is essential to have those living with HIV and those living in hard-hit communities leading our HIV/AIDS efforts. Prioritizing their ideas and resourcefulness in setting policies to deal not just with this crisis but in designing a city and country that is made safer by policies that bring equity is absolutely necessary -and can't happen if we focus on shaming and blaming.

Originally published at preventionjustice.org.

You helped us develop this important and ambitious agenda... Now join us to ensure its success!

Download the Action Agenda: bit.ly/ActionAgenda
Join our Working Groups: http://bit.ly/HIV_PJA_WG

An introduction to our Action Agenda, and our thanks:

As you know, the HIV Prevention Justice Alliance (HIV PJA) is a network of organizations and individuals advocating for effective and just HIV prevention policies for the United States.

We grew out of the successful 2007 Prevention Justice Mobilization coordinated by the Community HIV/AIDS Mobilization Project (CHAMP), which united hundreds of groups across the country at the intersection of HIV/AIDS, human rights, and struggles for social, racial and economic justice.

During our first year in our new organizational home at AIDS Foundation of Chicago (due to CHAMP's closure at the end of 2010), we grew beyond our primary role as a national HIV prevention communication network of over 13,000 people, toward becoming more of a people-centered movement to bring social justice to the forefront of the fight against HIV/AIDS in the United States.

We remain a lean operation as far as our budget, with only two part-time staff people, guided by a 16-member national steering committee that is majority people living with HIV and people of color. 

As with all our efforts, we created this Action Agenda though a multi-step and open process.

We invited  network members to contribute through online surveys, at in-person meetings and strategy sessions, through one-on-one conversations, on our webinars, and in different stages of the drafting of the document.

One of the strengths of our network is its diversity. You are an interesting and opinionated bunch, from all walks of life and in all areas of the struggle against HIV/AIDS in the United States. We know that not everyone in our network will agree with everything in this agenda. However, we hope that you will find something in here that reflects your experiences, beliefs and passions, even if all of it does not completely resonate with your priorities or work.

Most importantly, we hope that within the range of working groups, campaigns, strategies and ways to engage, you will find yourself taking the next steps to deepen your involvement as an HIV prevention justice activist in 2012 and beyond. This agenda is just the beginning - the real work is ahead of us as we move into action.

We thank all of you who took the time to contribute to this agenda, by talking with us on the phone or in person; in your online survey entries; participation in our conference calls, meetings and webinars; and/or your comments on our written drafts.

Thank you to our allies for your work and campaigns, many of which we look forward to supporting as part of this agenda in the coming year. 

And finally, a special thank you to AIDS Foundation of Chicago interns: Emily Hanak, Emily 2.0 Jastromb,  Kelly Nowicki and Rachel Farris for all their help this year on the HIV PJA and this Action Agenda.  

Yours in the Struggle:

The Staff and Steering Committee of the HIV Prevention Justice Alliance:

Dee Borrego, Gina Brown, BJ Cavnor, Hadiyah Charles, Julie Davids, Daxon Dixon Diallo, Che Gossett, Keith Green, Venton Jones, Kiesha McCurtis, Jim Merrell, Mark Peterson, Anistla Rugama, Waheedah Shabazz-El, Charles Stephens, Laura Thomas, Monique Tula and Robin T. Webb

Download the Action Agenda: bit.ly/ActionAgenda


Join our Working Groups:
http://bit.ly/HIV_PJA_WG

and stay tuned: We will post  full-length versions of each area of our agenda to the website next week, in preparation for our upcoming Working Group planning calls
As the year draws to a close, I'm just delighted that we are so close to launching our HIV prevention justice agenda for 2012!

We've spent two months of gathering input online, in-person and over the phone - thanks to all of you who have contributed - and we're asking all  of you to continue to help make it better...

Send us your comments on the draft 2012 Action Agenda by December 27!

The 2012 Action Agenda will serve as the foundation for our work in the new year and lays out both what we'll be working on and how we plan on carrying out that work... so in January, the real fun begins - join our working groups and campaigns for HIV prevention justice in the United States!

Below you can download the entire document or separate sections to review. 

We set up an online feedback form for you to submit your comments on any or all of the sections of the agenda.  If you're really motivated and/or geeky, you can even make changes directly to the documents and email them to me at jdavids@aidschicago.org.

Comments are due by December 27 - so if you have moment during the joys and/or challenges of the "holiday season," please tell us what you think:

HIV PJA 2012 Action Agenda FULL Document Download File
What is HIV Prevention Justice? Download File
Mobilization & Methods Download File
HIV Prevention Policy Agenda Download File
Health Care and AIDS Services Agenda Download File
Economic Justice Agenda Download File
Mass Imprisonment & Criminalization Agenda Download File
Queer and Trans Justice Agenda Download File

Submit comments by December 27 via this online feedback form - or email them directly to me at jdavids@aidschicago.org.



Many thanks to Treatment Action Group for inviting me to reflect on the history of CHAMP and the future of the HIV Prevention Justice movement in the current issue of their TAGline newsletter.

For your convenience, I've also posted the story below.

The CHAMP Board of Directors has put a call out for all people who were involved with CHAMP in any way or who have thoughts about HIV prevention justice to step forward with recollections, observations, critiques, questions and suggestions. Feel free to post them as comments here!

Thanks for all you do.

Julie

Julie Davids Reflects on CHAMP and the Future of HIV Prevention Justice

Interview with Veteran HIV Prevention and Social Justice Activist Julie Davids

In December 2010, TAGline caught up with the super energetic and visionary HIV activist Julie Davids, veteran of ACT UP/Philadelphia, HealthGAP, and a slew of more recent U.S. HIV prevention and social justice organizations such as CHAMP, Project UNSHACKLE, and the HIV Prevention Justice Alliance. In January 2011 Julie took over as national advocacy and mobilization director for the AIDS Foundation of Chicago. TAGline asked Julie to address the following questions:

o   What changes have happened to HIV prevention research and programs domestically since CHAMP was formed?

o   How have they changed over that period?

o   What are the challenges facing HIV prevention research and programs today?

o   What are the key activist strategies to deal with these challenges?

o   What is needed, and who needs to do it?

Julie Davids: The Community HIV/AIDS Mobilization Project (CHAMP) has ended operations as of this writing, though is sustaining our two main networks (Project UNSHACKLE and the HIV Prevention Justice Alliance) through excellent allied organizations (NYCAHN/VOCAL and AIDS Foundation of Chicago, respectively).

Having had the privilege of founding the group in 2003, and working with it until its closure, my feelings about this transition are understandably complex--but I appreciate the opportunity to reflect a bit on the past and speculate on the future in these pages.

But first, I wish to invite anyone who has had experiences with CHAMP and/or thoughts on the past decade of mobilization, organizing, and policy work on HIV/AIDS in the United States to join our online reflections on our work, the climate in which it occurred, and ideas for future directions. The discussion will be hosted by www.preventionjustice.org on an ongoing basis, and submissions can be made as letters, statements, comments on other posts, or links to online media.

In 2002, I began to engage in dialogue with other HIV/AIDS and social change activists as I sought to sketch out what became CHAMP. That fall I had the opportunity to craft some thoughts on domestic HIV/AIDS organizing in this newsletter  ("The Way Forward: Philly ACT UPer and Health Gap Founder Tackles the Challenges of an Aging Activist Movement," TAGline, October 2002).

At that time I assumed that a regional or national HIV mobilization initiative focused on building a new generation of leadership while maintaining our community's history of strong advocacy would and should be focused on treatment. But as I moved forward in talking to others about these ideas, people started to confront me, asking, "What about HIV prevention?"

There was a sense of frustration that HIV prevention was, for the most part, outside the scope of much of the AIDS community's diverse organizing and policy change efforts while remaining underfunded and underresearched. Yet it was visibly in the crosshairs of conservative politicians in the seemingly endless days of the [George W.] Bush administration.  And I was part of the problem for sure: I remember my broad ignorance on the subject, thinking, "HIV prevention? That doesn't really work, does it, outside of syringe exchange and PMTCT?"

But the more I learned, the more I felt compelled to jump in. I got schooled in the need for HIV prevention advocacy, which had to not only build the power to resist attacks but integrate a broad range of social justice and equity issues; broaden the concept of HIV prevention beyond abstinence, condoms, and clean needles; and delve into challenging research questions that had never been adequately explored.

Although we struggled with issues of capacity and sustainability, CHAMP had a noted impact on HIV prevention advocacy. Entering a realm with little public, strategic conversation and a wide gap between the small but growing body of prevention research and the underfunded, earnest prevention programs at the community level, we found ourselves bridging disciplines and sectors, becoming a trusted "content provider" feeding honest and strategic information to hardworking front-line prevention workers and policy leaders alike, and a leader in strategic campaigns and coalition efforts.

Over time we crafted a national network of 12,000 people--many deeply involved in the fight against HIV/AIDS--who were able to take quick action through online alerts, and who were invited to contribute to debate and dialogue at our events, conference calls, and trainings.

CHAMP began in 2003 by drawing community attention to the secretive process the Centers for Disease Control and Prevention (CDC) was using to revamp their prevention efforts under the "Advancing HIV Prevention" rubric, which was to have major implications, including the near fossilization of interventions into a set of mandated "boxed" interventions.

Now the broader federal government, with much leadership from the CDC, stands poised to reorient prevention approaches in a time of the National HIV/AIDS Strategy (NHAS). Last year was a very busy year that saw the release of the unprecedented NHAS as well as encouraging results of partial efficacy from microbicide and preexposure prophylaxis (PrEP) trials. But CHAMP, which grew out of those initial constructive confrontations from prevention advocates seeking a national movement, is shutting down.

TAGline: So what do we do now?

JD: We continue the fight.

Looking at the successes and failures of CHAMP and other efforts, I've learned that this fight must not be limited to one-time or short-term trainings, small-scale technical assistance, capacity building, and/or online organizing. For those who have noted and respected our work, I'd ask you to look at our capacity struggles as well as our successes as useful data about the need to have strategic alliances and resources to stabilize efforts over the course of years, allowing activists to work together with support and a sustainable home for ongoing campaigns and flexible networks.

In the near term, state-level and regional efforts--providing training and support for new and longtime leaders--need to be scaled up in partnership with national initiatives. We can leverage interest in the 2012 International AIDS Conference (AIDS 2012) in Washington, D.C., and the presidential election of that year into resources for leadership development, political education, and on-the-ground field organizing. But we also should reap the benefit of skilled facilitation and strategic support for healthy collaboration to ensure that passionate and opinionated individuals and organizations in our movement are best able to build our collective power in the coming years, and to allow new leaders to emerge for the fight that will continue long past the conference and election.

And fundamentally, we need to continue the fight for the very basics of HIV prevention, such as condom access and funding for syringe exchange, that remain out of reach for many.

We must amplify the fight against the social drivers of HIV in our country, like mass imprisonment, lack of safe and affordable housing, and LGBTQ marginalization.

And we should challenge ourselves across and beyond the HIV sector--whether people living with HIV, prevention providers, public health advocates, funders or cogs in the wheels of struggling public systems--to bridge the now-artificial distinction between treatment and prevention and aim higher for cross-cutting efforts that have a shot at reaching population-level success to reduce HIV incidence and health inequities.

We must also use the momentum of the NHAS and the upcoming spotlight on the U.S. epidemic at AIDS 2012 to ensure that more and better coordinated resources reach, and are accountable to, the populations most affected by HIV in our country: gay men, other MSM, and transgender people of all races and ethnicities; and people of color of all sexual orientations.

We need to continue the fight because HIV prevention does work.

The basic HIV prevention package--including counseling, access to condoms and sterile syringes, and STD treatment--has helped and continues to help many people avoid infection. Its success has actually made it harder to get results from efficacy studies of additional or alternative prevention interventions, since the systematic inclusion of the basics in the placebo arms has often meant the overall infection rate in trial participants declined substantially.

We have never had a basic, solid, comprehensive foundation of HIV prevention in our country upon which to build more innovative solutions or combination approaches. Notably, it was just this past year that the CDC released a powerful and clear set of data and recommendations on condoms as a structural intervention in HIV prevention. Not just an individual intervention, where one person chooses or is able to use a condom, but a structural intervention, meaning that overarching civic structures can and should make condom access a priority (as has been done in New York City).

In addition, most students and young people never get fully comprehensive sexuality education. There is still no data at all about whether or how sex ed is protective or helpful for LGBTQ youth, and abstinence-only programs still spread misinformation on the public's dime.

These days, the basic prevention package should also include seamless access to postexposure prophylaxis (PEP) for serodiscordant couples and those who have a risky encounter and/or self-identify as at high risk for HIV acquisition, even as we puzzle out how to best move forward on interpreting and implementing initial PrEP results. While there are longstanding public health service guidelines on PEP, actual local programs to get it quickly into the hands of those who need it are rare.

That's why it's encouraging to see that a 12-city expanded HIV planning initiative that's one of the first cross-agency offerings out of the NHAS box--Enhanced Comprehensive HIV Prevention Planning and Implementation for Metropolitan Statistical Areas Most Affected by HIV/AIDS  (ECHPP; http://blog.aids.gov/2010/10/national-hivaids-strategy-working-across-agency-lines.html)--mandates "PEP access for populations at greatest risk" as one of the required interventions.

Of course, we could hope that syringe access could become more reliably a part of the basic package, now that the federal funding ban has finally been lifted. But two major barriers remain.

Sadly, the NHAS perpetuates Bush-era bias against harm reduction, in a time in which those on the front lines believe we could virtually eliminate HIV in injection drug users through concerted, systemic efforts. For example, the ECHPP doesn't even list sterile syringe provision as a "recommended" intervention, much less require it (though it notably highlights a brief alcohol screening/intervention for HIV positive and high-risk people that's seen some success in New York). Even if many of these municipalities are already committed to sustaining syringe exchange (which we cannot count on in this economic climate), the absence of these words in the intervention list of this much-publicized new initiative is chilling.

And there's just not likely to be new money for HIV prevention federally (and much less money given recent and pending cuts at the state and local levels.) This probably means that federal funds must be taken from something else in HIV prevention in order to be redirected to syringe access, setting up competition between different camps or constituents in HIV prevention. While this could and should provoke healthy conversations about the most vital interventions in the current era, it's not an easy process, especially while our organizations and constituents are battered by economic challenges.

Clearly, it's not just syringe access that's threatened by budget woes. The now-worldwide recession is not likely to disappear any time soon--and if/when it does, there's nothing guaranteeing that funds will flow into the path of justice and public health rather than into the pockets of the banks and corporations that are steering much of the decision making around the U.S. economy.

This is a challenge to us on multiple levels. It's not only harder to find the city, state, federal, and private funds to implement the best strategies of the NHAS and push for much needed investments in HIV prevention, treatment and care. Those hardest hit by economic turmoil are those who are or will be put in harm's way and made more vulnerable to HIV. The CDC has now acknowledged that poverty is a major driver of HIV in heterosexuals, and as the number of impoverished people goes up, we could guess that HIV incidence will as well--and not just in straight people; poverty jeopardizes the health of all.

Even in this economic downturn we are finding potential innovations in prevention, like PrEP. But we must use these breakthroughs to inspire us to find ways to confront and overcome, rather than reenforce, longtime and persistent health disparities based in economic, racial, and social injustice in order to ensure that interventions reach all people who could use them.

So we need to also continue the fight because in order to prevent HIV; we need prevention justice.

During CHAMP's lifetime, we launched and promoted an HIV prevention justice movement--one that will be sustained and expanded, in part, through the HIV Prevention Justice Alliance (HIV PJA; http://www.preventionjustice.org/) as it moves forward with its two other cofounders, the AIDS Foundation of Chicago and SisterLove. Prevention justice asserts that advocates for HIV prevention must join in common-cause struggles for social, racial, and economic justice, and that human rights are essential in furthering our fight against HIV.

The HIV PJA has identified three key social drivers as major contributors to stubbornly high HIV incidence rates in the United States: shortage of stable, safe housing access (which is a marker of economic injustice), mass imprisonment (particularly of people of color), and the marginalization of LGBTQ people.

As we move forward in coming generations, we must twin our efforts to combat the proximate, or immediate, causes of HIV, such as sex without condoms or syringe sharing, with an ongoing commitment to the distal causes that determine relative vulnerability or resiliency against HIV, such as poverty and discriminatory policies, that are the focus of HIV prevention justice.

For example, by joining efforts to fight for fair housing for all people at the local level, we bring the strength and passion of the HIV/AIDS community to a human rights struggle that is concretely tied to HIV prevention, treatment, and care. And when we do so as people openly living with HIV and their allies, we create visible space for others to come out, and that's also a good, grassroots way to combat HIV stigma.

CHAMP and others have worked assiduously to draw attention to the reality that gay men of all races and ethnicities are the largest group of those infected in the United States, with the highest rates in black gay men, and the only group in which incidence rates continue to increase. Thus it can come as a shock to some that efforts to end LGBTQ marginalization are often at a distance from the HIV/AIDS community.

Data keep coming out about how events early in the lives of queer people--like whether or not we are accepted by our parents, or to what degree we are targeted for bullying in schools--are formative issues that set in place a cascade of vulnerability or resiliency for a lifetime of health issues, including substance abuse and intimate partner violence as well as HIV/AIDS. And groups like Queers for Economic Justice (http://www.q4ej.org) have challenged the AIDS community to recognize the distinct and compelling challenges faced by low-income and poor LGBTQ people that draw our attention right back to core social drivers like poverty, housing, imprisonment, and immigrant issues.

Fortunately, the NHAS explicitly states that we will never overcome HIV in the United States if we do not deal with the epidemic in gay men. But it remains to be seen if resources truly shift in a smart and sustained way to address the prevention needs of gay men (both HIV-positive and HIV-negative) across the lifespan--and if the HIV/AIDS community will bolster important justice efforts for the liberation of LGBTQ youth and adults that need to go way past issues of marriage.

We know that success in struggles for true justice and human rights do not happen overnight. These sorts of realities--despite encouraging news on the biomedical prevention front--make it clear that HIV will probably be a health and political challenge well beyond our lifetimes.

Moving forward, I think we should be honest that it's very likely that we are talking about a fight that will last multiple generations. While we may be able to drastically decrease HIV rates, we are likely to see sustained transmission in marginalized communities as well as the need for care and treatment in the absence of a cure for some time to come. (As an aside, the reemergence of campaigns to fight for a true cure for HIV are encouraging and vital as a counter to any belief that its acceptable to assign people with HIV to a lifetime of expensive and non-benign treatment.)

It seems increasingly disingenuous to state that the epidemic is fueled by longstanding, complex problems like racial injustice, homophobia, gender bias, and poverty, but then also assert that we could "end AIDS" in five or ten years if we just had enough funding.

We might want to look at the vision of groups like Generation Five (http://www.generationfive.org/), an Oakland-based initiative whose mission is to end childhood sexual abuse in five generations, and consider the following challenge: How would we fight HIV/AIDS in the current time if we both want to move forward to improve things today, and put things in place so our descendants can further the fight in their lifetimes?

The provisions of the Affordable Care Act do hold some promise for near-term resources for HIV prevention. The act's Prevention and Public Health Fund contributed some $30 million to HIV research and prevention in fiscal year 2011, and is (hopefully) the source to pay for the implementation of the 12-city plans in fiscal year 2012, if it survives conservative attack. And the fund is slated to grow each year, without the need for annual appropriation battles.

In addition, the planned massive expansion of health care and medication access as many of the major provisions of the Affordable Care Act roll out in 2014 will increase access to care for many people living with HIV. This should spur innovative and collaborative planning to scale up prevention resources for people living with HIV, and the integration of PEP, PrEP, and testing into a more holistic vision of HIV prevention efforts that bridge behavioral support with treatment and biomedical approaches.

But it's not 2014 yet, and problems abound as AIDS drug assistance program waiting lists grow, immigrant populations are increasingly distanced from care with little hope of abatement from anything in health care reform, and the Affordable Care Act remains a big target for old-school conservatives and Tea Party leaders alike.

As we seek to survive to 2014 and beyond, we can acknowledge that this is a long-term struggle and bolster our strategies for furthering HIV-specific advocacy, marshaling the passion of the HIV/AIDS community as a powerful part of broader coalitions and collaborations to confront the social drivers of the epidemic while we confront HIV stigma through our very participation in these broader campaigns.

Despite cuts that are slimming the HIV sector and public health infrastructure, there are people ready to join and sustain the fight for HIV prevention justice.

We can and must usher in a next-generation approach to prevention that breaks down silos of treatment, care, behavioral interventions, mobilization, and research in order to innovate, evaluate, and expand combination interventions deeply rooted in community that marshals the strengths of large health care and public systems.

We can and should move forward on initiating no-cost, low-cost, or independently funded DIY and grassroots sex ed and HIV prevention that can be as down and dirty and explicit as it needs to be--without worrying about the political climate that can make funders balk.

Oh, there's so much we can and should do. But no matter what, we need strategic approaches that bring our best ideas together to give us a shot at succeeding. I feel lucky to have been able to be a part of CHAMP, which helped so many people turn frustration into power, and hope that the ideas, actions, and national activist networks that we helped to inspire will resonate for some time to come.

 




This week at the Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, researchers and clinicians from around the world met to share and discuss HIV research.

The opening plenary on Monday was delivered by Jonathan Mermin, Director of the Division of HIV/AIDS. Titled The Science and Practice of HIV Prevention in the US, the 30 minute presentation outlined Mermin's vision of a new approach called high-impact prevention (HIP). I caught up with Mermin the following day, and asked him to talk about his speech, explaining what HIP is all about.

If this quick video grabs your interest, you can view Mermin's full presentations and slides right here - and you can look around that conference site for more webcasts of important sessions. I'll be blogging about other conference matters of interest to HIV prevention justice advocates in the coming days, including some thoughts on high-impact prevention, pre-exposure prophylaxis, racial disparities in infection, and other matters...

One of the smaller parts of the Affordable Care Act (otherwise known as Health Care Reform) would nonetheless be a crucial investment in HIV prevention. The Prevention and Public Health Fund (PPHF) was meant to be a guaranteed source of support for preventing disease and ill health, and would provide a greater and greater infusion of resources each year.

So, it was disturbing to see that the announcement of the PPHF for 2011 that came out this week DOES NOT MENTION HIV.

In the post below, Jim Merrell of the HIV Prevention Justice Alliance spells out why this is a problem. Stay tuned in the coming weeks as we'll almost surely need to make a big noise about rectifying this...


On Wednesday, the U.S. Department of Health and Human Services (HHS), the section of the federal government that oversees the majority of health related federal programs, announced $750 million in Prevention and Public Health Fund (PPHF) investments for 2011.  The announcement is big news in the fight for health equity and community-based health promotion and prevention.   HHS is explicitly targeting health disparities, coordinated chronic disease prevention, enhanced public health infrastructure and improved research and tracking - all big wins for in the fight against the structural drivers of the HIV epidemic.

But something was missing...

Gone from the 2011 PPHF announcement is the $30 million investment in expanded HIV testing initiatives we saw in 2010. 

Certainly this investment, a small percentage of the overall funding, closely aligns with the goals of the initiative - so why the cold shoulder?

It's a question we'll be asking at every opportunity and we hope you'll do the same.

However, it's important to keep in mind that the PPHF, and the Affordable Care Act as a whole, represent two of the boldest moves against health injustice in generations.  In 2011, the federal government will inject almost $300 million in community prevention programming, half of which will go to local and state health departments in the form of 'community transformation grants' - focusing on, among other things, health disparities and coordinated chronic disease prevention.

As local authorities prepare to apply for these funds, we must ensure that HIV prevention is at the table and explicitly included in grants going to our communities.  This is especially critical given the likelihood that HIV prevention funding at the state and federal levels will be subject to deep cuts or flat funded at best. 

With renewed energy and investment around public health and community level health promotion and prevention, now is the time to make sure that HIV prevention is an integral part of the broader vision for a renewal of the commitment to health and wellness in our communities.


More reading:

State by state fact sheets on 2010 Prevention and Public Health Fund

Trust for America's Health - Factsheet on FY2011 PPHF Allocations and Detailed Table of Funding





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