HIV/AIDS in Georgia – How we have failed and will continue to fail

This is a not something new. We have know for years that HIV/AIDS was becoming a real threat for rural, female, African-American and poor people.

This is not all the fault of the state (but plenty of blame does reside there). The CDC has never really EVER had a HIV prevention plan in place. When the CDC gets criticized or the HIV numbers don’t go down (or get worse) they throw ideas and plans at HIV prevention and then next year abandon this for the newest idea or plan that comes up.

Add to this the interference (CDC) at the highest levels of government (The White House) and our national fear of talking about sex or sex being referenced to some religious thought that says any sex is bad unless you are making more Christian babies (search this blog for CDC articles) and you have the national response for the past 25 years.

As far as Georgia is concerned we have only done what was absolutely required to address HIV after activists and the federal government forced the issue. There has not been any high level leadership on the issue from either party or political group.

The Division of Public Health is part of DHR and Governor Perdue hired B.J. Walker in 2004 to head up DHR mainly to deal with the Division of Families and Children Services (which is another thing we cannot ever seem to fix) and Walker did/does not know anything about Public Health or HIV. Walker has been too busy firing and replacing DFCS Division directors and ignoring the Mental Health Division issues (patients dying in the hospitals/feds coming to take it over etc) to do more than pay lip service to HIV. 

At the same time in 2004 Purdue put Bruce Cook in as the Chairman of the DHR board whose job it is to oversee Walker, set budget and policy for all of DHR including the Division of Public Health. Cook owns “Choosing the Best”, an abstinence-only company and was finally removed because he was roundly criticized for doing business with Georgia’s Department of Education while serving as board chairman of DHR.

Cook constantly ran foul of the HIV community as he made false claims about condoms failure rates and other data concerning HIV. The AJC and Creative Loafing in Atlanta did many articles about him during 2004-2006 concerning his company and his “philosophy” and finally he got too hot for Perdue and was dumped and appointed to some obscure Mental Health Task Force committee (now, the Mental Health Hospitals are under federal investigation) and finally he disappeared from the radar for awhile.

Want to know how NOT to effectively deal with a disease that is spread through sex, drug needles and pregnant women?

Study HIV in this county and state.

Facts are things to be ignored- they just get in the way of our beliefs.

AIDS finds a hidden niche in Georgia

The Atlanta Journal-Constitution

HIV/AIDS has assumed a new face in Georgia.

It is younger and more rural, more likely to be black or female.

And it is harder to reach with prevention messages, testing and services.

Old messages geared to urban, white, gay men simply don’t resonate with many African-American and rural people, advocates say.

That worries the advocates.

The inability to reach those groups “is really a threat to everyone’s well-being,” said Clarence Reynolds, spokesman for AID Atlanta, the largest AIDS service organization in the Southeast. He said people who do not receive services and safe-sex counseling are more likely to spread the virus.

The number of Georgians living with HIV/AIDS jumped almost 27 percent from 2004 to 2007, to 32,740, reports the state Division of Public Health. The number of deaths has leveled off, as stronger drugs have allowed infected people to live longer.

Stigma for gays in rural and black communities, has often kept the issue out of churches and schools, advocates say. Continue reading

National Minority AIDS Council Call to Action- New HIV rates

There website is here.

FOR IMMEDIATE RELEASE
Contact: Circe J. Gray Le Compte, Director of Communications
National Minority AIDS Council, 1931 13th Street NW, Washington, DC 20009
Telephone: (202) 234-5120 ext. 309; (202) 352-7240
E-mail: communications@nmac.org

“And all the centuries passed and they survived and became a kind of people that the world had never known. In the center of themselves they alone bore their suffering while the world theorized about their humanity or gazed on them with icy dismay. Now nothing. No gestures, no greetings, no embraces. What’s gone and past help, should be past action.”

NMAC Calls for Comprehensive Health Response to
Reported Increase in HIV Incidence in the U.S.

August 3, 2008 – Washington, DC – Re-evaluation of HIV incidence data at the Centers for Disease Control and Prevention (CDC) has revealed that over 55,500 new HIV cases occurred each year from 2003-2006, with 56,300 cases in 2006 alone. These numbers are approximately 40% higher than the CDC’s previous estimate of 40,000 new HIV cases annually, an estimate that had remained the same for over ten years.

“We applaud the CDC’s efforts to provide a clearer picture of the AIDS epidemic,” says Paul Kawata, Executive Director of the National Minority AIDS Council (NMAC). “While the Federal government’s focus in recent years on testing, care and treatment has saved the lives of many people living with HIV/AIDS, these new numbers clearly indicate that this approach has done little to prevent new infections.”

NMAC supports the formation of a comprehensive national strategy to address HIV/AIDS in this country that includes input from all people vested in the fight against AIDS from elected officials and health care workers, to vaccine researchers and people living with HIV/AIDS. Ravinia Hayes-Cozier, NMAC’s Director of Government Relations and Public Policy explains, “These numbers are unacceptable for all of America. At NMAC, we consider HIV/AIDS just one symptom of an overall health emergency in this country particularly in communities of color, which have been disproportionately impacted by HIV/AIDS since the epidemic began three decades ago.

“Ethnicity is not a risk factor for HIV/AIDS, which, of course, can impact anyone, regardless of age, gender or race. However, the limited access to support services - such as education and health care – and high rates of homelessness, malnutrition, substance use, incarceration and poverty unfortunately found in many minority communities has left their members immuno-suppressed and more susceptible to HIV/AIDS and its co-morbidities, like diabetes, tuberculosis, heart disease, hypertension and hepatitis A, B and C.”

Indeed, the distribution of HIV in communities of color has remained relatively the same, despite the new numbers from the CDC. Nearly half – 45% – of all new HIV cases occur among African Americans, followed by Latinos at 17%; Asian and Pacific Islanders at 2%, and Native Americans at 1%. African American women and men who have sex with men (MSM) of color also are testing positive for HIV in shockingly high numbers.

In addition to a comprehensive, national health strategy that includes HIV/AIDS prevention, testing, treatment and care, NMAC calls on federal and state government agencies, faith- and community-based organizations, AIDS service organizations and other stakeholders in the epidemic to increase their support for the following:

  • Comprehensive sex education for all young people and their families. We need to ensure that all generations in this country can protect themselves and others from HIV transmission, and can serve as peer educators for others.
  • HIV vaccine research. We must support the development of an HIV vaccine that works for everyone and the only way any viral epidemic has been stopped in recent history is through the development of a vaccine.
  • Expanded programs for low-income housing, utility bill relief and food stamp initiatives for those living with HIV/AIDS and its co-morbidities. We cannot build the health of a nation without ensuring access to the basic necessities of life.
  • Programs addressing the unique health needs of girls and women. In many families, the primary caretakers are women, many of whom sacrifice their health for their children and are not aware of their own susceptibility to HIV and other diseases.
  • Initiatives addressing stigma around HIV and homosexuality. These will empower young MSM of color to learn and experience their sexuality safely, in a society that understands and accepts them.
  • Expansion of harm reduction and substance use programs. Harm reduction offers many people access to drug rehabilitation and care. These programs, however, must not only treat addicts, but their families as well, particularly when children may be separated from their parents/guardians entering care.
  • Providing incarcerated persons living with HIV/AIDS access to discharge planning and treatment, as well as delivering comprehensive HIV/AIDS prevention education in correctional facilities. Prisoners who have access to condoms, voluntary testing and comprehensive health care will be less likely to contract or transmit HIV while incarcerated and when returning to their communities.
  • Programs that support, and increase the visibility of, HIV/AIDS prevention, treatment and care programs at the grassroots level. We need to continue to build the infrastructure of faith- and community-based organizations delivering services to those hardest hit by the AIDS epidemic.

“We cannot worry about assigning blame around HIV/AIDS, nor should any elected U.S. official claim ignorance about, and remain complacent on, the AIDS epidemic in this country,” says Kawata. “Having a clearer picture of HIV incidence in the U.S. offers us yet another opportunity to work and speak out together in the fight against HIV/AIDS. The very future of our communities depends on it.”

# # #

The National Minority AIDS Council (NMAC) was founded in 1987 to develop leadership within communities of color to address challenges of HIV/AIDS. NMAC has responded to the needs of communities of color by developing programs enhancing the skills necessary to confront this health crisis, including a public policy education program; national and regional training conferences; treatment and research programs and trainings; numerous publications and a website: http://www.nmac.org. The agency also serves an association of AIDS service organizations, F/CBOs, hospitals, clinics, health departments and other groups assisting people and families living with and affected by the AIDS epidemic. NMAC’s advocacy efforts are funded through private funders and donors only.

The International AIDS Conference 2008 – Resources

Today the XVII International AIDS Conference starts in Mexico City. Lots of information is going to be coming out including the new incidence of HIV infections in the US. If you want to keep up with the conference, see live webcast, or view recorded sessions for later viewing please visit the Kaisernetwork.org site.  Here is the link.

Black America and HIV – US failure to combat problem

Here is the link to the report and whole article.

What If Black America Were Its Own Country?
“Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic” incorporates a new analysis by the Black AIDS Institute showing how Black America would rank on the global health and HIV scale if it were a separate country. The results put the U.S. government’s neglect of its own citizens’ healthcare into stark relief.According to the report:
Standing on its own, Black America would constitute the world’s 35th most populous country, but would rank 16th in the world in the number of people living with HIV.
A free-standing Black America would rank 105th worldwide in life expectancy and 88th in infant mortality. Blacks in the U.S. have a lower life expectancy than do citizens of Algeria, the Dominican Republic or Sri Lanka.
Outside of sub-Saharan Africa, only four countries – and only two in the Western Hemisphere – have adult HIV prevalence as high as the conservative estimate (2% among adults) for Black America. Blacks represent about one in eight Americans, but account for one in two people living with HIV in the U.S.
Despite extraordinary improvements in HIV treatment, AIDS remains the leading cause of death among Black women between 25-34 years and the second leading cause of death in Black men between 35-44 years.
Black women in the U.S. are 23 times more likely than White women to be diagnosed with AIDS.
Blacks make up 70% of new HIV diagnoses among teenagers and 65% of HIV-infected newborns.

“The AIDS pandemic, including the epidemic right here at home, is a worldwide crisis. That is why we must ensure it is addressed it in a truly global way,” said Barbara Lee, member of Congress from California and a co-author of the legislation that created PEPFAR.

A Misdirected Response
“Left Behind!” posits that the Federal government is taking a fundamentally flawed approach to the epidemic in Black America, applying the prevention paradigm developed for concentrated epidemics, which focuses almost exclusively on so-called “high-risk” groups.

“The ‘concentrated epidemic’ approach reflects a fundamental misunderstanding of the social networks of Blacks in America. We are experiencing an epidemic with significant transmission beyond vulnerable populations. Nothing short of a mass Black mobilization will be sufficient to turn around the AIDS epidemic in Black America,” noted Wilson. “The U.S. should understand from its work in countries with similar epidemiological profiles that a more effective approach for Black America would include a mix of targeted programs for high-risk populations; broad-based initiatives that mobilize entire communities; and efforts to address the role of concurrent partnerships and the rapid spread of HIV transmission in social networks.”

“Black women are particularly affected by the domestic AIDS response and attention to their needs are inadequate. Lives are lost as a result,” said Dr. Helene Gayle, President/CEO of CARE. “As in other parts of the world, Black women in the U.S. often face increased vulnerability to HIV due to lack of a perception of power in sexual relationships and low self-esteem. Many cannot insist on abstinence or the use of condoms because of fear of emotional or physical abuse by their partners. Development of female-initiated prevention methods is not only a critical priority for Black women overseas, but also for Black women here at home.”

The report illustrates that young people in Black America, as in other parts of the world, are often at highest risk of infection because of inadequate knowledge of HIV infection, a high prevalence of inter-generational relationships, and a shortage of youth-tailored HIV prevention programs. And it points out that the silence that masks the particularly high risk of HIV confronting men who have sex with men in Africa and other heavily impacted regions also exacerbates AIDS in Black America. “Among men who have sex with men worldwide, Blacks in the U.S. may have the highest HIV prevalence. In the U.S., Black gay men experience more than twice the rate of infection as their White counterparts,” noted Jesse Milan, Vice President of the non-profit health management consultancy Altarum. “Black men who have sex with men in the U.S. share important attributes related to HIV risk with their peers in other regions, including the experience of severe stigma and discrimination that often impedes HIV prevention efforts.&

The South has 52% of all HIV cases

Here is the link to the Southern States Manifesto

Report warns of Southern AIDS ‘crisis’

Half of deaths occur in 17-state region as federal, private money dries up

By Alex Johnson
MSNBC
July. 24, 2008

AIDS specialists are calling for a fundamental rethinking of HIV policy after a new report showed that infection with the virus was rising dramatically in the South even as it dropped everywhere else in the country.

The warning, issued this week by the Southern AIDS Coalition, a nonprofit partnership of government and private-sector programs based in Birmingham, Ala., concluded that AIDS was creating a health disaster in the South.

AIDS deaths fell or held steady in other parts of the country from 2001 to 2006, the last year for which complete figures were available, but they rose by more than 10 percent in the South, according to the report, titled “Southern States Manifesto 2008.”

The report, an update to a landmark 2002 report that identified the disproportionate impact of HIV and AIDS in the South, was based on data compiled by the federal Centers for Disease Control and Prevention, state health departments and academic researchers. It defined the region as Alabama, Arkansas, Delaware, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia and Washington, D.C.

Among the findings:

  • Although the covered area is home to only 36 percent of the nation’s population, half of all U.S. AIDS deaths in 2005 were in the South, and more than half of all Americans with HIV lived in the region in 2006.
  • Nine of the 15 states with the highest HIV diagnosis rates are in the South.
  • More than 40 percent of all new infections are in the South.
  • Of the 20 metropolitan areas with the highest rates of AIDS cases in 2006, 16 were in the South.
  • “The South is faced with a crisis of having to provide medical and support care for increasing numbers of infected individuals without adequate funding,” especially among the young and among minority Southern communities, the report concluded.

    “African-American women are 83 percent of all [new] cases that we can document,” said Bambi Gaddist, executive director of the South Carolina HIV/AIDS Council and a member of the AIDS Coalition board of directors. “And the new epidemic is young people. They’re between 22 and 24.” Continue reading

    HIV estimates in US are 40% higher that thought

    Here is the NPR story on the issue: HIV rates higher than thought

    And print story from NYT

    H.I.V. Study Finds Rate 40% Higher Than Estimated

    MEXICO CITY — The United States has significantly underreported the number of new H.I.V. infections occurring nationally each year, with a study released here on Saturday showing that the annual infection rate is 40 percent higher than previously estimated.

    The study, conducted by the Centers for Disease Control and Prevention, found that 56,300 people became newly infected with H.I.V in 2006, compared with the 40,000 figure the agency has cited as the recent annual incidence of the disease.

    The findings confirm that H.I.V., the virus that causes AIDS, has its greatest effect among gay and bisexual men of all races (53 percent of all new infections) and among African-American men and women.

    The new figures are likely to strongly influence a number of decisions about efforts to control the epidemic, said the disease centers’ director, Dr. Julie L. Gerberding, and other AIDS experts. Timely data about trends in H.I.V. transmission, they said, is essential for planning and evaluating prevention efforts and the money spent on them.

    Dr. Gerberding said the new findings were “unacceptable,” adding that new efforts must be made to lower the infection rates. “We are not effectively reaching men who have sex with men and African-Americans to lower their risk,” she said.

    Dr. Kevin A. Fenton, who directs H.I.V. prevention efforts at the agency, said, “C.D.C.’s new incidence estimates reveal that the H.I.V. epidemic is and has been worse than previously known.”

    A separate historical trend analysis published as part of the study suggests that the number of new infections was probably never as low as the earlier estimate of 40,000 and that it has been roughly stable overall since the late 1990s.

    C.D.C. officials said the revised figure did not necessarily represent an increase in the number of new infections but reflected the ability of a new testing method to more precisely measure H.I.V. incidence and secure a better understanding of the epidemic.

    Dr. Philip Alcabes, an epidemiologist at Hunter College in Manhattan, raised questions about the validity of the findings. If they are true, Dr. Alcabes said in a statement, the agency has undercounted new H.I.V. infections by about 15,000 per year for about 15 years. “Therefore, there are roughly 225,000 more people living with H.I.V. in the U.S. than previously suspected,” he said. “The previous estimate was 1 million to 1.1 million.”

    A C.D.C. spokeswoman said Dr. Alcabes’s estimates were incorrect because the new figures could not be used to calculate the total number of people with H.I.V. The C.D.C. does not know the total number but is expected to determine it later in the year.

    The C.D.C., the federal agency responsible for tracking the AIDS epidemic in the United States, said its new monitoring system provided more precise estimates than were previously possible of new infections in specific populations. Infection rates among blacks were found to be seven times as high as for whites (83.7 per 100,000 people versus 11.5 per 100,000) and almost three times as high as for Hispanics (29.3 per 100,000 people), a group that was also disproportionately affected.

    The C.D.C. has known of the new figures since last October, when the authors completed a manuscript and sent it to the first of three journals. But the agency refused to release the findings until they were published in a peer-reviewed medical journal. The first two journals rejected the authors’ request for a fast-track review. Continue reading

    AIDS fight in the South hard

    From NPR

    HIV in the South

    Follow

    Get every new post delivered to your Inbox.