South Georgia HIV/AIDS

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

goingsouth — Sun, 17 Aug 2008 14:58:00 +0000

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

By CRAIG SCHNEIDER

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.

An “unholy trinity” of silence, shame and stigma prevents many African-Americans from getting tested for the virus, said the Rev. Raphael Warnock, senior pastor at Ebenezer Baptist Church in Atlanta.

Hartsel Shirley has felt that stigma firsthand. The 39-year-old southwest Atlantan was diagnosed with HIV years ago but a fear of being exposed kept him from seeking care, he said.

“If you’re black and a gay man, you’re not even looked at as a man,” Shirley said. “If you have HIV, you’re almost not human.”

By 2006, 71 percent of those living with HIV/AIDS in Georgia were black, although African-Americans are about 30 percent of the state’s population, according to state figures. Seventy-nine percent of Georgians diagnosed with HIV that year were African-American.

Rural and other areas outside metro Atlanta often have HIV/AIDS prejudice.

Frank Tant, who grew up in Rome, said his parents asked him to move out when, at 19, he told them he was gay. He has since moved back to Rome and sees better treatment of gay people.

He’s gotten overwhelming support since sharing his story in the local newspaper. “People in Rome think of me as Mr. HIV,” the 48-year-old said.

Lola Thomas, executive director of the AIDS Alliance of Northwest Georgia, said reaching gay men in rural areas, where they have few public gathering places, has proved so difficult that she all but gave up trying.

“We’ve stayed away from gay and bisexual men. They’re much more difficult to target,” Thomas said.

Instead, the Cartersville nonprofit has focused on emergency assistance, financial help, transportation and counseling for clients.

Frustrations abound, as mirrored in several recent national reports.

The Centers for Disease Control and Prevention issued a revised estimate this month that 56,000 people nationally were newly infected with HIV in 2006, 40 percent more than previously estimated.

A report by the Southern AIDS Coalition said inadequate health care for HIV/AIDS patients in the rural South is a regional catastrophe. The Black AIDS Institute said if black America were a country, it would rank 16th in the world in the number of people with the virus.

Health officials are particularly concerned about the number of young people being infected. Many came of age after the AIDS ravages of the 1980s and early 1990s. As more effective drugs helped reduce the death rate, many young people saw it as a manageable illness rather than a death sentence, activists said.

“They see the drugs as a cure,” said Cathalene Teahan, president of the Georgia AIDS Coalition.

In Georgia, one-third of newly diagnosed HIV cases in 2006 were among 20-29 year olds, according to the state public health division.

Teahan said reaching young people in schools has been difficult since so much sex education in Georgia is abstinence centered.

“No one can use the word condom now,” she said.

But Bruce Cook, whose Atlanta company Choosing the Best provides abstinence-centered education materials to Georgia schools, said such instruction can be effective in leading young people to make the right decisions.

“The only way you eliminate risk is abstinence,” Cook said. “Condoms do break and they do slip off.”

The majority of HIV/AIDS cases still occur in metro Atlanta, where advocates say they see more women, particularly African-American women, with the virus.

Dazon Dixon Diallo, executive director of SisterLove, said her group has seen success by addressing the broader economic and relationship issues in many of these women’s lives.

“Ignoring women, young people of color, people in rural areas — we have done them a disservice,” said Diallo, whose Atlanta nonprofit works with African-American women.

Freda Jones got HIV from sex with a man she didn’t know had the virus. When she was diagnosed, the hairstylist did not tell her customers for years, afraid they would abandon her.

She said she pushed her boyfriend to get tested and he was positive, but he went into denial and refused care. It broke up their relationship.

She is now a peer counselor for people with HIV.

“It made me grow up,” she said. “I thought it couldn’t happen to me.”

Meanwhile, some advocates say the response of state and local governments has been inadequate. The state has done little to provide leadership and coordinate prevention efforts, advocates say.

“It is a disorganized mess,” said Kathie Hiers, community co-charwoman of the Southern AIDS Coalition.

Among rural county and municipal governments, HIV/AIDS “is not even on the radar,” said Thomas, with the AIDS Alliance. “Most government people here see it as a city problem.”

The state appointed a new HIV unit director a few months ago, and Raphael Holloway acknowledged that the agency needs to do better at reaching out to community advocates. At the same time, he said increasing services would be difficult at a time of budget cuts.

Still, state officials say they are making progress, increasing testing and working with community leaders to craft a comprehensive plan for the prevention of HIV in urban and rural areas.

But advocates say there’s a long way to go. Thomas said many of the men who come to her Cartersville office to get tested worry they’ll be seen and identified.

“Some are shaking in their boots,” she said, “and practically wearing disguises.”

Staff researcher Sharon Gaus contributed to this article.

National Minority AIDS Council Call to Action- New HIV rates

goingsouth — Mon, 04 Aug 2008 18:49:17 +0000

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: 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

goingsouth — Mon, 04 Aug 2008 14:03:53 +0000

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

goingsouth — Sun, 03 Aug 2008 13:54:27 +0000

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

goingsouth — Sun, 03 Aug 2008 12:41:33 +0000

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.”

‘Specific problems here in the South’
AIDS specialists pointed to unequal government funding of anti-AIDS programs as a major problem in the South, where they said economic and cultural factors played unique roles in transmission of the disease.

“We have specific problems here in the South, especially because of our rural areas — transportation issues, translation, lack of access to proper health care,” said Mary Elizabeth Marr, executive director of the AIDS Action Coalition of North Alabama.

Education plays a particularly important role in fighting HIV in rural communities, said Marr, who blamed the “it can’t happen to me factor.”

“Some of those are parents in denial that their children are sexually active [and] people not getting tested,” she said. “People aren’t getting proper health care early on and are transmitting the disease to others.”

But “even though we have now seen this increase in the South, we are not seeing the increase in funding for the Southern states,” she said.

The Southern AIDS Coalition blamed “rising infection rates coupled with inadequate funding, resources and infrastructures” for what it called “a disparate and catastrophic situation in our public health care systems in the South.”

“There are vast geographic areas that encompass large cities, less urban areas, and rural areas that result in screening, care, treatment, and housing challenges,” it said. “Historically, the South has also received the least amount of federal funding.”

At the same time, “only 19 percent of U.S. philanthropic commitments for HIV/AIDS” go to the South, it said.

More funding, education, testing urged
The coalition called for more “age-appropriate, science-driven education for prevention of all sexually transmitted diseases,” along with increased federal funding for “prevention, treatment, care, and housing in the southern United States to rectify the historical inequities embedded in the federal HIV and STD funding portfolios.”

“Unless we act to correct funding and treatment disparities, we endanger not just isolated communities, but our states and our nation,” the report said.

Specialists said people could not get treatment if they did not know they were infected, which the report said could represent as many as 25 percent of all HIV cases in the South. They added a plea for inexpensive testing for every sexually active person.

“People in the South will die for lack of a simple test that can cost under $8 to provide, so we must work together to provide early screening,” said Evelyn Foust, a disease expert with the North Carolina Division of Public Health and a member of the AIDS Coalition’s board.

NBC affiliates WAFF of Huntsville, Ala., and WVTM of Birmingham, Ala., contributed to this report.

URL: http://www.msnbc.msn.com/id/25819585/

HIV estimates in US are 40% higher that thought

goingsouth — Sun, 03 Aug 2008 12:22:06 +0000

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

By LAWRENCE K. ALTMAN

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.

The paper is being published in the Aug. 6 issue of The Journal of the American Medical Association. The journal and the disease centers had planned to release it at a news conference on Sunday at the opening of the 17th International AIDS Conference here. But the paper was released on Saturday because the embargo was broken. A number of leading health experts have criticized the agency for not releasing the information earlier. On Nov. 21, C.D.C. officials told AIDS advocacy groups and reporters that the data would be released soon.

In an editorial on June 21, The Lancet, an internationally prestigious journal published in London, severely criticized the disease centers for failing to release the information and said, “U.S. efforts to prevent H.I.V. have failed dismally.”

Dr. Gerberding, in defending the decision not to release the data earlier, said: “This paper has been scrutinized by some of the best statisticians in the country and is much better now than when we started this process. It was so complicated that even I, who has some expertise in this area, could not stand by it without making sure we had gone through the review process.”

She added, “This is one of those examples where getting the external review process to really scrutinize the paper, pick it apart, build it back up, has in my opinion fundamentally improved it.”

The delay, however, has also fueled criticism that the Bush administration, which has earned plaudits for spending tens of billions to fight AIDS in a number of highly affected countries, has not done enough to fight the disease at home.

Representative Henry A. Waxman, Democrat of California and chairman of the Committee on Oversight and Government Reform, was critical of the administration. “H.I.V. prevention has been underfunded and too often hindered by politics and ideology,” Mr. Waxman said in a statement released Saturday.

He said the administration had reduced domestic spending against H.I.V. “Since fiscal year 2002, when adjusted for inflation, C.D.C.’s prevention budget has actually shrunk by 19 percent. The president has recently requested decreases in funding for H.I.V. prevention at C.D.C.”

Mr. Waxman said he would soon hold hearings on why health officials had had “less and less money to actually get these programs to the communities that need them.”

Dr. Alcabes disagreed with critics who contend that the new numbers point to a failure of United States policy on AIDS, saying his conclusion was that “it looks like prevention campaigns make even less difference than anyone thought.”

“H.I.V. incidence did not decline as much from the 1980s to the 1990s as we believed,” he said, “despite the dramatic increase in condom promotion and so-called prevention education.”

The C.D.C. said the findings confirmed sharp declines in the number of new H.I.V. infections each year, from a peak of about 130,000 in the mid-1980s to a low of roughly 50,000 in the early 1990s. But the findings also indicate that the number of new infections increased in the late 1990s but has since remained relatively stable, with estimates of 55,000 to 58,500 in the three most recent time periods analyzed.

Dr. Gerberding said: “If there is any good news here, it is hard to report it, but there is a little bit in the sense that while incidence rates are certainly too high, they are stable. That is important because a stable number of new infections in a world that has got more and more people with H.I.V. and people with AIDS living in it suggests that we are keeping up with that pressure for transmission.”

The revised figures are based on a new laboratory test that can distinguish between recent and long-standing H.I.V. infection, as well as on statistical measures and extrapolations.

The test is done in the laboratory on left-over serum from the standard H.I.V. test after it shows that a person is infected. The Food and Drug Administration has approved the test, known as BED.

Dr. Gerberding said that an earlier version of the new test was too crude to do the same kind of study earlier this decade. Despite the improvements in the test, she said, it is “not perfect yet.”

AIDS fight in the South hard

goingsouth — Sun, 03 Aug 2008 12:14:14 +0000

From NPR

HIV in the South

Doctors now holding patients hostage

goingsouth — Fri, 20 Jun 2008 18:16:28 +0000

Best damn health care in the whole WORLD!!

(insert sound of flushing)

Three indicted on charges of holding woman captive at clinic
The Atlanta Journal-Constitution
Published on: 06/20/08

A doctor and two staffers at a Duluth medical practice face charges of false imprisonment for allegedly locking a patient in a room when concerns arose about her ability to pay the bill.

Dr. John Drew Laurusonis and office assistants Leslie Ann York and Alexander Acquah of the Doctors Medical Center were indicted this week on false imprisonment charges. The three face arraignment July 3 on the charge.

Police say Frances Bales, 36, of Duluth, was held against her will on Oct. 4, 2007, when she went to the clinic seeking treatment for arm pain.

A receptionist at Doctors Medical Center said the clinic would have no comment and then hung up. Office staff for Laurusonis’ attorney, Richard Ryczek, said the attorney would call back later for comment.

Bales’ attorney, Joseph Fried, said Friday she was told initially that the visit would cost $98. Bales had been visiting from out-of-state and didn’t have health insurance, Fried said.

“They took her debit card and her driver’s license at the reception desk,” Fried said. “She figured with X-rays it might be a little more.”

Instead, after tests, she was charged $755, Fried said.

“She says, ‘I don’t have the money,’ ” Fried said. “They direct her to go into what they called their billing office.” For several hours, the staff refused to allow her to leave, locking her in for periods of time, Fried said. They had her log into her bank records from a computer while she was there, he said.

“They said, ‘Don’t you have anyone who loves you who can come and help you? Because you’re not leaving until this bill is paid,’ ” Fried said. “They made her feel like she was a criminal. She was made to feel like she couldn’t leave without something bad to happen to her.”

Fried described Bales’ personality as less assertive than other people.

At one point, they allowed her to go to her truck to get a paycheck, but held her keys while she looked, unlocking the vehicle’s doors with the electronic key fob on the keychain, Fried said.

Our neighbor to the south gets their hate on

goingsouth — Sun, 27 Apr 2008 19:47:07 +0000

This the link to the original story.

From Pam’s house blend. I think she has the best analysis of what is really going on. Go read the whole thing.

For those who don’t know, fundamentalist right-wingers in Florida are attempting to pass a constitutional amendment in Florida this year that would ban gay marriage in the Sunshine State. The same gay marriage that is already illegal under four separate parts of state law. And this amendment wouldn’t just ban gay marriage, it would also prevent civil unions, cities and corporations from offering benefits to gay couples and anyone from giving benefits to unmarried straight couples. But let’s leave aside the practical implications of the proposed gay marriage ban in question, I’ve talked about that in the past and I’ll come back to it over and over again throughout the year, let’s look at the hate ingrained in this particular phrase.

This is a tremendous social crisis, greater even than the issue of slavery.

Keep in mind, this isn’t about banning gay marriage. Gay marriage is already banned in Florida under four different laws. What this nutjob is actually saying is that the fact that they haven’t yet enshrined hatred in the Florida Constitution, despite not one single legal gay marriage ever taking place in Florida, is not only a “tremendous social crisis,” but one greater than slavery. That shows an astounding amount of hatred not only for gay people, but for African Americans as well.

It took countless deaths, but Georgia finally gets a Mental Health Ombudsman

goingsouth — Fri, 11 Apr 2008 13:30:16 +0000

While on the face of it it is a good sign that Georgia is finally doing something to address this horrible issue, it is outrageous that it takes people dying, a federal investigation and a investigative piece from the AJC to make this happen.

Having an ombudsmen and advocates for the most helpless of our residents is a good idea and should have been in place years ago. But to do it because mentally ill Georgians and our children who are dependent on on the state are being killed and abused points to a much deeper problem.

Why is it that we as Georgians do not care about the most helpless of our residents? That we do not demand that we fund programs and monitor the well being of those who are being cared for? That we are shocked to learn that people are dying and being abused in state facilities then start blaming the “state” and even the victims for the issue?

What is this really about for us? It is time for a reality check and to look in the mirror.

OUR OPINIONS: Overdue advocacy
First-time funding for a mental health ombudsman is a lifesaving development

By Mike King
The Atlanta Journal-Constitution
Published on: 04/10/08

Mentally ill Georgians who depend on the state for services may finally be getting the advocate they need.

In one of its few real accomplishments, the 2008 General Assembly revamped the ombudsman’s office it created in 2000 to oversee the quality of services delivered in the state’s seven mental hospitals and community mental health system. Legislators also authorized creation of an independent medical review panel to investigate unexplained deaths at the state’s mental hospitals —- a much-needed step to move beyond the cursory reviews now performed by the Department for Human Resources, which runs the hospitals.

The ombudsman’s post had been dormant since 2000 because it had never been provided funds to get started. This year the Legislature appropriated $250,000 to fund the office, as well as to pay for the new fatality review process.

An Atlanta Journal-Constitution investigation revealed last year that from 2002 through 2006, there were 115 suspicious deaths at state mental health hospitals —- many of which could have been prevented had hospital wards not been overcrowded and understaffed. The deaths continued in 2007, with 21 suspicious fatalities, the newspaper reported, even while the U.S. Justice Department was launching an investigation into whether Georgia was violating the civil rights of hospitalized mental patients.

The new medical review board will function much like one already in place to examine the fatalities of children in the state’s foster care system. It is empowered to review all deaths at state hospitals and community residential facilities, including those of residents who had been discharged from state-run or sponsored facilities within two weeks of their death.

The panel will provide a quarterly summary of its findings to the ombudsman, identifying any trends that might improve the quality of care and reduce the risk of death. Those reports will be considered public records, available for anyone to see.

The ombudsman will serve a five-year term. The first task will be to establish a formal complaint process so that quality-of-care and other disputes can be resolved. The office will also be required to file an annual report documenting the types of complaints and other problems raised by consumers and recommending changes in policy, regulation and administration for the governor and Legislature to consider.

The General Assembly’s decision to provide funds and power to the ombudsman may end the indifference to mental health issues. The sad fact is that, had the state acted sooner, lives could have been saved. Perhaps the new ombudsman will be in a position to convince legislators that more and better-targeted spending is needed in the state’s troubled mental health system.

—- Mike King, for the editorial board (mking@ajc.com)