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Plunge in state revenue triggers AIDS funding ‘crisis’



Heather Hauck, director of the Maryland Department of Health & Mental Hygiene’s infectious disease division (DC Agenda photo by Michael Key)

The worst economic recession since the Great Depression is devastating state and local government budgets, especially HIV/AIDS budgets, a panel of AIDS experts said Thursday.

In a briefing on Capitol Hill for congressional staff members, state and local AIDS office officials from Maryland and California, along with leaders of AIDS service groups in Los Angeles and Louisville, Ky., said they were scrambling to carry out their work in the midst of unprecedented state budget cuts.

Facing a multi-billion dollar deficit, California slashed its state AIDS budget by $85 million, resulting in what two of the panelists from Los Angeles called crushing budget cuts for HIV prevention and treatment programs.

“To say that we were shocked is to put it mildly,” said Phillip Curtis, director of government affairs for AIDS Project Los Angeles.

Curtis and Mario Perez, director of the Los Angeles County Office of AIDS Programs & Policy, told about 25 Senate staffers in one of two presentations that cutbacks in HIV treatment and prevention programs could result in an increase in new HIV infections.

According to Curtis, AIDS Project Los Angeles lost $1.9 million in state funds, forcing it to lay off staff and reduce the HIV treatment and prevention services it provides to thousands of clients, including gay male and transgender clients.

Both said their respective agencies were continuing to assist a large number of clients and, in the case of Curtis’s group, fundraisers were retained to solicit more private sector funds from foundations. Their main concern now, the two said, was the possibility of more state funding cuts in the next fiscal year.

Heather Hauck, director of the Maryland Department of Health & Mental Hygiene’s infectious disease division, said her state’s HIV programs were hit with a $786,720 budget cut in fiscal year 2009 and a $702,768 cut in fiscal 2010. She noted that the cuts have resulted in some staff layoffs, furloughs and salary reductions.

Pointing to a national survey, she said state revenue shortfalls due to the recession are forcing many states to reduce their contribution to the joint state-federal AIDS Drug Assistance Program, known as ADAP.

Hauck said the cutbacks have resulted in at least nine states running out of funds to provide life-saving antiretroviral drugs to all the low-income HIV patients that need them. The funding shortfall means these and possibly other states must establish waiting lists for patients to obtain ADAP funded drugs.

Maryland, Virginia and D.C. are not among the jurisdictions forced to set up ADAP waiting lists, according to information Hauck provided. But she and the other panelists expressed concern that unless the federal government boosts its share of ADAP funding, waiting lists will surface in more states.

Carl Schmid, deputy executive director of The AIDS Institute, a Washington-based advocacy group, and moderator of the two congressional briefings, said state and local AIDS office officials are calling on the Obama administration to help offset the state budget cuts by increasing funds for the Ryan White Care Act. The Ryan White program is the federal government’s main funding source to state and local AIDS agencies.

Schmid said a coalition of AIDS organizations called the Federal AIDS Policy Partnership wants the administration to ask Congress to appropriate $3.1 billion for the Ryan White program in fiscal year 2011, representing an increase of $818 million over the fiscal year 2010 funding.

He said the coalition also wants Congress to approve an emergency supplemental budget allocation of $126 million this year for ADAP.

“We know times are tight, but there are a lot of people’s lives at stake,” Schmid said.

Bobby Edelen, president of the Kentucky HIV/AIDS Advocacy Action Group and a person living with AIDS, told the briefing that the lives of many of the people his organization assists in Louisville and other cities are being placed in jeopardy over his own state’s budget cuts.

“You’ve heard enough about numbers,” he said. “I’m here to talk about the personal side of this. I’ve been living with this disease for 20 years.”

He said an ADAP waiting list in Kentucky is likely to result in a decline in health of people with HIV that he knows personally.

“You’re going to lose some people if they can’t get the treatment and services they need,” he said. “I understand that money is tight. But we are the greatest nation on earth. We can make things possible.”

The four panelists and Schmid, who served as moderator, conducted a morning briefing at the Dirksen Senate Office Building for Senate staffers and an afternoon briefing at the Rayburn House Office Building for U.S. House staffers.



Gilead awards $5 million grant to HRC’s HIV and health equity programs

Money to support efforts to end the epidemic and combat stigma



Human Rights Campaign headquarters in D.C.(Washington Blade photo by Michael Key)

The Human Rights Campaign was awarded a $5 million grant from drugmaker Gilead Sciences to expand the organization’s HIV and health equity programs, supporting efforts to end the HIV epidemic by 2030 while combatting stigma in Black and Latino communities.

Funds will be used over the next three years for the HRC Foundation’s HIV and Health Equity Program, its Historically Black Colleges and Universities Program, and its Transgender Justice Initiative, HRC said in a statement Wednesday announcing receipt of the award, which extends Gilead’s $3.2 million grant to the HRC Foundation in 2021.

The organization said its HIV and Health Equity Program plans to develop a “benchmarking tool for institutions that provide HIV services, helping better evaluate the quality of care and measure racially and socially inclusive approaches” while defining “best practices, policies and procedures to optimize HIV service provision for BIPOC LGBTQ+ communities.”

HRC President Kelley Robinson said, “Since the beginning of the HIV epidemic, racism and anti-LGBTQ+ discrimination have created dangerous hurdles for those seeking prevention or treatment.”

“With the generous support of Gilead Sciences, we’ll be able to continue providing critical
resources to help overcome these hurdles, especially focusing on Black and Latine communities in the U.S. South,” Robinson added. “We’ll also be able to expand our efforts, as we seek to remove institutional barriers often unknowingly created by HIV service providers. We must decrease the disparities that place an unnecessary burden on Black and Latine LGBTQ+ people and people living with HIV.”

Gilead Executive Vice President of Corporate Affairs and General Counsel Deborah Telman said the company “is committed to advancing health equity, particularly in Black communities and other communities of color that are disproportionately affected by HIV.”

“This grant will build on the impactful work HRC has done with community partners and HBCUs to increase awareness of HIV treatment and prevention options and reduce health disparities, combat discrimination and fight stigma,” Telman said.

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New CDC data shows HIV infections dropped, but mostly among whites

Socioeconomic factor into disproportionate rates



Data published Tuesday by the Centers for Disease Control and Prevention shows a significant decline in new HIV infections, but suggests the impact of prevention efforts was far less substantial for Black and Latino populations.

From 2017-2021, as rates of HIV testing, treatment and the use of pre-exposure prophylaxis (PrEP) medication rose, new cases dropped by 12 percent overall and by as much as 34 percent among gay and bisexual males aged 13-24.

The numbers show a “move in the right direction,” CDC Director Rochelle Walensky said in a press release.

However, when broken down by race, the CDC found new infections were down by 27 percent and 36 percent, respectively, among Black and Latino populations, compared with 45 percent of whites.

Similarly, by 2021 about one third of those who are considered eligible were taking PrEP for HIV prevention, but the CDC noted this number includes “relatively few Black people or Hispanic/Latino people” despite the significant increase in prescriptions up from just 13 percent in 2017.

“Longstanding factors, such as systemic inequities, social and economic marginalization and residential segregation,” Walensky noted, continue to act as barriers “between highly effective HIV treatment and prevention and people who could benefit from them.”

She added, “Efforts must be accelerated and strengthened for progress to reach all groups faster and equitably.”

Robyn Neblett Fanfair, acting director of the CDC’s Division of HIV Prevention, said that “At least three people in the U.S. get HIV every hour — at a time when we have more effective prevention and treatment options than ever before.”

“These tools must reach deep into communities and be delivered faster to expand progress from some groups to all groups,” she said.

The HIV+Hepatitis Policy Institute issued a press release following the CDC’s announcement of the new data, noting both the encouraging progress and need for improvement.

“It appears that our investments in HIV prevention are providing some positive results, but the persistent high number of new diagnoses and the low usage of PrEP among the communities most impacted by HIV point to the need for increased resources, particularly for a national PrEP program,” said the group’s executive director, Carl Schmid.

President Joe Biden’s FY24 budget requested $237 million for a national PrEP program along with $850 million to support the U.S. Department of Health and Human Services’ “Ending the HIV Epidemic in the U.S.” initiative.

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Officials eye mpox prevention, vaccination initiatives for this summer’s LGBTQ events

New cluster of cases reported in Chicago



Drs. Robert Fenton and Demetre Daskalakis, coordinator and deputy coordinator for the White House national mpox response, during a briefing in August 2022 (Official White House Photo by Cameron Smith)

Federal health agencies, in coordination with their state and local counterparts and community partners, are exploring opportunities to offer mpox prevention initiatives and vaccinations at LGBTQ events this summer, Dr. Demetre Daskalakis said on Thursday.

Daskalakis, the deputy coordinator for the White House’s national mpox response, described these deliberations in response to a question from the Washington Blade during a media telebriefing on mpox that was hosted by the Centers for Disease Control and Prevention.

The CDC on Monday issued a Health Alert Network Health Update on the potential risk for new mpox cases.

Since the peak of about 460 cases per day in August 2022, new cases have steadily declined, but following the cluster recently reported in the Chicago area, the update warns, “spring and summer season in 2023 could lead to a resurgence of mpox as people gather for festivals and other events.”

“We have the vaccine, and we have organizations that are willing to do it,” Daskalakis said during Thursday’s call, adding that resources are available and can be deployed flexibly because they are built into existing “HIV and STI funding to allow for this work.”

And the Mpox Crisis Response Cooperative Agreement, Daskalakis said, “provides even more resources locally for such efforts.”

Daskalakis and CDC Mpox Response Incident Manager Dr. Christopher R. Braden also briefed reporters on findings from new studies on the efficacy of the JYNNEOS vaccine for the prevention of mpox.

That data, per the CDC’s Morbidity and Mortality Weekly Report, reveals that “Among gay, bisexual, and other MSM and transgender adults aged 18-49 years, two doses of the JYNNEOS vaccine were 86 percent effective against mpox, indicating substantial protection against mpox.”

Additionally, “All routes of vaccine administration provided similar protection.”

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