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D.C. prepares to host Int’l AIDS Conference

Event expected to draw more than 30,000 to city from July 22-27

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Gay News, Washington Blade, HIV/AIDS

Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors (Blade photo by Michael Key)

The International AIDS Conference is expected to draw more than 30,000 people from around the world to D.C. July 22-27.

Former President Bill Clinton, former first lady Laura Bush, Bill Gates of the Bill and Melinda Gates Foundation, Health and Human Services Secretary Kathleen Sebelius, U.S. Global AIDS Coordinator Eric Goosby, ā€œThe Viewā€ co-host Whoopi Goldberg and singer Elton John are among those who are scheduled to speak at the Walter E. Washington Convention Center. The White House has yet to confirm whether President Obama will attend; California Rep. Barbara Lee and Michel SidibĆ©, executive director of UNAIDS, are among those who are scheduled to speak at the opening session on July 22. The Gay Menā€™s Chorus of Washington is also slated to perform.

ā€œWe are gathering at a defining moment in the AIDS epidemic where the science tells us we can turn the tide on HIV,ā€ said Dr. Elly Katabira, president of the International AIDS Society who serves as the conferenceā€™s international chair, and Dr. Diane Havlir of the University of California-San Francisco, who is the U.S. co-chair of AIDS 2012, in a statement that officially welcomed delegates to the nationā€™s capital. ā€œScientific advances are also propelling towards the efforts to find a cure and vaccine for HIV. AIDS 2012 will unite science, community and leadership from around the globe to develop strategies and mobilize support for translating new evidence into meaningful action that reflects HIVā€™s complex web of social, human rights and political issues.ā€

The conference ā€” the theme of which is ā€œTurning the Tide Togetherā€ ā€” will feature a number of workshops and other events that will specifically discuss the epidemicā€™s impact among men who have sex with men and other LGBT communities. These will include networking spaces in the Global Village that will allow LGBT people and MSM to share strategies to more effectively respond to HIV and advocate on behalf of those living with the virus. ā€œThe Lancetā€ will also present a symposium on the epidemicā€™s impact among MSM on July 24.

Debbie McMillan of Transgender Health Empowerment will be among the panelists on a July 26 plenary that will examine the virusā€™ effects on at-risk populations. A symposium on the same day will discuss the future of HIV prevention and related health and human rights issues among gay, transgender and MSM communities.

The Blade is also an official media sponsor of the conference and will host a photo exhibit chronicling AIDS in Washington in the Global Village, which is open to the public.

A call to action

The International AIDS Society and the University of California-San Francisco on Tuesday unveiled a nine-point plan designed to further combat the global epidemic.

The ā€œWashington, D.C., Declarationā€ specifically calls for an end to stigma, discrimination and human rights abuses against people with the virus and those who remain at-risk for HIV. It backs what it describes as evidence-based prevention, treatment and care that respects the human rights of ā€œthose at greatest risk and in greatest need.ā€ The declaration further stresses the need for accelerated research on new HIV prevention initiatives, treatments and a vaccine.

UNAIDS noted in its 2010 report that an estimated 33.3 million people around the world live with HIV. The agency further reported that the number of new infections has fallen 19 percent since 1999. UNAIDS also found that 5.2 million of the estimated 15 million people with the virus in developing countries who need antiretroviral treatment receive it.

ā€œIn a scenario unthinkable just a few years ago, we now have the knowledge to begin to end AIDS in our lifetimes,ā€ said Katabira, professor of medicine at Ugandaā€™s Makerere University. ā€œYet, at this moment of extraordinary scientific progress and potential, the global response to AIDS faces crippling financial challenges that threaten past success and future progress. Through this declaration, we stand together to call on world leaders across all sectors to provide increased resources, visionary leadership and a full-fledged commitment to seize the opportunity before us.ā€

This year marks the first time since 1990 that the International AIDS Conference has taken place in the United Statesā€”President Obama in 2009 completed the process that lifted the ban on people with HIV from entering the country. City officials and HIV/AIDS service providers alike plan to use the biennial gathering to highlight local efforts to combat the epidemic.

D.C. Officials, HIV/AIDS groups seek presence at conference

The Department of Healthā€™s HIV/AIDS, Hepatitis, Sexually Transmitted Disease and Tuberculosis Administration will present 15 scientific abstracts on the epidemic during the conference. The D.C. Center for AIDS Research, the body that coordinates HIV/AIDS-specific research in Washington, will highlight city-based research in a Global Village session. Mayor Vincent Gray is among those who will speak at a Memorial AIDS Quilt ceremony on July 22.

ā€œItā€™s appropriate that AIDS 2012 is taking place in the District, its first return to the U.S. in 22 years, as the District has in so many ways been the face of our nationā€™s epidemic,ā€ said D.C. Council member David Catania (I-At Large.) ā€œFrom years of an inadequate and failed response to now, an increasingly effective and aggressive one, the District embodies the varied and diverse experience our nation has endured with the deadly disease.Ā AIDS2012 will be a fantastic opportunity for the District to showcase its innovative prevention and treatment programs for the best and brightest in the field. The District stands as an example of what can occur when data-driven, evidence-based policies are put in place.ā€

Whitman-Walker Health will hold a forum on the state of the epidemic at the Lisner Auditorium, where the cityā€™s first AIDS forum took place in 1983, on July 24. Metro Teen AIDS and Us Helping Us have also scheduled a series of events to coincide with the conference. Organizers have also organized tours of Helping Individual Prostitutes Survive, Food and Friends, La Clinica del Pueblo and other D.C. HIV/AIDS service organizations for delegates.

ā€œWe are pleased and honored to have the International AIDS Conference come to D.C.,ā€ Dr. Ray Martins, chief medical officer at Whitman-Walker, told the Blade. ā€œThe conference gives the world a chance to learn more about the state of HIV/AIDS in the District of Columbia, but also the breadth of the response to the epidemic locally. It will allow us to highlight the tremendous efforts made by outreach workers and volunteers as well as health care providers and our elected officials.ā€

A number of gatherings, panels and other events will also take place throughout the city in the days leading up to the conference. These include the Gay Menā€™s Health Summit at George Washington University and the Global Forum on MSM and HIV on July 21, a panel on stigma in transgender and other HIV-vulnerable communities at the Human Rights Campaign on July 21 and Youth Forceā€™s annual conference at Gallaudet University in Northeast Washington from July 17-19 and the International Network of Religious Leaders Living with or Personally Affected by HIV/AIDS’ conference at Howard University from July 17-19.

ā€œItā€™s really an incredible event, so Iā€™m glad itā€™s coming back here,ā€ Ron Simmons, president of Us Helping Us, told the Blade. ā€œWith the eyes of the world focused on you, this is the time to take advantage of it.ā€

Calls to bolster response to domestic epidemic

HIV/AIDS activists also plan to use the conference to urge lawmakers in this country and around the world to reaffirm their commitment to ending the epidemic.

The Rev. Al Sharpton, journalist Tavis Smiley and former Atlanta Mayor Andrew Young are among those scheduled to speak at the ā€œKeep the Promiseā€ March that will wind its way from the Washington Monument to the intersections of 3rd Street, N.W., and Constitution and Pennsylvania Avenues, N.W., on July 22. Members of the We Can End AIDS coalition told the Blade earlier this month that they plan to hold a five-point march on July 24 that organizers said could end in acts of non-violent civil disobedience.

Policy makers also plan to urge Congress to adequately fund policies they say effectively combat the domestic epidemic.

ā€œWhen people think of AIDS today, most probably donā€™t realize that AIDS is still really in a crisis mode in our country,ā€ said Carl Schmid, deputy executive director at the AIDS Institute, during a press conference at the National Press Club in D.C. on Tuesday. He noted that 20 percent of the 1.2 million Americans with HIV today do not know their status. Schmid also pointed to roughly 50,000 new diagnoses each year. ā€œMany, including our youth, have become complacent. With nearly 40 percent of new infections occurring in those under age 29 and with more HIV in our country than ever before, it is imperative that we raise our countryā€™s consciousness.ā€

President Obama in 2010 unveiled a National HIV/AIDS Strategy that seeks to reduce rates of HIV and HIV-related health disparities and increase access to care for people with the virus.

Under the White Houseā€™s proposed budget for fiscal year 2013, funding for HIV prevention programs would increase by $40 million. The president also seeks a $75 million increase in funding for the AIDS Drug Assistance Program under the Ryan White Comprehensive AIDS Response Emergency Act.

Julie Scofield, executive director of the National Alliance of State and Territorial AIDS Directors, applauded the Obama administration for what she described during the National Press Club press conference as its ongoing commitment to fight the domestic epidemic. She stressed, however, that federal funding has not kept pace with the needs of those with HIV.

ā€œIt has always been important to acknowledge from the very beginning of this fight that the goals of the strategy cannot be achieved without significant increases in funding for critical domestic HIV/AIDS discretionary programs,ā€ said Scofield.

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Monkeypox

US contributes more than $90 million to fight mpox outbreak in Africa

WHO and Africa CDC has declared a public health emergency

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The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa. (Photo courtesy of the Centers for Disease Control and Prevention)

The U.S. has contributed more than $90 million to the fight against the mpox outbreak in Africa.

The U.S. Agency for International Development on Tuesday in a press release announced “up to an additional” $35 million “in emergency health assistance to bolster response efforts for the clade I mpox outbreak in Central and Eastern Africa, pending congressional notification.” The press release notes the Biden-Harris administration previously pledged more than $55 million to fight the outbreak in Congo and other African countries.

“The additional assistance announced today will enable USAID to continue working closely with affected countries, as well as regional and global health partners, to expand support and reduce the impact of this outbreak as it continues to evolve,” it reads. “USAID support includes assistance with surveillance, diagnostics, risk communication and community engagement, infection prevention and control, case management, and vaccination planning and coordination.” 

The World Health Organization and the Africa Centers for Disease Control and Prevention last week declared the outbreak a public health emergency.

The Washington Blade last week reported there are more than 17,000 suspected mpox cases across in Congo, Uganda, Kenya, Rwanda, and other African countries. The outbreak has claimed more than 500 lives, mostly in Congo.Ā 

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Mpox outbreak in Africa declared global health emergency

ONE: 10 million vaccine doses needed on the continent

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The declaration of a public health emergency over an mpox outbreak in Africa has prompted calls for additional vaccine doses for the continent. (Photo courtesy of the Centers for Disease Control and Prevention)

Medical facilities that provide treatment to gay and bisexual men in some East African countries are already collaborating with them to prevent the spread of a new wave of mpox cases after the World Health Organization on Wednesday declared a global health emergency.

The collaboration, both in Uganda and Kenya, comes amid WHO’s latestĀ reportĀ released on Aug. 12, which reveals that nine out of every 10 reported mpox cases are men with sex as the most common cause of infection.Ā 

The global mpox outbreak report ā€” based on data that national authorities collected between January 2022 and June of this year ā€” notes 87,189 of the 90,410 reported cases were men. Ninety-six percent of whom were infected through sex.

Sexual contact as the leading mode of transmission accounted for 19,102 of 22,802 cases, followed by non-sexual person-to-person contact. Genital rash was the most common symptom, followed by fever and systemic rash.

The WHO report states the pattern of mpox virus transmission has persisted over the last six months, with 97 percent of new cases reporting sexual contact through oral, vaginal, or anal sex with infected people.Ā 

ā€œSexual transmission has been recorded in the Democratic Republic of Congo among sex workers and men who have sex with men,ā€ the report reads. ā€œAmong cases exposed through sexual contact in the Democratic Republic of the Congo, some individuals present only with genital lesions, rather than the more typical extensive rash associated with the virus.ā€

The growing mpox cases, which are now more than 2,800 reported cases in at least 13 African countries that include Kenya, Uganda, Rwanda, and prompted the Africa Centers for Disease Control and Prevention this week to declare the disease a public health emergency for resource mobilization on the continent to tackle it.

ā€œAfrica has long been on the frontlines in the fight against infectious diseases, often with limited resources,” said Africa CDC Director General Jean Kaseya. “The battle against Mpox demands a global response. We need your support, expertise, and solidarity. The world cannot afford to turn a blind eye to this crisis.ā€ 

The disease has so far claimed more than 500 lives, mostly in Congo, even as the Africa CDC notes suspected mpox cases across the continent have surged past 17,000, compared to 7,146 cases in 2022 and 14,957 cases last year. Ā Ā 

ā€œThis is just the tip of the iceberg when we consider the many weaknesses in surveillance, laboratory testing, and contact tracing,ā€ Kaseya said.  

WHO, led by Director General Tedros Adhanom Ghebreyesus, also followed the Africa CDCā€™s move by declaring the mpox outbreak a public health emergency of international concern.

The latest WHO report reveals that men, including those who identify as gay and bisexual, constitute most mpox cases in Kenya and Uganda. The two countries have recorded their first cases, and has put queer rights organizations and health care centers that treat the LGBTQ community on high alert.Ā 

The Uganda Minority Shelters Consortium, for example, confirmed to the Washington Blade that the collaboration with health service providers to prevent the spread of mpox among gay and bisexual men is ā€œnascent and uneven.ā€ 

ā€œWhile some community-led health service providers such as Ark Wellness Clinic, Children of the Sun Clinic, Ice Breakers Uganda Clinic, and Happy Family Youth Clinic, have demonstrated commendable efforts, widespread collaboration on mpox prevention remains a significant gap,ā€ UMSC Coordinator John Grace stated. ā€œThis is particularly evident when compared to the response to the previous Red Eyes outbreak within the LGBT community.ā€

Grace noted that as of Wednesday, there were no known queer-friendly health service providers to offer mpox vaccinations to men who have sex with men. He called for health care centers to provide inclusive services and a more coordinated approach.

Although Grace pointed out the fear of discrimination ā€” and particularly Uganda’s Anti-Homosexuality Act ā€” remains a big barrier to mpox prevention through testing, vaccination, and treatment among queer people, he confirmed no mpox cases have been reported among the LGBTQ community.

Uganda so far has reported two mpox cases ā€” refugees who had travelled from Congo.

ā€œWe are for the most part encouraging safer sex practices even after potential future vaccinations are conducted as it can also be spread through bodily fluids like saliva and sweat,ā€ Grace said. 

Grace also noted that raising awareness about mpox among the queer community and seeking treatment when infected remains a challenge due to the historical and ongoing homophobic stigma and that more comprehensive and reliable advocacy is needed. He said Grindr and other digital platforms have been crucial in raising awareness.

The declarations of mpox as a global health emergency have already attracted demand for global leaders to support African countries to swiftly obtain the necessary vaccines and diagnostics.

ā€œHistory shows we must act quickly and decisively when a public health emergency strikes. The current Mpox outbreak in Africa is one such emergency,ā€ said ONE Global Health Senior Policy Director Jenny Ottenhoff.

ONE is a global, nonpartisan organization that advocates for the investments needed to create economic opportunities and healthier lives in Africa.

Ottenhoff warned failure to support the African countries with medical supplies needed to tackle mpox would leave the continent defenseless against the virus.  

To ensure that African countries are adequately supported, ONE wants governments and pharmaceutical companies to urgently increase the provision of mpox vaccines so that the most affected African countries have affordable access to them. It also notes 10 million vaccine doses are currently needed to control the mpox outbreak in Africa, yet the continent has only 200,000 doses.

The Blade has reached out to Ishtar MSM, a community-based healthcare center in Nairobi, Kenya, that offers to service to gay and bisexual men, about their response to the mpox outbreak. 

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White House urged to expand PrEP coverage for injectable form

HIV/AIDS service organizations made call on Wednesday

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Apretude is a long-lasting PrEP injection that has proven to be significantly more effective at reducing the risk of sexually-acquired HIV. (Photo courtesy of ViiV Healthcare)

A coalition of 63 organizations dedicated to ending HIV called on the Biden-Harris administration on Wednesday to require insurers to cover long-acting pre-exposure prophylaxis (PrEP) without cost-sharing.

In a letter to Chiquita Brooks-LaSure, administrator of the Centers for Medicare and Medicaid Services, the groups emphasized the need for broad and equitable access to PrEP free of insurance barriers.

Long-acting PrEP is an injectable form of PrEP that’s effective over a long period of time. The FDA approved Apretude (cabotegravir extended-release injectable suspension) as the first and only long-acting injectable PrEP in late 2021. It’s intended for adults and adolescents weighing at least 77 lbs. who are at risk for HIV through sex.

The U.S. Preventive Services Task Force updated its recommendation for PrEP on Aug. 22, 2023, to include new medications such as the first long-acting PrEP drug. The coalition wants CMS to issue guidance requiring insurers to cover all forms of PrEP, including current and future FDA-approved drugs.

“Long-acting PrEP can be the answer to low PrEP uptake, particularly in communities not using PrEP today,” said Carl Schmid, executive director of the HIV+Hepatitis Policy Institute. “The Biden administration has an opportunity to ensure that people with private insurance can access PrEP now and into the future, free of any cost-sharing, with properly worded guidance to insurers.”

Currently, only 36 percent of those who could benefit from PrEP are using it. Significant disparities exist among racial and ethnic groups. Black people constitute 39 percent of new HIV diagnoses but only 14 percent of PrEP users, while Latinos represent 31 percent of new diagnoses but only 18 percent of PrEP users. In contrast, white people represent 24 percent of HIV diagnoses but 64 percent of PrEP users.

The groups also want CMS to prohibit insurers from employing prior authorization for PrEP, citing it as a significant barrier to access. Several states, including New York and California, already prohibit prior authorization for PrEP.

Modeling conducted for HIV+Hep, based on clinical trials of a once every 2-month injection, suggests that 87 percent more HIV cases would be averted compared to daily oral PrEP, with $4.25 billion in averted healthcare costs over 10 years.

Despite guidance issued to insurers in July 2021, PrEP users continue to report being charged cost-sharing for both the drug and ancillary services. A recent review of claims data found that 36 percent of PrEP users were charged for their drugs, and even 31 percent of those using generic PrEP faced cost-sharing.

The coalition’s letter follows a more detailed communication sent by HIV+Hepatitis Policy Institute to the Biden administration on July 2.

Signatories to the community letter include Advocates for Youth, AIDS United, Equality California, Fenway Health, Human Rights Campaign, and the National Coalition of STD Directors, among others.

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