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AIDS 2012: Measuring progress by lives saved

President Obama committed to the fight to create an AIDS-free generation

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By DR. GRANT COLFAX & DR. ERIC GOOSBY

As the two people who worked as physicians in the early years of the HIV/AIDS epidemic before the miracle of antiretroviral drug (ARV) therapy, and who now have the honor of leading the domestic and global HIV/AIDS programs for the Obama administration, we look back in awe of the American leadership that has transformed the epidemic in the 22 years since the International AIDS Conference was last held on U.S. soil. As we remember the lives lost to this disease and commit to the vision of an AIDS-free generation, it’s worth reflecting on how U.S. leadership and U.S. investments to combat HIV/AIDS domestically and internationally are saving lives and turning the tide against the disease.

Here at home, we have more than tripled the life expectancy of people living with HIV/AIDS since 1993. More than half a million persons living with HIV receive care and treatment through the Ryan White program, established in 1990 and maintained with consistent bipartisan congressional support through four administrations. Successful prevention efforts have averted more than 350,000 new infections and mother-to-child transmission of HIV has dropped by more than 90 percent since the early 1990s. HIV prevention has also generated substantial economic benefits. A recent study estimated that HIV prevention efforts in the United States have saved $129.9 billion in medical costs.

In 2010, President Obama released the first-ever National HIV/AIDS Strategy, and he has made implementing the strategy a top priority by requesting increased funding for HIV treatment and care services every fiscal year. In Fiscal Year (FY) 2013, the president’s domestic budget for HIV/AIDS is $22.25 billion, including requesting a $40 million increase for the Centers for Disease Control and Prevention (CDC) HIV prevention efforts, and an additional $74 million to increase treatment and care services for our nation’s veterans living with HIV. The president has also increased federal investments for AIDS Drug Assistance Programs (ADAPs) to expand access to life-saving medications and assist states with ADAP waiting lists. A shared federal-state program, federal funding for ADAPs has increased every year of the Obama administration, rising from $815 million in FY 2009 to $933 million in FY 2012. In FY 2013, the president proposed a total of $1 billion for ADAPs, a $67 million increase above FY 2012. These steps have concrete results — ADAP waitlists have declined by 80 percent since September 2011, dropping from more than 9,000 to approximately 2,000 today, and the federal budget provides sufficient resources to end the waitlists once and for all, if states also step up and do their part.

In addition, people living with HIV have much to gain from the Affordable Care Act. People with HIV are more likely to be uninsured, are more likely to face barriers in accessing medical care, and often experience higher rates of stigma and discrimination than other groups. The Affordable Care Act seeks to expand Medicaid for the lowest income people; it strengthens and improves Medicare, and makes private insurance work better for all Americans, including people with HIV. The Act also prohibits discrimination on the basis of HIV status, bans lifetime limits on insurance coverage and is phasing out annual limits in coverage.

Globally and building on the strong foundation laid by President George W. Bush, the Obama administration has made unprecedented progress in the fight against AIDS. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) has expanded its prevention, care and treatment programming, and now has significant investments in more than 80 countries in several regions worldwide. Since FY 2008, PEPFAR has increased the number of people supported on treatment by more than 2.1 million and the number of individuals receiving HIV testing and counseling by almost 19.9 million, supporting nearly four million people on treatment HIV testing and counseling for more than 40 million people in 2011 alone. And on World AIDS Day 2011, President Obama announced a new treatment goal of reaching six million people by the end of 2013.

Since taking office, President Obama has requested more than $26 billion in funding for global HIV/AIDS, including both bilateral U.S. government PEPFAR programs and our contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. In his FY 2013 Budget, the president fulfilled his historic commitment to request $4 billion over three years for the Global Fund. We are grateful for the bipartisan support that PEPFAR has received from Congress since its inception and the continued bipartisan support for the Global Fund.

In FY 2013, we made the decision to re-allocate resources from within PEPFAR and take an exceptional step at a unique moment to strengthen the Global Fund. Because of the interdependence of the two programs, strengthening the Global Fund now will also help ensure the success of PEPFAR; equally as important, U.S. contributions to multilateral institutions like the Global Fund allow us to leverage increased contributions from other countries. In recent months, new and existing donors, including Saudi Arabia, Japan, Germany and the Gates Foundation, have stepped up their contributions. We know that other donors are also planning to do the same.

The fact of the matter is that our achievements are continuing to grow rapidly. This is due to greater efficiencies borne of driving our programming with evidence of impact, the growing commitment of governments and citizens in the developing world, the reduced costs of treatment, and the growing impact of prevention. With our current budget request PEPFAR will meet the President’s World AIDS Day goals for treatment, care and prevention, including the dramatic increase in people supported on treatment from 4 to 6 million. Along with complementary efforts to strengthen the Global Fund, this will accelerate progress toward the goal of an AIDS-free generation.

While tough budget decisions come with the job, President Obama has committed us to achieving more in the fight to create an AIDS-free generation in the U.S. and across the globe, and we’re succeeding. That continues the legacy of American leadership on HIV/AIDS that should make us all proud.

Dr. Grant Colfax is director of the Office of National AIDS Policy and Dr. Eric Goosby is the nation’s Global AIDS Coordinator.

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1 Comment

  1. Will

    July 25, 2012 at 8:26 am

    Democracy Now! is doing an in-depth hour long episode on global HIV/AIDS. They are covering not only the International AIDS conference in DC, but also an alternative conference in Calcutta, India for sex workers and others who could not get into the US due to a travel ban. Watch now at democracynow.org

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Opinions

Trend of banning books threatens our freedom

‘History has taught you nothing if you think you can kill ideas’

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National Book Festival, gay news, Washington Blade

I knew Helen Keller was a DeafBlind activist. But, until recently, I didn’t know that some of her books were torched.

Nearly 90 years ago, in 1933 Germany, the Nazis added “How I Became a Socialist,” by Keller to a list of “degenerate” books. Keller’s book, along with works by authors from H.G. Wells to Einstein were burned. 

The Nazi book burnings were horrific, you might think, but what does this have to do with the queer community now?

I speak of this because a nano-sec of the news tells us that book censorship, if not from literal fires, but from the removal from school libraries, is alive and well. Nationwide, in small towns and suburbs, school boards, reacting to pressure from parents and politicians, are removing books from school libraries. Many of these books are by queer authors and feature LGBTQ+ characters.

Until recently, I didn’t worry that much about books being banned. My ears have pricked up, every year, in September when Banned Books Week is observed. Growing up, my parents instilled in me their belief that reading was one of life’s great pleasures as well as a chance to learn about new ideas – especially, those we disagreed with. The freedom to read what we choose is vital to democracy, my folks taught me. 

“I don’t care if it’s ‘Mein Kampf,’” my Dad who was Jewish told me, “I’ll defend to my death against its being banned.”

“Teachers should be allowed to teach it,” he added, “so kids can learn what a monster Hitler was.”

In this country, there have always been people who wanted to ban books from “Uncle Tom’s Cabin” by writer and abolitionist Harriet Beecher Stowe to gay poet Allen Ginsberg’s “Howl.”

In the 1920s, in the Scopes trial, a Tennessee science teacher was fined $100 for teaching evolution. (The law against teaching evolution in Tennessee was later repealed.)

But, these folks, generally, seemed to be on “the fringe” of society. We didn’t expect that book banning would be endorsed by mainstream politicians.

Until lately.

Take just one example of the uptake in book-banning: In September, the Blade reported, Fairfax County, Virginia public school officials said at a school board meeting that two books had been removed from school libraries to “reassess their suitability for high school students.”

Both books – “Lawn Boy” a novel by Jonathan Evison and “Gender Queer: A Memoir” by non-binary author Maia Koabe feature queer characters and themes, along with graphic descriptions of sex.

Opponents of the books say the books contain descriptions of pedophilia. But, many book reviewers and LGBTQ students as well as the American Library Association dispute this false claim.

The American Library Association honored both books with its Alex Award, the Associated Press reported. The award recognizes the year’s “10 books written for adults that have special appeal to young adults ages 12 through 18.”

Given how things have changed for us queers in recent years – from marriage equality to Pete Buttigieg running for president – it’s not surprising that there’s been a backlash. As part of the blowback, books by queer authors with LGBTQ+ characters have become a flashpoint in the culture wars.

As a writer, it’s easy for me to joke that book banning is fabulous for writers. Nothing improves sales more than censorship.

Yet, there’s nothing funny about this for queer youth. My friend Penny has a queer son. “LGBTQ kids need to read about people like themselves,” she told me. “It’s horrible if queer kids can’t find these books. They could become depressed or even suicidal.”

If we allow books to be banned, our freedom to think and learn will be erased.

“History has taught you nothing if you think you can kill ideas,” Keller wrote in a letter to students in Nazi Germany.

Anti-queer officials may remove LGBTQ books from school libraries. But, our thoughts will not be unshelved.

Kathi Wolfe, a writer and a poet, is a regular contributor to the Blade.

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Opinions

Thanksgiving is a time to share

Take a moment to think about what you can do to help others

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This Thanksgiving, many of us will once again celebrate with family and friends around the dinner table. Sadly at too many tables friends and family members will be missing. They will be one of the over 766,000 Americans who lost their lives to coronavirus. May the shared grief over lost loved ones cause us to try to bridge our differences and lift each other. As those of us with plenty sit down for dinner let us not forget the many in the world not so fortunate and think of what we can do to make their lives better.

In the midst of the pandemic we defeated a president who through his words and actions tore our country apart — a president who managed to poison relationships among family and friends. We elected a president who we felt would try to unite the nation. But we know that has yet to happen and the recent reaction to the not-guilty verdict in the Kyle Rittenhouse trial shows us that. The use of race-baiting in the recent Virginia governor’s election shows us that. We still suffer from the implicit permission the former president gave to some Americans to once again give public voice to their sexism, homophobia, racism, and anti-Semitism. That didn’t suddenly end with his loss. While we cannot pretend those feelings weren’t always there it seemed we had reached a point in American society where people understood you couldn’t voice them in public without rebuke. While it will take many years to put that genie back in the bottle we need to try if we are to move forward again. Around our Thanksgiving table is a place to begin. I am an optimist and believe we can do that even while recognizing it won’t be easy.

Thanksgiving should be a time to look within ourselves and determine who we are as individuals and what we can do to make life better for ourselves, our families, and others here in the United States and around the world.

Around our Thanksgiving table we should take a moment to think about what we can do to help feed the hungry, house the homeless, and give equal opportunity to everyone who wants to work hard. Maybe even give some thought as to how we change policies causing institutional racism to ones giving everyone a chance to succeed. It is a moment to think about how we can open up the eyes of the world to understand how racism, homophobia, and sexism hurt everyone, not just those who are discriminated against.

We must renew our efforts to heal the rifts in our own families and make an effort to try to see each other in a more positive light. If we start to do that with those closest to us we might have a fighting chance to do it with others.

I recognize my life is privileged having just returned from a 14-day transatlantic cruise. My Thanksgiving weekend will be spent with friends in Rehoboth Beach, Del., and we will remember our experiences over the past year. For many it also begins the Christmas season and the Friday of Thanksgiving weekend each year Rehoboth Beach lights its community Christmas tree. So surely we will talk about what that season means to each of us.

For me each year it means thinking about which charities I can support as the requests for end-of-year gifts arrive. It is a time to think about volunteering some precious time for a cause you care about.
Wherever you live, there are many chances to volunteer and do your part to make a difference for others. The rewards of doing so will come back to you in abundance. As anyone who has helped someone else will tell you the feeling you get for having done so is wonderful.

So wishing all my friends and those of you who I may be lucky enough to call friends in the future, a very happy Thanksgiving. May this holiday find you happy, healthy and sharing peaceful times with those you love.

Peter Rosenstein is a longtime LGBTQ rights and Democratic Party activist. He writes regularly for the Blade.

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Commentary

Fighting for equality for decades, trans elders still face endless hardships

Lisa Oakley rejected by 60 long-term care facilities in Colo.

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transgender, Gender Conference East, trans, transgender flag, gay news, Washington Blade
(Washington Blade photo by Michael Key)

November 20 will mark the 22nd International Transgender Day of Remembrance, an international event honoring and commemorating the many transgender people murdered in transphobic hate crimes every year.

Since 2013, at least 200 transgender people have been murdered in the United States alone, 80 percent being Black and Latinx women. This number is undoubtedly an underestimate, as many murders go unreported and trans victims often are misgendered by law enforcement.

These murders are not isolated crime statistics. They grow out of a culture of violence against transgender and non-binary (TGNB) people that encompasses stigma, exclusion, discrimination, poverty, and lack of access to essential resources, including health care, employment and housing. 

These challenges result in early death. In Latin America, for example, it has been reported that the average life expectancy of a transgender person is only 35 years.

This climate of stigma and transphobia is particularly challenging for TGNB older people, who face extraordinary hardships due both to the cumulative impact of lifetimes of discrimination and regular mistreatment in their elder years. Due to isolation from family and greater medical and financial needs, trans older people are more likely to require professionalized elder services and care. 

Unfortunately, these services and the facilities that provide them are often either unavailable to TGNB elders, or hostile to them. A national survey of LGBTQ+ older people by AARP found that more than 60 percent of those surveyed were concerned about how they would be treated in a long-term care setting. This includes the fear of being refused or receiving limited care, in danger of neglect or abuse, facing verbal or physical harassment, or being forced to hide or deny their identity once again. 

This is a sobering reality. In October, GLBTQ Legal Advocates and Defenders filed a claim against Sunrise Assisted Living in Maine, which openly denied admission to an older transgender woman because of her gender identity. 

In Colorado, Lisa Oakley was, astonishingly, rejected by 60 long-term care facilities, which her caseworker ascribes to Lisa’s gender identity. One facility that agreed to admit Lisa would only house her with a male roommate. 

After waiting far too long for welcoming care, Lisa eventually got help from SAGE and other community supporters and found a home in Eagle Ridge of Grand Valley. Fortunately, Eagle Ridge has participated in specialized training to be LGBTQ+-welcoming. While Lisa feels welcomed at Eagle Ridge and has made friends, she has been forced to live far from a community she loves. 

These cases in Maine and Colorado are just the tip of the iceberg regarding the discrimination faced by TGNB elders. That’s why it’s so important that Congress pass the Equality Act, which would once and for all prohibit discrimination based on gender identity in key areas like employment, housing, and care and services.

And while legal progress is important, it’s not enough. TGNB elders need more equity in their day to day lives. Older transgender people are more likely to experience financial barriers than non-transgender elders, regardless of age, income and education.

They’re also at a higher risk of disability, general poor mental and physical health, and loneliness, compared to their cisgender counterparts.

These experiences have been part of everyday life for trans elders for far too long. We continue to see them struggle with the long-term effects of transphobia and violence every day. That’s why organizations like SAGE are stepping up our support for TGNB elders by investing $1 million to support TGNB-focused services and advocacy both in New York and nationwide.

And we are continually amazed by the resilience of TGNB elders, creating communities built on their strength and courage. 

Their resilience is nothing new. It dates back generations and was evident during the Stonewall Uprising. Over the years, trans luminaries like Marsha P. Johnson, Sylvia Rivera, Victoria Cruz—leaders of the modern LGBTQ+ civil rights movement—and countless others have repeatedly proved that they will not be invisible.  

We see this determination in so many programs and activities led by trans elders at SAGE. 

For example, the TransGenerational Theater Project brings together transgender people of all ages to create theater from their experiences and perspectives. These types of elder-driven programs serve as powerful reminders that transgender older people are leading their lives with resilience, creativity, and perseverance, despite the dangers they face. 

Transgender and non-binary elders have survived and fought for equality for decades. They are brave. They are strong. They are leaders. Here at SAGE, we will continue to walk side-by-side with them as we continue the fight to ensure TGNB elders get the respect, change, and acceptance they deserve.

Michael Adams is the CEO of SAGE, the world’s largest and oldest organization dedicated to improving the lives of LGBTQ+ elders.

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