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Council restores proposed cuts for AIDS groups

Catania says they must rely more on insurance reimbursement

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The D.C. City Council Tuesday voted to restore $427,000 in proposed cuts by Mayor Adrian Fenty in city funding for community-based AIDS organizations, including the Whitman-Walker Clinic.

At the request of Mayor-elect Vincent Gray, who is finishing his term as Council chair, the Council approved a series of revisions to the mayorā€™s budget proposal that included restoring the cuts for groups that provide HIV-related services to city residents.

The action came during a marathon session that lasted until 9 p.m. in which the Council grappled with reconciling a projected $188 million budget shortfall the city is facing for fiscal year 2011 and far greater expected shortfalls for the following two years.

Gay D.C. Council member David Catania (I-At-Large), who chairs the Councilā€™s Committee on Health, said he was pleased that his colleagues backed Grayā€™s proposal to restore the AIDS-related funds.

But he said a decision by the city to participate in an expanded Medicaid reimbursement program for low-income residents under President Obamaā€™s health insurance reform package would likely have offset the cuts even if the Council did not restore them.

Catania said the funds Fenty proposed cutting were for paying community-based service providers like Whitman-Walker Clinic to perform a variety of HIV-related services for low-income residents, including HIV testing and counseling. He said the expanded Medicaid coverage made possible under the Obama health reform program, which Congress approved last year, now enables community clinics to obtain reimbursement for their services from patientsā€™ Medicaid or other health insurance providers.

He noted that that phase of the Obama health program went into effect this year.

Due to a shortfall in tax revenue caused by the recession, Catania, Gray and other Council members said during Tuesdayā€™s Council session that cuts would be needed in city spending. The said a failure to either cut the budget or approve steep tax increases could lead the city into bankruptcy or to a congressional take-over of the cityā€™s budget process similar to the oneĀ that occurred in the early 1990s.

ā€œNinety-four percent of our residents now have health insurance,ā€ Catania said. ā€œWe have the second lowest rate of uninsured in the country. As such, providers are going to have to work harder to get reimbursed from insurance companies that provide reimbursement as opposed to simply relying on local city grants,ā€ he said.

ā€œEveryone has to roll up their sleeves and work harder,ā€ he said.

Whitman-Walker Executive Director Don Blanchon said that if the Fenty cuts were approved by the Council, a $145,000 city grant to the clinic for HIV testing and counseling would have been cut by $14,500, reducing the grant to $130,500.

Blanchon said a separate city grant of $144,500 for HIV-related legal services for low-income patients at the Clinicā€™s Max Robinson facility in Anacostia also would have been targeted for reduction, although he did not know the size of the reduction.

Ron Simmons, executive director of Us Helping Us, a community-based group that provides HIV-related services to black gay men, said his group expected to receive a similar cut in an HIV testing and counseling grant from the city had the Council approved the proposed cuts.

Simmons and Blanchon noted that the overwhelming amount of funding for the cityā€™s AIDS programs, especially patient medical care, comes from the federal government through the Ryan White CARE Act and is not subject to city budget cuts.

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MISTR announces itā€™s now prescribing DoxyPE

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MISTR, the telemedicine provider that offers free online PrEP and long-term HIV care in all 50 states, D.C., and Puerto Rico, announced it is now prescribing Doxycycline Post-Exposure Prophylaxis (DoxyPEP), an antibiotic that reduces bacterial STIs, including gonorrhea, chlamydia, and syphilis. Patients can now use MISTRā€™s telehealth platform to receive DoxyPEP online for free, according to a release from the company.

With this launch, MISTR plans to offer patients access to post-exposure care, in addition to its existing preventive and long-term HIV treatment options, which include PrEP and antiretroviral therapy (ART). This comes at a time when the rate of STIs continue to rise. In 2022, more than 2.5 million cases of syphilis, gonorrhea, and chlamydia were reported in the U.S; of that population, gay and bisexual men are disproportionately affected, the company reported.

ā€œDespite an ongoing STI epidemic affecting the LGBTQ+ community, there are few resources available for this underserved, vulnerable community to get the preventative medication they need,ā€ said Tristan Schukraft, CEO and founder of MISTR. ā€œIā€™m proud that MISTR is democratizing access to PrEP, HIV care, and now DoxyPEP.ā€

An NIH-funded study published by the New England Journal of Medicine in April 2023 found that doxycycline as post-exposure prophylaxis, now known as DoxyPEP, reduced syphilis by 87%, chlamydia by 88%, and gonorrhea by 55% in individuals taking HIV PrEP, and reduced syphilis by 77%, chlamydia by 74% and gonorrhea by 57% in people living with HIV. 

MISTR is a telemedicine platform offering free online access to pre-exposure prophylaxis (PrEP) and long-term HIV care Visit mistr.com for more information.

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UNAIDS to commemorate Zero Discrimination Dayā€™s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,ā€ she said in a press release. ā€œStigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyoneā€™s rights that we can protect everyoneā€™s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for womenā€™s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyoneā€™s health is synonymous with protecting everyoneā€™s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world ā€” for everyone,” said Byanyima.

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New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, theĀ National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25Ā Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The studyā€™s researchers noted: ā€œEmployment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.ā€

The study stated that trans womenā€™s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to ā€œsurvival sex workā€ and violence, which increases the risk of contracting HIV. 

The studyā€™s authorā€™s pointed out: ā€œWhen economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis ā€¦demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.ā€

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