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A Review of “Obama’s” National HIV/AIDS Strategy: Will it Benefit Black People?

by Cleo Manago

(Taken from a posting on Facebook)
(Jul 15, 2010) – On Tuesday, Jul 13, 2010, president Obama presented the National HIV/AIDS Strategy (NHAS) for the United States. According to his administration, the NHAS is a concise plan for moving the country forward in the fight against HIV and AIDS with three primary goals: reducing HIV incidence, increasing access to care and optimizing health outcomes, and reducing HIV-related health disparities.

The NHAS is a good first start for America. What I appreciate about the strategy is its’ unprecedented existence. No other administration has created a White House Office of National HIV/AIDS Policy, or has had so many progressive people in its midst. (The NHAS is now available to the public: http://www.whitehouse.gov/sites/default/files/uploads/NHAS.pdf).

Theoretically, this is a history making initiative. However, upon close review, NHAS content features elements that are not necessarily signs of innovation or a framework shift in terms of how HIV services may roll out or be resourced. It appears that the strong [white] gay identity bias (to be explained in more detail later) will continue to skew attempts at culturally diversifying how HIV services are framed, funded and prioritized.

Though diverse groups in America are impacted by HIV/AIDS, blacks, by a large percentage, are more impacted than all other groups in the country. Yet, deciphering this could be a challenge as presented in this NHAS excerpt, “While anyone can become infected with HIV, some Americans are at greater risk than others. This includes gay and bisexual men of all races and ethnicities, black men and women, Latinos and Latinas, people struggling with addiction, including injection drug users, and people in geographic hot spots, including the United States South and Northeast, as well as Puerto Rico and the U.S. Virgin Islands. By focusing our efforts in communities where HIV is concentrated, we can have the biggest impact in lowering all communities’ collective risk of acquiring HIV.”

This NHAS passage also abstracts the disproportionate depth of HIV in black communities by bundling everyone as “Communities where HIV is concentrated.” This passage, “While anyone can become infected with HIV, some Americans are at greater risk than others. This includes gay and bisexual men of all races and ethnicities…” muddles the fact that – by leaps and bounds – black men, specifically, are the most HIV impacted group in the United States. Yet, what is not abstract is how much the NHSA affirms gay identity, despite that many homosexual and bisexual men of color don’t identify with or as gay. Over the last 30 years, this gay identity bias and barrier has been a contributing factor to diverse black men at HIV sexual risk not seeking HIV services or internalizing prevention messages.

While Obama’s White House is committing resources and efforts to initiatives like HIV/AIDS and healthcare, the explicit context of race and culture continues to be overlooked.

The first HIV/AIDS services paradigm in America was designed by white gay men, and ultimately was very effective for that community. Despite the relative success of the white gay community at saving itself from HIV/AIDS, a once frequently deadly disease, the disease has since gotten blacker and blacker. To date, there are no published examples of similar HIV success among African Americans. Even after three decades. Not to mention, gay identified men – black and white – have controlled and directed this epidemic, and blamed its failure to blacks simply on “homophobia.”

The organization identified as the Black AIDS Institute once featured an article stating, “Homophobia Causes AIDS (http://www.blackaids.org/ShowArticle.aspx?articletype=NEWS&articleid=168&pagenumber=1).” Yet, if this was true, given the still very present existence of the rabidly anti-homosexual white right-wing – Pat Roberson, Rush Limbaugh, the legacy of Jerry Falwell and most republicans – the white gay community should still have an HIV problem – equal if not similar to African Americans. But they don’t.

Frequently, within the black HIV industry, while black gay identity and “pride” (in being gay identified) are often encouraged, engagement of the symptoms of social injustice toward black communities and self-concept, cultural affirmation, repair and restoration are very rarely included as HIV problem-solving strategies. The white gay community understood one thing: in order to eradicate the numbers of new HIV cases they had to empower their community, while at the same time address the self-esteem damage done by homophobia, discrimination, hatred and oppression. Their primary HIV prevention strategy was (because, ultimately, most finally knew how HIV was transmitted) to publicly and actively resist social injustice toward their community, and affirm [white] gay identity. As a result, it has been comparatively (to all others) very successful at managing HIV/AIDS.

Unfortunately and concurrently, the white gay community has had little interest in resisting [white] racism within its community or society as a whole, just homophobia. And the black gay-identifying movement and approach (including within HIV services) has taken on that same paradigm; not an approach that is directly relevant to black culture, history, circumstance, problem-solving, diversity, process and under-engagement of relevant black issues. “Gay” acceptance is often more important than issues directly relevant to diverse black life, culture, history and healing. As a result, many black gay identified HIV leaders have become ill-equipped to address black community issues, to counter the risk behavior inducing impact of internalized racism, institutionalized racism, black male or female trauma and white biases internalized by [black] America.

Essentially identity politics have superseded capacity to effectively engage diverse black subgroups and communities facing disproportionate HIV threats. The NHAS, while strong on affirming gay identity, fails to affirm black specific culture, diversity and relevance.

The gay paradigm creates little to no encouragement for same-gender loving (SGL) and bisexual African American healing and cultural affirmation. Being limited to “gay” has created HIV issue disenchantment among Black men who have sex with men (MSM). As a result, black homosexual subgroups have emerged in an attempt to connect more with the rhythms of black life and culture. Many black homosexual and bisexual males do not have an affinity with gay identity and culture, seeing it as white or culturally unrelated. There are “homo-thugs,” men on the “down-low,” and more in the affirmative men who identify as same-gender-loving (SGL) or bisexual. If more space was created for homosexual and bisexual black males to be fluid and “black” regarding their identity, more would likely self-identify.

In the late 1980s, the Centers for Disease Control and Prevention (CDC) discovered that the term or label “gay” was a barrier in getting black and Latino men to identify as men who had sex with men, and disclose HIV risk factors. As a result, the now widely used term MSM, or men-who-have-sex with men was derived. Initially, white gays and black homosexuals who internalized the gay politic balked at the term, claiming it was homophobic. The fact of the matter was the term MSM was more neutral in terms of identity, inclusive and culturally responsive to the diverse ways of being among homosexual and bisexual black men.

A footnote excerpt from the NHAS states: “Throughout this document we use the terms “gay and bisexual men” and “gay men” interchangeably, and we intend these terms to be inclusive of all men who have sex with men (MSM); even those who do not identify as gay or bisexual.” In other words, even if you are not gay, or don’t identify as gay, or don’t want to, we are referring to all homosexual and bisexual men as gay regardless. This is not helpful to African Americans and is an example of an institutionally racist barrier to life and ways of being very present within black communities.

Sure, many of us are used to simply calling all homosexuals gay. In the black community this is not the result of an identify poll taken in the community, but because SGL black people have rarely been rationally engaged in a Black community context. While the powerful white gay community vigilantly profiles its gay idenity politics and ideas, this does not necessarily represent all homosexual and bisexual Black people.

Without these considerations or an examination of the relationship cultural barriers have to HIV risks among Black women and men, the NHAS will likely have limited impact on advancing the Black HIV landscape. As a result it may be discreetly shelved by many Black organizations.

While the National HIV/AIDS Strategy (NHAS) for the United States does represent a potentially progressive step forward, its’ lack of specific strategies for African Americans has resulted in some response. National organizations are in the process of generating recommendations to the president as an addendum to the historic NHAS. All African Americans interested in getting involved or contributing somehow to this effort are earnestly invited to do so. If interested in contributing call The National Black Leadership Commission on AIDS (NBLCA) at 800-992-6531,  or the Black Men’s Xchange National at 888-472-2837

July 16, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, Blogroll, Caribbean, Caribbean Community, community, Elderly LGBT, Health, HIV, HIV Status, LGBT community, LGBT Rights, LGBT Seniors, Male Health, Mental Health, Obama, Politics, Public Health | , , , , , , , , , , | Leave a comment

HIV/AIDS orgs respond to Obama’s HIV/AIDS Strategy

Following release of National HIV/AIDS Strategy

By Antoine Craigwell

(Wednesday, July 14, 2010) – Paul Kawata, executive director of the National Minority AIDS Council, posted on the social networking site, Facebook, a letter signed by 180 national and community organizations at the forefront of the fight against HIV and AIDS. This letter was in response to the announcement and release of the National HIV/AIDS Strategy (NHAS) yesterday.

The text of the letter below:

Honorable Barack H. Obama
President, United States Of America
The White House
Washington, DC

Dear President Obama,

On behalf of the180 national and community based organizations (see list below) on the front lines of this epidemic, thank you for your leadership and commitment to fight the HIV/AIDS epidemic. Each of us stands here in the footprints of so many heroes we’ve lost to HIV/AIDS. Our friends who fought so hard in the early days could probably never imagine a President holding a reception at the White House to honor the HIV/AIDS community. Most would have loved to be part of this event. We miss them and will never forget the sacrifices they made so that we can be here today.

In the first 18 months of your administration the travel ban on those living with HIV was removed, restrictions on the use of federal funds to support needle exchange were removed, the Ryan White Care Act was reauthorized, and $30.4 Million was set aside as part of the Prevention and Wellness Fund for HIV/AIDS Prevention. However, we’ve also had our challenges in ensuring adequate funding for PEPFAR and other international HIV/AIDS initiatives.

As you implement the National HIV/AIDS Strategy (NHAS), we ask that the first thing you address is the AIDS Drug Assistance Program (ADAP) funding crisis. We appreciate the $25 million to see us through September 30, 2010. We are concerned that is not a long-term solution and will only get us through a limited period. As of Jul 8, 2010, 2,291 individuals are on waiting lists. This number does not include individuals in states that don’t keep waiting lists, have significantly reduced the drug formulary, or have significantly changed the income eligibility levels. On Jul 1, Georgia became the 12th state to close enrollment and start a waiting list. Ohio changed its income eligibility levels so that more then 1,000 HIV/AIDS patients will lose their benefits. New Jersey also changed its income eligibility levels so that 947 HIV/AIDS patients will lose their benefits. Without an immediate solution, other states will follow.

As you consider solutions, please make it [funding for ADAP] multi-year funding through 2014, support states that don’t keep waiting lists but have closed enrollment or that are on the brink of a waiting list, ensure that all the necessary drugs are covered, and [the] integration of a permanent solution into health care reform.

We look forward to the reviewing the National HIV/AIDS Strategy and the opportunity to work with your administration to ensure its implementation across the country. Thank you for your support and leadership.

Sincerely,

2 God B The Glory, Inc     A Brave New Day     A Family Affair

ACT UP Philadelphia     Action for a Better Community    Advocates For Youth

African American Hispanic Health Education Resource Center

AID For AIDS Nevada      AIDS Alabama

AIDS Alliance for Children, Youth & Families

AIDS Care Services, Inc.   AIDS Community Research Initiative of America

AIDS Foundation of Chicago    AIDS/HIV Services Group (ASG)

The AIDS LIFE Campaign   AIDS Resource Center of Wisconsin

AIDS Project of Central Iowa     AIDS Resources of Rural Texas

AIDS Treatment Activists Coalition (ATAC)      Albany Damien Center

Amanda Beck-Myers     Ananias      Anxiety Disorders Association of America

Asian Media Access     Asian & Pacific Islander American Health Forum

Asian & Pacific Islander Coalition on HIV/AIDS

Asian & Pacific Islander Wellness Center

Aspirations Wholistic Tutorial Services     Baton Rouge AIDS Society

Bienestar Human Services    Black AIDS Institute

The Black Women’s Health Imperative     Broadway Cares/Equity Fights AIDS

Paul Browne       CAEAR Coalition      CALOR

Camden NJ Area Health Education Center (AHEC)

Camillus Health Concern, Inc.    CARES     CareSouth Carolina

Cascade AIDS Project        Central City AIDS Network, Inc.

Central Illinois FRIENDS of People with AIDS

CenterLink: The Community of LGBT Centers

William H. Chastang Consumer Advocate/Outreach Coordinator

Christie’s Place, Inc.        Citywide Project/Citywide Ministries

Coai, Inc.       Community Access National Network

Community HIV/AIDS Mobilization Project (CHAMP)

Community Information Center, Inc.        Comprehensive Health Education

Connecticut AIDS Resource Coalition         DeKalb Prevention Alliance, Inc

Desert AIDS Project         Gregory W. Edwards, EdD

Eternal Hope Community Development Corporation, Inc.

Family Heath & AIDS Care Services International     Family Health Project

Family Planning Association of Puerto Rico        F.L.A.S., INC.

Fort Worth Northside Community Health Center, Inc.

Greater Love Tabernacle    Gregory House Programs    GROUP Ministries, Inc.

Harlem United Community AIDS Center      Harmony House, Inc.

Hawaii Island HIV/AIDS Foundation     Hermanas de Luna y Sol    HEROES

HIV/AIDS Alliance for Region Two, Inc.

HIV/AIDS Services for African Americans in Alaska    HIV-AIDS UETS

HIV Care Program       HIVictorious, Inc.

HIV Planning Council Santa Clara County      Housing Works

Illinois Alliance for Sound AIDS Policy       Iris House

Johns Hopkins Local Performance Site

PA/MidAtlantic AIDS Education and Training Center

Monica Johnson, NMAC Board Member

Lambda Legal     Lark Lands, M.S., Ph.D.       H.O.P.E.

The LaStraw, Inc.      Latino Commission on AIDS

Latino Community Services

Helen Lemay, Distinguished Teaching Professor Emerita, Stony Brook University

Liberty Research Group

Don Little, MPH, Former Chair of the Oklahoma Native American AIDS Coalition

The Living Room     LMPHW Specialty Clinic

Love Heals, the Alison Gertz Foundation for AIDS Education

Lower East Side Harm Reduction Center

Kentucky HIV/AIDS Advocacy Action Group

Michigan Positive Action Coalition (MI-POZ)

Minnesota AIDS Project

Minority AIDS Council of Orangeburg, Bamberg, and Calhoun Council, Inc.

Missoula AIDS Council             M OCHA Center Inc.

Multicultural AIDS Coalition, Inc.       he NAMES Project/AIDS Memorial Quilt

Native Health             National African American Drug Policy Coalition, Inc.

National AIDS Fund         National AIDS Housing Coalition

National Association of People with AIDS

National Association of Social Workers

National Latino AIDS Action Network          National Minority AIDS Council

National Native American AIDS Prevention Center

NCLR/CSULB Center for Latino Community Health, Evaluation and Leadership Training

New Jersey Women and AIDS Network        New Destiny Recovery Ministry

New York AIDS Coalition          New York City AIDS Housing Network

Nightsweats & T-cells, Co          North Carolina Harm Reduction Coalition

Oklahoma City Indian Clinic         One Heartland       One Love Project

Open Door Clinic        Leonardo Ortega, NMAC Board Member

David G. Ostrow, MD, PhD              Partnership Project

Choyce Perkinds, Advocate For AAHHERC           Positive Efforts, Inc

Project Aware at Stanley Street Treatment & Resources

PROCEED, Inc.      Project HANDLE, Neighborhood House         Project Lazarus

Project Link of South Florida, Inc.       Proyecto SOL Filadelfia

Puerto Rico Community Network for Clinical Research on AIDS (PR CoNCRA)

Andre Weatherby Rawls     Recovery 2000, Inc.       Redemption Outreach Intl

Regional AIDS Project

Genevieve Rohan, FNP-C, AAHIVMS and Tegest Hailu, MD, AAHIVMS, Hailu/Rohan Family Practice

SAYFSM          Vanessa Sasso, Seattle HIV/AIDS Planning Council

Shanti

S.H.A.P.E. (Stop HIV/AIDS and Addiction through Prevention and Education)

Carlton R. Smith, Baltimore Black Pride, Inc. Founder, Churches United Against AIDS; Board chair

South Carolina Campaign to End AIDS (SC-C2EA)

South Central Educational Development, Inc.   South Jersey AIDS Alliance

South LA Access Center        Southern AIDS Coalition (SAC)

Southwest Louisiana AHEC         Stanley Street Treatment & Resources

Street Works       St. Luke AME Church/ Treat Me Right Inc.

Suburban HIV/AIDS Consortium (SHAC)

TACTS-THE Association of Clinical Trials Services

Tampa-Hillsborough Action Plan           C. Taylor

Ti-chee Native AIDS Prevention Project          Rose Todd-Stanford

Total Health Awareness Team            Treat Me Right Inc.

Treatment Access Expansion Project          Treatment Action Group

Two Spirit Society of Denver            U Can Do It 2!

Evelyn Ullah, NMAC Board Member            Us Helping Us

Valley AIDS Information Network Inc.

Vermont CARES        VillageCare

Volunteers of America Greater Baton Rouge

West County Health Centers, Inc.             Who’s Positive          Willis Center

The Women’s Collective      Women’s Health Center

Women Together For Change           Women Watch Afrika, Inc

July 14, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, Caribbean, Caribbean Community, community, Elderly LGBT, Health, HIV, HIV Status, LGBT community, LGBT Immigrant rights, LGBT Rights, LGBT Seniors, Male Health, Obama, Politics, Public Health | , , , , , , , , , , , , | Leave a comment

U.S. President announces national HIV/AIDS strategy

By Antoine Craigwell

(Tuesday, July 13, 2010) – Finally, U.S. President Barack Obama announced a National HIV/AIDS Strategy (NHAS) as a way of addressing the rising numbers of people in the U.S. who are HIV positive and living with AIDS.

President Obama meets with Jeffery Crowley, ONAP director.

Announcing the National HIV/AIDS Strategy, coordinated by the Office of National AIDS Policy (ONAP), the president said in a letter, “Thirty years ago, the first cases of human immunodeficiency virus (HIV) garnered the world’s attention. Since then, over 575,000 Americans have lost their lives to AIDS and more than 56,000 people in the United States become infected with HIV each year. Currently, there are more than 1.1 million Americans living with HIV. Moreover, almost half of all Americans know someone living with HIV.”

The country is at a crossroads with HIV as a domestic epidemic demanding a renewed commitment, increased public attention, and leadership, the president said. He said he challenged the Office of National AIDS Policy at the start of his administration to develop a national strategy with three goals: reducing the number of people who become infected with HIV; increasing access to care and improving health outcomes for people living with HIV; and, reducing HIV-related health disparities.

“To accomplish these goals, we must undertake a more coordinated national response to the epidemic. The Federal government can’t do this alone, nor should it. Success will require the commitment of governments at all levels, businesses, faith communities, philanthropy, the scientific and medical communities, educational institutions, people living with HIV, and others,” Obama said.

ONAP in its vision statement said: “The United States will become a place where new HIV infections are rare and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”

But leaders at the forefront in the fight against AIDS, especially in the Black community, suggest that the Strategy does not go far enough.

Phill Wilson, president and CEO. Black AIDS InstituteIn a press release, Phill Wilson, president and chief executive officer of the Black AIDS Institute, on his organization’s Website  said that the National AIDS Strategy represents a new day in the country’s nearly three-decade-long struggle against AIDS.

“For the first time, we finally have a national plan in place to guide our fight against the epidemic and to hold decision-makers accountable for results,” said Wilson.

Wilson pointed to the hypocrisy in the U.S.  AIDS policy toward other countries, which imposed as a condition to  receive AIDS assistance that they were required to have a national AIDS strategy, but America never had one.

“With no plan in place to mandate coordination between different government agencies or to ensure accountability, it is hardly surprising that we have an HIV/AIDS epidemic 40% worse than previously believed, with 1 in 5 Americans infected with HIV don’t know they have the disease, half or more of people diagnosed with HIV are not receiving regular medical care, and HIV rates in some communities worst than those found in some of the poorest countries on the planet,” Wilson said.

The new strategy provides a promising opportunity for Americans to get real about the shortcomings in its national response to the epidemic, he said. At a time when AIDS deaths are largely preventable, the government has provided only minimal leadership in making knowledge of HIV serostatus an essential social norm in the most heavily affected communities. And even though the face of AIDS in America is typically Black or brown, most people with HIV are forced to seek medical care from health providers who neither look like them nor understand the challenges they face. The new strategy provides a blueprint for changing some of these realities, and it is an opportunity we must energetically grasp, Wilson said in the release.

But, he said that while he praises the president for placing Black America front and center in his national HIV/AIDS strategy, AIDS in America today is a Black disease, which accounts for about 13% of the national population, with Black people making up half of all new HIV diagnoses. The AIDS death rate among Black males is eight times higher than for white males, while Black women are 19 times as likely to die as whites, he said.

Pointing to the limitations of the AIDS Stratefy, Wilson said, “If the new AIDS strategy is to succeed, it has to work for Black people. In reporting results, the Obama administration needs specifically to report outcomes for Black people. Only if prevention and treatment programs work for Black America will we win our national fight against AIDS. Unfortunately, the new strategy does not sufficiently address the issue of resources. Already, we are seeing many AIDS drug assistance programs impose caps or waiting lists for life-saving drugs. There are over 3000 people on ADAP waiting lists. This month, the President authorized a one-time funding increase for ADAP of $25 million, but this amount, while welcome, represents only about 7% of amounts needed this year alone to ensure the program’s continued solvency.

“At a time when we are largely losing the fight to prevent new infections, prevention programs currently account for only 3% of federal AIDS spending. To put available prevention weapons to effective use, experts estimate that annual prevention spending needs to increase from $750 million to $1.3 billion for at least each of the next five years. This new strategy offers a sound, evidence-based approach to better results, but it will be worth little more than the paper it is written on if we don’t follow through with essential resources.

“In difficult economic times, it is often necessary to make painful choices. As a country, though, we need to transition from AIDS “spending” to AIDS “investments.” By investing in cost-effective AIDS programs, we are investing in America’s families and helping young people remain productive contributors to society for future decades.”

Paul Kawata, executive director of the Washington-DC based National Minority AIDS Council (NMAC), in a statement said, “This is a historic time on many fronts. On the one hand, President Obama has made history today by being the first President ever to create a truly national strategy to deal with the HIV/AIDS epidemic. The ideas contained in this plan are aggressive and would certainly go a long way toward combating what continues to be one of our nation’s most troubling public health emergencies.”

Kawata said he purposefully used the word ‘plan’ to demonstrate that without the funds to carry out the president’s ambitious agenda, it significantly short of a strategy.

“The blueprint is most certainly there,” he said. “But now our collective attention must shift to resources.”

He said that while the president can rightly lay claim to a historic and much-needed moment in the HIV/AIDS movement, history continues to be made each day as more people living with HIV/AIDS continue to join the ranks of those waiting to receive life-saving medicines. Tragically, this has become an issue of resources as well—an issue that has become an all-too familiar refrain in the battle against this disease, he added.

“We must look at this plan as a solid first step in achieving our ultimate goal: eradicating HIV/AIDS. Now the conversation must turn to implementation—and how we fund such an audacious goal. To ignore the difficult topic of HIV/AIDS funding would be tantamount to placing the president’s strategy in a shredder,” said Kawata.

But, Jeffery Crowley, ONAP director, in a statement posted on the ONAP Website said, “Today, Secretary Sebelius also announced that $30 million of the Affordable Care Act’s Prevention Fund will be dedicated to the implementation of the NHAS. This funding will support the development of combination prevention interventions. It will also support improved surveillance, expanded, and targeted testing, and other activities.”

Among the many items the Strategy calls for is a three-step process of reducing HIV-related disparities and health inequities, which include reducing HIV-related mortality in communities at high risk for HIV infection, adopting community-level approach to reduce HIV infection in high-risk communities, and reducing stigma and discrimination against people living with HIV.

The Strategy said that regarding the third step of this process, in the earliest days of the HIV epidemic, fear, ignorance, and denial led to harsh, ugly treatment of people living with the disease, and some Americans even called for forced quarantine of all people living with HIV. Although such extreme measures never occurred, the stigma and discrimination faced by people living with HIV was often extremely high. Even today, some people living with HIV still face discrimina­tion in many areas of life including employment, housing, provision of health care services, and access to public accommodations. This undermines efforts to encourage all people to learn their HIV status, and it makes it harder for people to disclose their HIV status to their medical providers, their sex partners, and even clergy, and others from whom they may seek understanding and support.

Time and again, an essential element of what has caused social attitudes to change has been when the public sees and interacts with people who are openly living with HIV. For decades, community organizations have operated speaker’s bureaus where people with HIV go into schools, businesses, and churches to talk about living with HIV. In the 1990s, both major political parties had memorable keynote speakers at their presidential nominating conventions that were living with HIV.

With Americans with Disabilities Act, the Fair Housing Act, the Rehabilitation Act, and other civil rights laws commemorating their 20th anniversary this year, these laws have proven to be vital for the protection of people with disabilities including HIV. The Strategy calls for a greater commitment to civil rights enforcement and that to be free of discrimination based on HIV status is both a human and a civil right, “We know that many people feel shame and embarrassment when they learn their HIV status. And, there is too much social stigma that seeks to assign blame to people who acquire HIV. Encouraging more individuals to disclose their HIV status directly lessens the stigma associated with HIV. As we promote disclosure, however, we must also ensure that we are protecting people who are openly living with HIV.”

Working to end the stigma and discrimination experienced by people living with HIV is a critical compo­nent of curtailing the epidemic, said the Strategy document. People at high risk for HIV cannot be expected to, nor will they seek testing or treatment services if they fear that it would result in adverse consequences of discrimination. HIV stigma has been shown to be a barrier to HIV testing and people living with HIV who experience more stigma have poorer physical and mental health and are more likely to miss doses of their medication. An important step is to ensure that laws and policies support current understanding of best public health practices for preventing and treating HIV.

“While we understand the intent behind such laws, they may not have the desired effect and they may make people less willing to disclose their status by making people feel at even greater risk of discrimination. In some cases, it may be appropriate for legislators to reconsider whether existing laws continue to further the public interest and public health. In many instances, the continued existence and enforcement of these types of laws run counter to scientific evidence about routes of HIV transmission and may undermine the public health goals of promoting HIV screening and treatment,” the Strategy document said.

To reduce stigma and discrimination experienced by people living with HIV, the Strategy document recommends that communities be engaged to affirm support for people living with HIV: Faith communities, businesses, schools, community-based organizations, social gathering sites, and all types of media outlets should take responsibility for affirming nonjudgmental support for people living with HIV and high-risk communities. The promotion of public leadership of people living with HIV: Governments and other institutions (including HIV prevention community planning groups and Ryan White planning councils and consortia) should work with people with AIDS coalitions, HIV services organizations, and other institutions to actively promote public leadership by people living with HIV. The promotion of public health approaches to HIV prevention and care: State legislatures should consider reviewing HIV-specific criminal statutes to ensure that they are consistent with cur­rent knowledge of HIV transmission and support public health approaches to preventing and treating HIV. And, strengthening of enforcement of civil rights laws: The Department of Justice and federal agen­cies must enhance cooperation to facilitate enforcement of federal antidiscrimination laws.

July 13, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, Caribbean, Caribbean Community, community, death, depression, Economy, Elderly LGBT, Health, HIV, HIV Status, LGBT community, LGBT Immigrant rights, LGBT Rights, LGBT Seniors, Male Health, Mental Health, mental illness, Obama, Politics, Public Health | Leave a comment

U.S. HEALTH CARE REFORM of 2010

President signs Health Care Reform Bill into law

Key Improvements for People Living with HIV and AIDS in

The Patient Protection and Affordable Care Act of 2010

Health Care

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act of 2010 (“PPACA”) into law. Shortly thereafter the House and Senate amended the statute through the reconciliation process and we now have a final health care reform bill.  PPACA is the most comprehensive reform to the United States’ health care system since the passage of Medicare and Medicaid in 1965. While PPACA does not offer everything the HIV community had hoped for in health care reform, it does create tremendous opportunities for improving access to care and treatment for many people living with HIV and AIDS. The most important new health care access opportunities for people with HIV and AIDS are as follows:

Medical symbol

Public health insurance (Medicaid/Medicare) improvements

  • Eliminates the Medicaid disability requirement and provides access to Medicaid to individuals and families with income below 133% of FPL in 2014 (currently income below $14,403 for an individual and $29,326 for a family of four)
  • Eliminates the Medicare Part D “donut hole” by 2020, provides a $250 rebate for donut hole costs in 2010, and requires pharmaceutical companies to provide a 50% discount on brand-name drugs in the donut hole beginning in 2011
  • Counts ADAP contributions toward the Medicare Part D’s True Out of Pocket Spending Limit (“TrOOP”) starting in 2011

Health Care

Private health insurance improvements

  • Increases access to private health insurance by reducing discrimination based on health status or gender – prohibits pre-existing condition exclusions and lifetime limits on coverage in 2010, and charging higher premiums based on gender or health status in 2014
  • Increases scope of coverage through a new mandatory benefits package that among other benefits includes prescription drugs, mental health and substance abuse treatment, preventive care and chronic disease management in 2014.
  • Increases affordability through subsidies for people with incomes up to 400% of the federal poverty line (“FPL”) (income up to $43,320 for an individual and $88,200 for a family of four)
  • Creates an individual mandate requiring uninsured individuals to purchase insurance beginning in 2014Health Care - Doctor and infant

Other key reforms

  • Invests in prevention, wellness and public health activities
  • Invests in efforts to reduce health disparities
    • Supports the clinical workforce with an emphasis on the needs of underserved communities

Health Care advocate protesting

Moving Forward with Future Reform Efforts

Despite the impressive progress that PPACA will make toward improving health care for people living with HIV and AIDS, the future is certain to bring continued challenges in health care access, quality, and cost.  Many of PPACA’s most important reforms, including the Medicaid expansion, will not occur until 2014. Thus, advocacy will be necessary both to encourage new reforms, and to provide health care access for those who are uninsured or underinsured during the transitional period before the reforms fully take effect.  PPACA will provide unprecedented opportunities to improve health care access, affordability, and quality for the HIV/AIDS community.  It is crucial that we fully take advantage of PPACA and continue to work toward a future of high quality, equitable, and sustainable health care for everyone in the United States.

President Obama listening to medical professionals

Prepared by staff of the Health Law and Policy Clinic of Harvard Law School and the Treatment Access Expansion Project. For more information contact Robert Greenwald at.rgreenwald@taepusa.org

March 31, 2010 Posted by | African-American News, Black Gay Men, Black Gay Men Health, Black Men, Black Men Health, community, Economy, Health, HIV, HIV Status, LGBT community, Male Health, Obama, Politics, Public Health | Leave a comment

Reflections: Mr. President Obama

Could this be true? America has a Black president

There is an emotional catch in my throat as I look and listen to all the commentaries and analyses, historical comparisons to Abraham Lincoln, Franklin Delanor Roosevelt, John F. Kennedy, Robert Kennedy, who was spot on when he said the U.S. would have an African-American president in 40 years; and Rev. Martin Luther King, Jr., who suggested a Black president in about 25 years, and contemporary parallels: the economic crises with Bank of America needing money to help them stay afloat; the three automotive industry giants needing money to keep more than half a million employees and subsidiary concerns, two of them forecasting being unable to stay in business come March; the second half of the promised $750 billion appropriated as a financial bailout of the finance sector: people are asking where has the first half gone, has it evaporated?There is no evidence financial institutions have resumed inter-bank lending, that businesses have been getting the advance credit they need to operate and produce, and an average 500,000 homes per month are going into foreclosure, there has been no mortgage renegotiation.

In recent days, there has been no mention of the issue of immigration. It was touching indeed to see his paternal grandmother who traveled from Kenya sharing the dais. Obama himself knew that without the strong support of the Hispanic community, who had grown to despise the Bush administration for the draconian immigration policies and renditions, the Berlin-like wall along the border between Mexico and the U.S.; that he would not have won.

Looking at television close up shots of the faces of people who had gathered on the National Mall, many men and women whose eyes welled with tears, many women their mascara running – haven’t they heard of waterproof mascara, or for many for whom the tears brim over their eye lids, like the waters of Lake Pontchartrain cresting the banks of the levees and inundating the basin below – sliding down their cheeks? Tears which hold not just the salt from their bodies, but the expectations commingled with longing, for all those who are Black in America, who struggled and endured ignominies and humiliations of every kind, yet did not live to see this day, when a Black man is president. The tears flow as many think of those Blacks who still endure slave like conditions, whose lives are inextricably bound to their white counterparts, and who dare not murmur a word or breathe a sigh of discontent or disagreement for fear of a disengagement or termination, which would reduce them to penury.

In a commentary on the eve of the Inauguration on BBC America’s Notes to Obama, national poet Maya Angelou said that she was not presenting a poem, she was presenting ruminations or reflections of what an Obama presidency means to and for her. She said that while the nation needs him, it is he who needs us more.

“We need him, the race needs him, the banks need him, and the economy needs him. He brought to us something we cannot live without, hope. He offers us the chance to have a great president, with whom we can identify, not as a Black president, but a president who would speak for the voiceless, for the poor black, poor white and for the disadvantaged Hispanic person.

I believe he needs us more than we need him. I believe that each of us has to do something more. I believe that we Americans deserve the most we can get. I will work alongside being of use and I will look for you working alongside, being of use,” she said.

During the Inauguration, when Obama took the oat of office, was there a hint of petty vindictiveness and partisanship, even subtle racism? Could it be that because Obama opposed John Roberts’ confirmation as Chief Justice, that Roberts felt to get back at Obama, to fumbled the words of the oat of office while the world looked on, as if to remind the President that he is still subject to the White establishment? Roberts’ subsequent apologies to the President, even re-administering the oat of office, have only highlighted the shadow of incompetence of the Bush administration, but which with tiny wisps and tendrils are trying to reach out to contaminate the new administration. What a mark on an historic and memorable day. Did anyone see the television close up of Obama’s expression during the fumbling? No doubt if it hadn’t been re-administered, constitutional lawyers would have had a field day on the legitimacy of the President.

As he promised, Obama has issued executive orders closing Guantanamo Bay within a year, which while keeping a campaign promise to the American people and assuaging the Islamic world, opens up other problems: reports suggest that some of the detainees would be brought at imprisoned at Levanworth prisons, which is on U.S. soil and places the detainees under the dictates of the Constitution: is there justification to holding them, how are the rules of evidence applied and exercised, what proof is there of involvement or collusion, except for some of the 250 detainees, who were held on hearsay or suspicion, and what about the Patriot’s Act? He has also ordered troops home within 16 months, and outlawed torture.

January 22, 2009 Posted by | African-American News, Black Men, Blogroll, community, Economy, Obama, Politics | 1 Comment

Reflections: Obama, a President

Interregnum: the between time

Obama, should remember only too well the Roman observation: how fickle the populace of Rome – who briefly rejoiced in the victories of Pompeii and before the last sound of praise could be heard in his honor, turned against and reviled him. If he cannot deliver on the promises, like every politician before him, he has made, he would be hounded out of office in infamy. He is a lawyer and like all of his profession, he has over the last several weeks, since the elections, when the campaigning was over and he became starkly aware that his rhetoric had now to become practical, began to cover himself with a disclaimer. Not wanting to seem as though he has stepped away from his promises of change, he has begun to temper the expectations he created in the people of what HE would do. In the later days of the interregnum, he has changed his tune, repeatedly he has cautioned that in the first 100 days of his administration, he may not be able to meet all the expectations people have of him, not that he has created in a people thirsty and desperate for a new American direction, and more importantly, being able to fulfill the promises he made to win; admitting to the possibility of making mistakes and missteps. His electoral victory was a demonstration of who could fool all of the people better; everyone saw through Sen. John McCain’s weak political strategies and rejected his posturing as a continuation of a Republican party steeped in the corrupt machinery born and developed since the Regan presidential era.

Many Black leaders, after the euphoria of the electoral victory and the prospect of a Black president in the White House had worn off, have admitted that he cannot achieve and accomplish all he promised. They recognized that they were fooled, but preferred to abandon their righteous anger of being deceived by one of their own, to celebrating the accomplishment of one of their kind; as opposed to the anger if John McCain would have won. Can anyone imagine what would have been the national reaction if McCain had won, the abject apathy of many Black people – many of whom would have said, “see I could’ve told you the White man would never allow a Black man to get higher,” “Did that Black man, Obama, think he is better than the Whites,” or the disgust and increased disrespect of the wider international community, who laughed at and mocked Americans for reelecting George Bush for a second term, what would they say should McCain have won the elections?

With the vapors of his electoral victory’s honeymoon quickly dissipating under the heat and starkness of the light of people looking for satisfaction, Obama has acknowledged that closing Guantanamo Bay may not be as immediate as he first thought, it would take the better part of the year. Why, this new administration has to find a way to either bring the inmates to a fair trial – grounds which so far are dubious – or to export them to other countries, many of whom the outgoing administration was looking for help, and as recent reports revealed, many stalled on committing to the Bush administration, but have now agreed to accept prisoners; he won’t be able to bring the troops home from Iraq as soon as he had originally planned, because now the Iraqi government has locked the Americans in a contract binding their presence up into 2011, yet some battalions may be withdrawn; there is doubt in Congress, where once he felt he was confident in bipartisan support, about passing his proposed $850 billion economic stimulus package, which has raised fears of at least a $2 trillion budget deficit, which would be visited on the next two generations; but held true to his word he would make torture illegal for the armed services.

January 22, 2009 Posted by | African-American News, Black Men, Blogroll, community, Obama, Politics | Leave a comment

Reflections: Obama – A President

Election: hope and change mantra

As the celebrations from the night, when it was announced that Sen. Barack Obama, by majority of the electoral college and later confirmed by pronouncement by the combined houses of the legislature, had won the elections and was named President-elect, had given way to the stark reality of daylight, in Washington Heights trees lining the streets were festooned with toilet paper hanging from branches as if it was the morning after a festival, presenting a surreal image as if New Years had arrived early on November 5.

In a country steeped in racism, both subtle and overt, what really does an Obama win actually mean for Americans: Native Americans, Blacks, Hispanics, Asians and Whites? What did his win against a weakened religious conservative political right mean for immigrants, those from Central and South America, from the Caribbean, from Africa, from Asia, minor and major?

Did the White majority in the country say that by electing a Black man as president that they have moved pass the bigotry for which they are known, that they now recognize that Black people are capable of thinking, of governing, of being responsible and are not lazy, lay-abouts, welfare dependents? Is the White establishment now saying that they are willing to take orders from a Black man, consoling themselves by the fact that the president is half Black and half White, and that they had in fact voted for his White half?

As a friend, Clarence Reynolds, a book editor and an English professor at Brooklyn College in Brooklyn said while watching the results come in from across the country that he felt overwhelmed by the experience that here is a Black man becoming president of the United States.

“I’m excited that this will change the psyche, the way people think, the way they see themselves and the way they are perceived. For Black people, this would give them an opportunity to rethink their attitude and a newness of pride in themselves, to at least pull their pants up,” he said.

Since bursting on the national stage at the Democratic National Convention in 2004, his star has continued its meteoric rise. Large crowds have followed him since he declared, speaking to both whites and Blacks, in a statement that single handedly removed the stigma attached to educated Blacks and challenged the perception that only whites are educated – that a Black child reading is not acting white. Obama’s charisma has drawn crowds, from the time of his announcement that he was putting himself forward as a candidate for the presidency in Springfield, IL, to his acceptance speech in Denver, CO and to his gracious victory speech in Grant Park, Chicago, IL on the night of November 4.

Everyone agrees that not only is the country eager and desperate for a change, but a startling phenomena is the perceptible shift in the American attention span: more than 83 million people watched his acceptance speech at the Democratic National Convention at the Mile High Stadium in Denver, CO, millions watched on their televisions and an estimated 125,000 people crammed into Grant Park to hear his victory speech, which was not as gloating as one would have expected from a contest that celebrated negativity, divisiveness, and attacks ad hominim; but was magnanimous and conciliatory, saying that those who did not vote or support him should know that change has come to America. And, for Americans known for their sensationalist mentality, Obama has not faded into the background of politics as usual. Rather, on Sunday, November 16 an estimated 24 million viewers looked on as he was interviewed by Steve Croft on the CBS Sunday magazine, 60 Minutes. Surprising too, as Gwen Ifill commented in the Newshour on PBS on the following Monday evening, that contrary to the politics as usual where politicians are known to shift or change their messages in the interregnum, after they are elected and sworn in, that Obama has remained true to his campaign messages and reinforced them in intended executive orders: an uncompromising stance on closing the U.S. military base at Guantanamo in Cuba, forbidding torture as a U.S. military practice so as to restore America’s morality on the global stage, and his withdrawal of U.S. troops from Iraq.

Puzzling, however, is why he chose not to attend the global leadership summit held in Washington, D.C. over the weekend of November 14 – 16? As usual there would be speculations, but interestingly enough, none of the main news outlets have ventured to comment on his absence except for brief mentions that he would not be attending. Is it that he wanted to ensure that when he contacts those heads of state that his interaction is free of the blight and the dross of the incumbent, soon to be former president? Was the meeting just simply window dressing, since even in the communiqué produced by the 20 heads of state, no decisions were made until when they meet again in April and by which time Obama would be present? By not attending the G-20 summit, did Obama miss out on an opportunity to meet his major global counterparts, or did he prefer not to seen in George Bush’s embarrassing shadow?

According to Neil Ferguson being interviewed by Matt Frei on BBC World News-America on Monday, November 17, alluding to Obama’s absence from the G-20 summit not being particularly helpful, he said that with the global economy in crisis and with a protracted American transition period, the world needs immediate action and intervention, and everyone was looking to Obama to pick up the reigns of leadership. Ferguson said that Bush’s comments at a speech on Wall Street in New York on Friday, November 14, where he spoke of support for a “free market system” literally sounded a death knell for that system, and suggested that anything Bush touched turns to ashes.

If this was truly a more global village, how many people from around the world would have joined lines, like Americans did on Election Day, to exercise their vote, their democratic right, and perhaps, the fact that they want to vote is a cry from the hearts of those many who long for the winds of democracy to blow in and through their respective countries? But what responsibilities does Obama have to the rest of the world?

No doubt Obama knows that is he bound by the shackles of his race, his paternal ancestry in Kenya, who are looking to him to make changes, as if he is the American representative of Africa in America, of those who in America claim association with him because of his skin color to lift them up not so much with a wave of his hand, but more of doing what he promised, after he himself has witnessed and experienced the suffering, downtrodden state, and systematic disenfranchisement of those like him in America; he has the sword of Damocles hanging over his head, a sword of extraordinary expectations from a nation and a world tired of duplicity and forked-tongue speaking, where promises are made with ulterior motives, brazen as they are revealing that they weren’t made in the best interest of those to whom they were made, and though he has good intentions, he would be beset by a machinery that has been grinding inexorably for more than 20 years, producing in the nation’s capital corruption, deceit, and secrecy. Really, rot at the core. And, as he assumes office, he himself would be stepping into this mire. The hope, a word which he has been trumpeting throughout his campaign, is that he would not be sucked into and be consumed by the god-like or quasi-monarchial status conferred on a president, but rise above it, perhaps hovering over the muck, to effect change, another word in his campaign mantra.

January 20, 2009 Posted by | African-American News, Black Men, community, Economy, Obama, Politics, Washington Heights Community | Leave a comment

Obama in exclusive interview with Black gay magazine

Obama a friend to gays and lesbians.
By A.B. Craigwell

New York, NY — Oct 24—In a statement of commitment, not only to the Black gay community but as a response to questions about his position on gays, Senator Barack Obama, a 2008 presidential candidate, recently granted an exclusive interview with PULSE, a magazine produced by Gay Men of African Descent (GMAD), a New York-based social service and advocacy agency.
More recently, however, on Oct 23, the Associate Press (AP) reported that there have been calls for Sen. Obama to distance himself from the gospel singer and minister, Donnie McClurkin, who is among several other gospel singers scheduled to perform in a concert in South Carolina this weekend. According to AP, McClurkin has elicited the ire of gays around the country with his views on homosexuality.
Obama, in a response, carried by AP, to the calls, ‘said he believes gays and lesbians are “our brothers and sisters” and should be afforded the same respect, dignity and rights granted all other citizens.’
In the interview with PULSE, Obama addressed issues such as the “Don’t ask Don’t tell” stance about gays in the military; homelessness and violence affecting gay youth; homophobia in the healthcare system; and the elimination of the “F” word (faggot or fag) along with the “N” and “B” words from common usage.
Interviewed by Tokes Osubu, executive director of GMAD, and Robert Crawford, associate publisher for PULSE, Obama said that he fully supports the repeal of the “Don’t ask Don’t tell policy, where the real test for the military is found in its sense of duty, patriotism and willingness to serve. He referred to the 2005 General Accounting Office (GAO) report, which said that the policy has resulted in significant loss of qualified service members for critical occupations and who have important language skills.
“I now believe that if gay men and lesbians served openly in the United States military, they would not undermine the efficacy of the armed forces,” said Obama.
He said that while the issue of homelessness and the perpetration of violence against gay youth are at crisis levels, gays and lesbians who make up 3% to 5% of the general population “account for 20% of homeless youth under age 21 in many urban areas.” Obama said that many young men and women face difficulties in their development, including rejection from family and friends, harassment, violence from peers, rejection from adults, HIV risks, and substance abuse.
“I believe we have to do more to ensure that we have adequate resources and support structures to nourish and encourage gay and lesbian youth, as well as all young people,” Obama said. He called attention to the cuts in funding to the Runaway and Homeless Youth Act and for funding restoration for the Community Development Block Grant program. “As president,” he said, “ I will fund these programs and ensure that we have adequate funding and support for homeless youth.”
With respect to the homophobia in the healthcare system and the Ryan White Care Act, Obama said, “We must continue to fund this vital program. It is a program that provides access to life-saving treatment and care for over half a million low-income Americans with HIV/AIDS.” He said in his campaign he proposed an affordable universal healthcare plan for all Americans.
“I will create a new national health program that will allow individuals and small businesses to buy affordable healthcare similar to that available to federal employees. No one will be turned away or charged more due to illness, and everyone who needs it will receive a subsidy for their premiums,” Obama said. The creation of a National Health Insurance Exchange, he said, is a way of reforming the private health insurance market so that any American could enroll in participating private plans and provide comprehensive benefits, issue every applicant a policy, and charge fair and stable premiums.
Weighing into and adding another letter to the controversy surrounding the use of the “N” and “B words,” Obama said, “I find the “F word” just as reprehensible as the “N and B words”, it too has no place in a tolerant America.” He said that all Americans have witnessed a coarsening of the culture that everyone has to think about. The entertainment industry has played a role, he said, “but in many ways we have to accept personal responsibility and begin to condemn discriminatory and derogatory insults, wherever they may arise.” ###

October 24, 2007 Posted by | Obama, Politics | , , , | 2 Comments