Trumping AIDS

As the Trump era begins, only one thing seems to be clear—anything could happen. And as far as HIV/AIDS goes, experts and advocates are not optimistic. Though the President has not, as of this printing, made any clear statements regarding his stance on AIDS and funding for the disease, the trend towards the cutting of public health funding and the elimination of the Affordable Care Act is almost certain to have a negative impact on the 1.2 million people living with HIV in the United States. Moreover, the recently issued executive order impacting international aid organizations pertaining to abortion counseling will likely have a detrimental effect on international AIDS funding coming from the U.S.; HIV prevention is often tied to family planning efforts.

One alarming aspect of the Trump administration in regards to HIV/AIDS policy is the individuals surrounding the President, notably Vice President Mike Pence and recently confirmed Secretary of Health and Human Services Tom Price. In 2000, Pence notably promoted conversion therapy for gay people and suggested that domestic AIDS funding not be renewed by Congress unless they could “ensure that federal dollars were no longer being given to organizations that celebrate and encourage the types of behaviors that facilitate the spreading of the HIV virus.”  Moreover, Pence was the governor of Indiana in the spring of 2015 when that state saw the worst outbreak of HIV in its history. Despite the fact that the outbreak was known to be tied to injection drug use, Pence refused to lift the state ban on needle exchanges, a well-documented public health measure used to combat the epidemic for decades.  

Republican congressman Tom Price, Trump’s newly appointed Health Secretary, belongs to a fringe medical society (AAPS) that not only questions the link between HIV and AIDS, but has asserted that abortion causes breast cancer. More worrisome, however, is the fact that Price is vehemently against any expansion of Medicaid and has spoken out against the Affordable Care Act since it first passed. Unfortunately, an attack on Medicaid and the ACA is tantamount to an attack on HIV/AIDS care and does not bode well for Americans who live with HIV and need medication and medical care.  

The Telluride AIDS Benefit (TAB) provides funding to Colorado-based HIV organizations that may be used for any purpose the organization deems necessary, including non-medical needs such as food, housing, and transportation. The uncertain future of HIV/AIDS funding in the U.S. only underlines how important the funds provided by non-governmental resources such as TAB will continue to be.

-Words by Sarah Gluckstern

Manzini Youth Care Clinic: Update on the CD4 Count Machine

The 2016 Telluride AIDS Benefit Gala Fashion Show fundraiser was just ending when Manzini Youth Care (MYC) asked for a special contribution for its Community Clinic in Manzini. Our special ask for was funding for a CD4 Count Machine. An accurate CD4 count in HIV/AIDS patients provides valuable feedback indicating whether antiviral treatments are effective in a given patient. For example, a CD4 count below 350 indicates that the medicines are not working effectively enough to prevent patients from acquiring opportunistic diseases such as pneumonia or tuberculosis. Likewise, a CD4 count above 350 reassures the patient that the medicines are indeed effective and patients can confidently continue on with the antiviral dosages prescribed.

Despite the fact that Swaziland has one of the world’s highest rates of HIV among its citizens, Swaziland is a country that does not have regular testing of this CD4 count. In fact, during the last couple of years there have only been a handful of persons who have been tested. This year, our goal for special funding was $5,500, the amount recently quoted to obtain a CD4 count machine for Manzini Youth Care Clinic, a clinic which began and continues to operate thanks to the generosity of the Telluride community. Within five minutes the town of Telluride came forward with the generous donation, which amounts to $1,100 per minute! Not bad Telluride – give yourself a well done! Three months later, Kyle Hendrikson, who volunteers his summers each year to work with MYC, set off to obtain the device and have the testing up and running in no time. Our optimism soon faded when we were notified by the manufacturer, located in Johannesburg, South Africa, that the cost had almost doubled, despite having received a written quote of $5,500 only six months prior. Although we still do not understand the cause of this dramatically inflated cost, the most reasonable conclusion that we can come up with is that the taxes and costs involved in moving this equipment over the border into Swaziland amount to nearly the cost of the machine itself!

The country of Swaziland is a Monarchy, one that struggles with over 60% unemployment and over a 30% HIV positive prevalence in working adults. Leslie and I have been working in Swaziland on and off since 1980 when we began as Peace Corps Volunteers. Although these sorts of setbacks are not uncommon in Swaziland, or any struggling African country for that matter, we have learned over time that a little patience and perseverance can go a long way. When we visit in November, we plan to investigate the possibility of collaborating with a local clinic in Manzini to obtain and possibly share a machine. Kyle and the clinic health care provider, Lovemore Garira, are in the process of getting the clinic registered as one of the first youth friendly health centers in Swaziland. This distinction will help to build MYC’s relationship in the healthcare community and possibly open the door for collaboration. We have also learned of a new screening product that is still being tested and scheduled for release in October of 2016. This screening tool is designed to test one drop of blood for CD4 levels within five minutes, and is estimated to cost approximately $10 per test. Meanwhile, we will continue to explore other ways that MYC Clinic can optimize the health of the children and MYC and the surrounding community.

Due to our personal connection with the Manzini community, the dedicated on-site staff and volunteers who work daily to make MYC both a successful and sustainable program, and the continuing generosity of the people of Telluride, the Manzini Youth Care Clinic continues to grow and evolve. MYC continues to provide residential homes, education, skills training, recreational opportunities, and health care for children and adolescents abandoned or orphaned due to the HIV/AIDS epidemic. During the course of the past three months, while trying to strengthen our social services, MYC has recently developed a partnership with the Ministry of Health Clinical Psychologist where MYC youths can be referred for counseling.

The money which MYC gratefully receives annually has made it possible to provide free clinic services to the youth and community around MYC, including clinic consultations, HIV counseling and testing, STI screening, life skills education and referrals for treatment care and support services.  

UPDATE (Dec. 14, 2016):  We are having some success here in Swaziland!  It is planned that the CD4 count laboratory testing strips should be here in January. We found a company in Capetown, South Africa that has developed new technology to help with getting low cost testing to rural areas. We are planning on starting with one hundred tests and expanding it as needed. 

Swaziland now has United Nations and PEPFAR money that pays to treat everyone that tests HIV+ with two antivirals and a protease inhibitor, and will use the new lab test to monitor sick patients. The program is called "Test and Treat".  We are now trying to get the clinic as an official "Test and Treat" center.  This will allow us to start treatment the day of the testing, and if we are lucky we will be adding another nurse to the staff soon.

 

Telluride AIDS Benefit more relevant than ever in 2017

Telluride AIDS Benefit more relevant than ever in 2017

AIDS might seem like a distant memory in the wake of a tumultuous 16 month-long election cycle. The soon-to-be Trump presidency is providing an unnerving picture for the future of AIDS related issues. Under the Affordable Care Act, Medicaid was greatly expanded and many prerequisites were dropped to make access to care easier for almost 45% of HIV positive people. Many of these improvements are likely to be cut or trimmed in the new administration. This will make other funding such as that provided by the Telluride AIDS Benefit more relevant than ever. 

Colorado Needle Exchange Programs Ramp Up

Colorado Needle Exchange Programs Ramp Up

Jeff Basinger, the director of regional programs at Western Colorado Aids Project (WestCAP), says needle exchange programs are often misunderstood and research proves the programs are effective in stopping the spread of disease. “With new legislation and subsequent implementation in various communities, these programs have been a step in the right direction in helping stop the spread of HIV,” Basinger says. 

Was Bush Better?

Was Bush Better?

Some praise the Obama administration for laying out a comprehensive plan and bumping up domestic funding to confront the epidemic, while others yearn For the Bush days because of the global initiatives the Republican president started despite his reputation for anti-gay policies. ¶ Jim Driscoll, a gay Nevada-based HIV/AIDS activist who served on the Presidential Advisory Council on HIV/AIDS during the Bush administration, is among those who believe Bush did more to stop the epidemic.