September 29, 2006
US CONFERENCE ON AIDS
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Activists connecting at the US Conference on AIDS. |
More than 3,500 people involved in the front-line fight against AIDS gathered in Miami Beach last week to learn what's new in treatment and recharge to fight the epidemic. The US Conference on AIDS chose South Florida, site of its first meeting in 1997, because the region reflects a national crisis: the growing rate of HIV infection among young people and in the black community. But US government initiatives showcased at the conference fail both young people and people of color. Women - who also face rapidly rising infection rates - fought just to get a place at the table.
A new generation needs prevention
"As a movement, we have failed our young people," said Paul Akio Kawata, executive director of the National Minority AIDS Council (NMAC), sponsor of the conference that has become the largest AIDS meeting in the United States. "We don't take the time to educate the new generation. Programs that worked 10 years ago probably don't work for this generation."
Bush and Congress have cut money for HIV/AIDS prevention campaigns. With even less justification, they dump billions of taxpayer dollars into abstinence-only-until-marriage programs. As a result, many of our schools preach abstinence rather than offering sexuality education. Healthcare settings are one of the few remaining places where young people can expect honest, comprehensive information about sex and how to protect themselves from HIV infection. For sexually active young people, an HIV-test is both a responsible step toward sexual health and an opportunity to talk with a knowledgeable professional about risk.
Healthcare providers, however, can do away with HIV pre-test counseling with new blessings from the Centers for Disease Control and Prevention (CDC). The CDC released new guidelines that promote routine testing while obliterating standards for counseling and consent. Implementing these guidelines, while the government chronically under-funds AIDS prevention, treatment, and care, will ultimately hurt young people, women, and poor communities of color.
"We have always encouraged sexually active young people to be tested," said James Wagoner, President of Advocates for Youth. "Concurrently, it is essential that we educate young people about how to protect themselves from the transmission of HIV. Prevention remains our best defense. We cannot afford to spend scarce resources on unproven programs that censor information about condoms, the most effective HIV prevention tool for sexually active people."
Where's the money for testing?
The CDC says healthcare providers don't have money or time to manage counseling or written consent protocols. Even with sub-standard delivery, HIV testing still costs money. While wealthy providers may be able to bill insurance providers, the healthcare system serving poor people must bear the cost, possibly by cutting back on even more services.
For millions of low income and uninsured women, family planning clinics funded under Title X of the Public Health Services Act are the entry point into the healthcare system. These clinics often provide HIV-testing and other AIDS-related services as part of holistic sexual and reproductive health care. The need is paramount. AIDS rates among women are growing faster than among men. African-American and Hispanic women represent less than 25% of all U.S. women, yet they account for more than 79% of AIDS cases in women. Yet women were missing from the CDC release panel until two women advocates insisted on joining the all-male officials.
"In theory we're wholly supportive of universal testing, but we remain concerned that the cash-strapped family planning clinic system cannot absorb these new costs," Marilyn Keefe, interim President and CEO of the National Family Planning Health Association, an organization that represents Title X family planning clinics.
Where's the money for everything else?
No one is arguing that we should not expand access to testing. Some advocates at the conference praised CDC's call for routine testing because African Americans and Latinos are less likely than others to know their HIV status. As the government pushes testing, advocates unanimously wonder: what is supposed to happen when people test positive?
"Testing without treatment is immoral. What good does it do to tell people they have HIV if we can't treat them?" Phill Wilson, executive director of the Black AIDS Institute, asked. "If we don't spend the money to prevent them from getting HIV, when they test positive, we have failed them."
Federal grants to states and cities for HIV treatment and services have been at $2.1 billion per year for the past four years, despite about 40,000 new HIV cases annually. So newly positive people have to fight for the medicine and care they need after being blindsided by an AIDS diagnosis (remember the elimination of pre-test counseling?).
"The real affects of this won't happen for another 10 years or so," explained Larry Bryant, Housing Works organizer. "Poor communities are always last on the list to receive anything, so they will again be most affected."
Squashing the spirit of activism
The CDC tried to sidestep these reality-based criticisms when they laid out their new guidelines. Lacking meaningful debate, the event was more of an "unveiling" than a "town hall meeting."
For many, the whole Conference seemed stifling.
"The sessions brought up issues that put officials on one side and a person living with AIDS whose services are being cut on the other, but it didn't seem to me that dialogue was actually encouraged," said Bryant. "We have people here who are living with the disease, who are working to prevent the disease, who are working to bring resources to PLWHAs. There is a certain sense of emotion."
There was a group of teens who spontaneously erupted in chants: End AIDS now! End AIDS now! They were "encouraged to be quiet."
"It was like an anti-rally," Bryant lamented. "These are black kids. Their parents have died of AIDS. But people were like, 'shhhhhh, don't do that.'"
Such pressure from the established AIDS community both turns-off young leaders and quashes critical debate. We need both to end AIDS.
Want to learn more about what's really going on with black youth and AIDS? The Black AIDS Institute recently issued Reclaiming Our Future: The State of AIDS Among Black American Youth. Check it out! Download it here.