world aids day – RI Future

December 1, 2015December 1, 2015

Ahead of World AIDS Day, RI leaders launched ambitious 90-90-90 Plan

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Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health, alongside Providence Mayor Jorge Elorza and Governor Gina Raimondo signed the Paris Declaration in a State House ceremony Monday.

In signing the declaration, the three leaders committed to putting Providence and Rhode Island “on the Fast-Track to ending the AIDS epidemic through a set of commitments. Those commitments include achieving the UNAIDS 90–90–90 targets, which will result in 90 percent of people living with HIV knowing their HIV status, 90 percent of people who know their HIV-positive status on antiretroviral treatment and 90 percent of people on treatment with suppressed viral loads, keeping them healthy and reducing the risk of HIV transmission.

“Rhode Island and the Providence partnership that we’re doing together, represents the first city/state group to join this world wide 90-90-90 campaign.” said Dr. Alexander-Scott in announcing the new effort.

2015-11-30 World AIDS Day 001 Kira Manser — Kira Manser

The announcement and signing ceremony came as part of the Rhode Island HIV Prevention Coalition‘s event held ahead of World AIDS Day 2015, which is today. The event was hosted by Kira Manser, the coalition co-chair.

Speaking at the event was Dr. Philip Chan, who works with AIDS patients at Miriam Hospital. Chan said that to curb the spread of HIV we must concentrate on a few areas. First, we must focus on access to care, especially among gay and bisexual and other men who have sex with men. Second, we must “address other STDs like syphilis, which has increased exponentially across the country. Third, we need to perform routine, opt-out HIV testing, to make sure that everyone gets tested at least once in their life. Fourth, we need to get people who are HIV positive on PrEP and lastly we need to need to work together, government and health officials, to end the epidemic.

Richie DeFilippo, the reigning Mr. Gay Rhode Island, explained the importance of PrEP, pre-exposure prophylactic. “PrEP is a preventative measure of HIV negative individuals to take daily to prevent them from contracting the virus.” It’s a pill taken once a day, but it is very expensive without insurance. DeFilippo aspoke of some of the social and economic barriers that prevent the effective use of PrEP.

Stephen Hourahan, executive director of AIDS Project RI, talked about the stigma still attached to the disease. Hourahan talked about the misunderstanding and stigma attached to the Charlie Sheen announcement. Stigma prevents many from getting tested for HIV, and increases transmission as a result.

The most energetic talk was given by Paul Fitzgerald of AIDS Care Ocean State. “Prevention without advocacy is no justice,” said Fitzgerald, before coming out from behind his podium and leading the audience in activist style chants. “We are not silent! We are not silent!” he shouted to applause. “We have activism to reach! We have people to change! We have policy to make! We have initiatives that must come about, to fruition. And it starts with us. It goes beyond these doors. Every place that we are we should be fighting about AIDS. We should be fighting about those people who cannot access services because they are not there, because they are not paid for, because there’s a political issue.”

2015-11-30 World AIDS Day 010 Richie DeFilippo — Richie DeFilippo

2015-11-30 World AIDS Day 009 Paul Fitzgerald — Paul Fitzgerald

2015-11-30 World AIDS Day 008 Stephen Hourahan — Stephen Hourahan

2015-11-30 World AIDS Day 007 Gina Raimondo — Gina Raimondo

2015-11-30 World AIDS Day 006 Jorge Elorza — Jorge Elorza

2015-11-30 World AIDS Day 004 Nicole Alexander-Scott — Nicole Alexander-Scott

2015-11-30 World AIDS Day 003 Philip A Chan — Philip A Chan

2015-11-30 World AIDS Day 002 David Cicilline — David Cicilline

February 25, 2015February 26, 2015

Experts agree: Criminalizing HIV transmission a ‘backwards step’

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If freshman legislator Robert Nardolillo accomplished anything with the introduction of legislation that seeks to criminalize the transmission of HIV, it was to demonstrate the hard won strength and unity of the LGBTQ and medical community in resisting a return to the ignorance, fear and stigma attached to the disease in the 1980s.

Though Nardolillo, in presenting his bill to the House Judiciary Committee claims to have done research on the issue, it became immediately obvious that he had not talked to any of the assembled experts in public health policy in the room last night. If anything, it looks like Nardolillo’s research amounted to little more than copying section 44-29-140 of a draconian and unhelpful South Carolina law passed in 1988, at the height of AIDS hysteria in the United States.

Nardolillo, who did not respond to my request to answer questions before the hearings, did speak to Zack Ford at ThinkProgress and when confronted with studies demonstrating the dangers of this kind of legislation, showed himself to be impervious to reason, saying,

‘Have I read the research? I did,’ Nardolillo confirmed, saying that he still felt that HIV was too serious not to prosecute in a distinct way.

Stephen Hourahan, Executive Director of AIDS Project RI strongly disagreed. The legislation’s passage, said Hourahan, “would mark a backwards step” in dealing with HIV. Since the bill criminalizes knowingly transmitting HIV, the bill will, “privilege the ignorance of not knowing your status.” We don’t want the mantra to be, “Take the test and risk arrest,” said Hourhan, adding that such a bill would create a “viral underclass” and should be opposed by all.

Paul Fitzgerald, executive director AIDS Care Ocean State, echoed Hourahan’s comments, adding, “I don’t believe that it’s smart” to pass such a bill.

Anthony Maselli, a healthcare worker and LGBTQ activist, said that transmission of HIV with “malicious intent is improbable and rare.” The law, says Maselli, “adds insult to injury” and is “a slap in the face.” At the conclusion of his excellent testimony, Maselli was greeted with applause from those crowded into the room.

Anthony DeRose, representing the Rhode Island Democratic Party LGBTQ Caucus and the Young Democrats of Rhode Island pointed out that as a country, we are in the process of rolling back similar laws. Laws such as the one Nardolillo introduced, said DeRose, are “outdated.”

Dr. Amy Nunn of Brown University, who I featured in a piece back in December during a State House event held for World AIDS Day, said that passage of such a law would set back decades of work here in Rhode Island. She called Dr. Michael Fine of the Rhode Island Department of Health a visionary for suggesting that Rhode island might be the first state to eliminate HIV transmission through sound public policy.

Rounding out the night’s testimony was Miriam Hospital’s Kristen Pfeiffer, chair of the RI HIV Prevention Coalition and Ben Klein, a Senior Attorney at Gay & Lesbian Advocates & Defenders. Both were vociferous and forceful in firmly opposing the legislation.

In the face of such strong opposition, it seems extremely unlikely that this legislation will advance out of committee.

December 3, 2014

PrEP: Why aren’t you on it?

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I’m a healthcare worker, Queer activist, and consider myself to be pretty well-informed and connected and yet if you had asked me about PrEP as recently as September, I would have wondered what you are talking about. I’m up here today because I feel that the word PrEP needs to be on the lips of every sexually active person and the people they love.

PrEP which stands for Pre-Exposure Prophylaxis is a once a day dose of an anti-retrovirus drug called, Truvada; which is also used for people who are HIV Positive to help keep viral loads low, but in people who are negative, if exposed to HIV, kills the virus before it has the chance to infect you. Numerous studies have shown it to be pretty darn effective.

Being newly single, and sexually active, this naturally piqued my interest; if a one a day pill can help prevent an unwanted condition, why wouldn’t I be on it?

But for good measure, I took to social media to see if anyone in my extended networks had any thoughts or experiences with it. The results were somewhat unsurprising, but worth breaking down:

Two people reached out to me privately to tell me their stories, which were well-received and appreciated, but I wondered why they didn’t feel safe to say publically they were PrEP users. Until I saw some of the other public responses (most of which were positive), but there were a strong current of people who were telling me that I weren’t being “sleazy” I wouldn’t have to worry about this or that they felt that this pill will encourage “bad” behavior.

This line of thought is nothing new…54 years after the Birth-control Pill hit the market and 41 years after safe and legal abortion was won, people are still saying that contraception will encourage “bad” behavior.

Well I’ve got news for them. “Bad” behavior does not need encouragement. At all. And furthermore, there is nothing bad, dirty, or shameful about sex. We owe it to ourselves, our partners, and the people we love to first and foremost, enjoy ourselves, but also to do everything we can to protect ourselves and other.

We as a society need to come to grips with the fact that sex-positive and queer-inclusive sex education not being a part of our public school curriculum is nothing short of a public health crisis; creating a layer of young people with lots of misinformation and questions who are afraid to seek out answers for fear of judgment. This is dangerous. Silence, in this case, literally equals death.

I, along with my Doctor, Dr, Chan, did decide that going on PrEP was the right decision for the type of life I lead. I was very fortunate to thus far not experience and of the side effects (nausea, vomiting etc.). And if you’re wondering, it didn’t encourage and more or less “bad” behavior.

To conclude, I would be remiss if I didn’t discuss how equally important access to this drug is to it’s availability. I am lucky in that I have a good job with good health insurance, so access to PrEP was no issue for me. But there are so many people in vulnerable demographics (I think of sex-workers and IV drug users especially) may not be as lucky and cannot afford to pay the over $1500 out-of-pocket cost of a monthly supply of Truvada. PrEP has the potential to make new HIV infections a thing of the past, but it cannot do that if no one’s heard of it and people who need it the most cannot access it.

These are the facts, but our challenge as healthcare providers, law-makers, activists, and people who want to see a world without HIV/AIDS is to overcome them. We have come so far already; research in tandem with activism has taken HIV for a death sentence to a chronic, but mostly manageable condition, and now we have the capability to prevent it in the first place. We need to be screaming about this from rooftops, flyering every gay bar, I also liked Dr. Nunn’s idea about using sites like grindr and scruff as tools for outreach, and also making the phrase “ask your doctor about PrEP” as recognizable a slogan as “get tested” and “know your status” is now!

December 2, 2014December 2, 2014

Online hookup sites key to combatting AIDS in Rhode Island

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Too many of us think of AIDS as something that occurred in the past, and see it as a manageable, if unfortunate disease that is well on its way to being eradicated.

The truth is that as of 2012, over 1591 Rhode Islanders has died because of this epidemic. Though the rate of new infections has decreased over the last 30 years, there were 74 new cases of AIDS in RI in 2013. This is an increase of over 17%, according to Dr. Amy Nunn of Brown University who spoke at the State House yesterday for World AIDS Day. She was joined by Governor Linc Chafee and US Rep. David Cicilline and many public health advocates.

“Today, over half of the new infections are among men, in Rhode Island, and we know from Dr. Philip Chan’s study that a lot of these people are meeting on line, on the Internet,” says Dr. Nunn, “The problem is that our preventative response hasn’t been as quick as those websites which are making money hand over fist and helping people hook up online.”

Dr. Nunn would like to avoid stigmatizing high risk lifestyles and instead concentrate on education as a means of protection.

The answer is “to get our preventive response aligned with how people are getting infected.” Dr. Nunn sees the answer as partnering with these online hook up sites like Grindr, “I would posit that they do a much better job of reaching the highest risk people than we have done in the public health community, and it’s time for a revolution.”

“I would like to challenge every one in the room that we really need to think about how we can enhance our prevention strategies by working with these companies online and also shaming them into corporate social responsibility. Why aren’t they doing more?”

Dr. Nunn would also like to implement AIDS screening as part of our regular checkups, as routine as blood pressure and temperature checks.

If we do this, says Dr. Nunn, we have a good chance of getting our AIDS infection rates down to zero.

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