LGBT POV

In observation of World AIDS Day, the Williams Institute hosted a panel on current developments in HIV/AIDS law and public policy. The panel included Catherine Hanssens, Executive Director of The Center for HIV Law and Policy, who spoke about HIV/AIDS policy under the Obama Administration; Phil Curtis, Director of Government Affairs, at AIDS Project Los Angeles (APLA), who analyzed the impact of state budget cuts on HIV/AIDS prevention and services in Los Angeles County and California; and Mary Sylla, Policy, Advocacy & Research Director at the Center For Health Justice, who described her efforts to improve HIV treatment and prevention in the California prison system.

Hanssens noted that the Obama Administration’s choice of Jeffrey Crowley as the Director of the Office of National AIDS Policy & Senior Advisor on Disability Policy is significant. “We have an AIDS czar with depth and experience in AIDS public policy and medical issues who’s also well-informed and very interested in health care reform,” she said. “The choice of Jeff Crawley reflects a level of seriousness in and of itself [by the Obama Administration].”

Hanssens, a strong proponent of including human rights as a priority in the national HIV/AIDS strategy, noted that the openness and access that HIV/AIDS advocates are currently experiencing with regard to national AIDS policy is a product of the administration’s interest. She said that working with the Obama Administration has been “…the only experience I’ve had in recent memory where an administration has been actively interested in the civil rights issues related to HIV/AIDS.”

Curtis summarized the events of the 2008 California budget impasse and subsequent line-item veto by Gov. Schwarzenegger, which resulted in the massive cuts to HIV/AIDS programs throughout California. “We’ve never seen anything like this,” he said. “The cuts to HIV education and prevention were the most shocking. HIV prevention is extremely cost-effective. Preventing someone from contracting HIV can save $600,000 of treatment and related expenses down the road.” Curtis noted that state cuts are now cascading to local governments; for example, LA County lost $10.9 million in fundingin funding from the State Office of AIDS.

With California currently facing a $20 billion deficit, Curtis wondered about the future of Californians living with HIV/AIDS. “What’s left to cut? ADAP?” he said, referring to the “absolutely lifesaving program” that provides medications to treat HIV disease and prevent related serious deterioration of health. $70 million of ADAP funding comes from state general funds. Curtis called the situation in California unprecedented: “Is this a budget issue or a human rights issue?” he asked.

Sylla worked on other health law issues before receiving a collect call from the LA Country jail from an inmate who wasn’t receiving his AIDS medications. She quickly learned that distribution of AIDS medications in LA County jails was “insanely horrible.” She found inmates who were forced to take drugs different from those prescribed by their doctors as well as those forced to wait weeks for access to their medications. Her work turned to providing direct services to county prisoners.

HIV prevention is another significant issue in prisons. “In the United States, one in four people with HIV pass through the prisons, jails, and corrections system,” Sylla said, yet most prisons forbid sex between inmates (even though such behavior occurs frequently). As Sylla worked to get condoms available for inmates, this situation caused a “culture clash”: “[Prison officials] say, ‘it’s illegal for inmates to have sex, so how can we allow condoms?” She looked forward with guarded optimism, citing a successful case study in which condoms were provided in a prison outside Vacaville, CA. The success caused prison officials to begin to change their views.

After the panel, I spoke with Aaron Aronow, M.D., an associate Clinical Professor of Neurology at USC and a longtime AIDS activist. He noted, with optimism, the unprecedented funding increases in funding to the National Institute of Health. “We have an Administration now that clearly understands civil rights, more than at any other time in my lifetime,” he said. “Do I see the results translating down into increased programs and health for people on a daily basis? Not to a large enough degree yet.”

Yet both Hanssens and Aronow strongly agreed that it’s too soon to tell whether the Obama Administration will do what’s necessary to obtain a sufficient HIV/AIDS policy. “We can’t judge an administration in less that a year, given our country’s current circumstances and the backlash facing President Obama,” said Aronow. “We’re still waiting to see if the programs and research and result in real differences for people.”