Monday, January 31, 2005

National Condom Week . . .

occurs every year February 14-21. (This is not to be confused with the British Condom Week, which occurs in May. Canada has apparently switch from "National Condom Week" to "National Sexual Health Awareness Week.")

Some light-hearted, but perhaps out-of-date, information is available at Condomania. Here's a Planned Parenthood press release from last year's Condom Week.

National Black HIV/AIDS Awareness Day . . .

will occur on February 7 this year. For more information, go to http://www.blackaidsday.org/NBHAAD_info_home.htm.

Friday, January 28, 2005

Texas Senate committees, too

Lt. Governor David Dewhurst has announced the appointment of Senate standing committees for the 79th Texas legislature. A list of committees with links to members is available on the capitol website. The Texas Senate website also has a list of committees with useful links. However, the Senate website has not yet been updated to reflect today's appointments.

Members of the Texas HIV/AIDS community will be most interested in the work of the Senate Committees on Finance and Health & Human Services. However, other legislation of interest will be referred to other committees, so it will be helpful to bookmark the entire lists of committees as well.

Texas House committees appointed

Speaker Tom Craddick has announced the appointment of House committees for the 79th Texas legislature. The capitol website provides a list of committees with links to membership lists. In addition, the House website provides a similar list of committees with a slightly different set of links. However, the House page has not yet been updated to reflect the new appointments.

Here is the speaker's press release on the committee appointments. Printable PDF documents with committee appointments can be found here.

The Texas HIV/AIDS community will be interested in the House Committees on Appropriations (especially the subcommittee on health and human services) and Public Health. Bills of interest will, however, be referred to other committees, so it is worthwhile to bookmark the links for the whole list of committees for easy access to useful information.

Thursday, January 27, 2005

H.R. 308: To amend title II of the Social Security Act to eliminate the 5-month waiting period

Congressman Mike McIntyre (D-NC) has introduced H.R. 308, "To amend title II of the Social Security Act to eliminate the 5-month waiting period for entitlement to disability benefits and to eliminate reconsideration as an intervening step between initial benefit entitlement decisions and subsequent hearings on the record on such decisions." The bill has been referred to the House Committee on Ways and Means.

The text of the bill is not yet available on Thomas. It should be available in a couple of days.

Wednesday, January 26, 2005

U.S. Women at Greatest Risk of Sexual Disease: Study

Why does this not surprise me?
LONDON (Reuters) - Americans, and especially women, are three times more likely to suffer premature death and adverse health due to sexual activity than people in other rich nations, scientists said on Thursday.

Researchers from the U.S. Centers for Disease Control (CDC) found some 20 million cases of adverse health conditions and 29,745 deaths in the United States in 1998 were related to sexually transmitted diseases.

"The research showed the sexual behavior attributable health burden is about three fold higher in the U.S. than other developed countries," Dr. Shahul Ebrahim, one of the authors of the CDC study, told Reuters.

"All of it is totally preventable and that's the message."

Ebrahim said the health burden included conditions such as infertility, abortions and infections such as gonorrhea.

Women accounted for 62 percent of all adverse health cases, with most female deaths attributable to cervical cancer and HIV.

Deaths from curable sexually transmitted diseases were, however, rare among both men and women.

The paper, published in the journal Sexually Transmitted Infections, was the first attempt to generate comprehensive findings on the health burden related to sexual
behavior in the United States.
Citation: Sexual Behavior- Related Adverse Health Burden in the United States. H. Ebrahim, M. T. McKenna, and J. Marks Sex Transm Infect 81: 38-40 (February 2005).

More information is available in this HealthDay-reported article.

Tuesday, January 25, 2005

Making a district visit

Well, I just lost this post somehow. Fumble fingers on the keyboard, I guess.

Anyway, as I was trying to say: Your elected representatives have offices both at the capital (Austin or Washington) and in their home district. Making a visit to the district office is a good way for advocates to have an impact on legislation without the added expense of traveling to the capital.

Texas AIDS Network has developed a brief PowerPoint presentation to give you some tips about finding your representatives' district offices as well as how to get the most out of your visit. The presentation is called, originally enough, "The District Visit."

Right now the Texas legislature is in session, but, in these early days of the session, legislators frequently leave Austin on Thursday evening and return on Monday. Their district staff members are, of course, available all week long.

Congress is in session, too, but Congress takes a lot of breaks for "district work periods." The district staff members are also available even when Congress is in session.

Monday, January 24, 2005

Who represents me?

Texas AIDS Network has provided a new PowerPoint presentation called "Who Represents Me?" to assist advocates in identifying their elected representatives. In 17 slides, the presentation explains the system for representation and points to web sites where advocates can enter their home addresses to find their state representative and senator as well as their U.S. representative. Full contact information for statewide representatives (including the President and Vice President) is also provided.

Wednesday, January 19, 2005

Food for thought

From the Boston Globe

WASHINGTON -- Disability benefits may not be safe from the across-the-board cuts that are likely in President Bush's proposal to allow personal investment accounts in the Social Security program.

Retirement and disability benefits are calculated using the same formula, so if future promised retirement benefits are cut, then disability benefits also would be reduced -- unless the program is somehow separated.

This raises big questions about how investment accounts would be structured for the disabled, especially if they are injured at a young age or are dependent on a parent. Disabled beneficiaries typically work less and need benefits sooner, so the accounts would not provide enough income to them.

. . .

Currently, disabled workers move seamlessly through the Social Security system, often unaware they draw their benefits from the disability program until they reach retirement age and shift to the retirement program. That would change with investment accounts, advocates say, with people falling through holes in a new system.

About 16 percent of the 47 million people receiving Social Security benefits are disabled workers and their dependents. The impact of accounts on beneficiaries who aren't retirees has not been publicly discussed by the Bush administration.

. . .

Thursday, January 13, 2005

Help save Medicaid for people with HIV

Below is an organizational sign-on letter written by the HIV Medicaid/Medicare Working Group. As you have likely heard, there is great concern that there will be efforts this year to cut funding and/or make harmful changes to Medicaid. This letter urges the President not to make such changes/cuts and explains the importance of Medicaid for people with HIV/AIDS.

The letter will be sent to the President and key Administrativeofficials, and will be distributed to Members of Congress during legislative visits in early February. Please help with this effort by signing your organization to the letter and encouraging others to do the same.

To sign this letter (organizations only), email Lei Chou at theaccessproject-at-aol.com

Please provide the following information:
  • Organization Name:
  • Address:
  • City/State/Zip:
  • Phone:
  • Contact person/Title:
  • email:

Deadline: 5 pm EST, Friday January 21st.

If you have any questions, contact Ryan Clary at rclary-at-projectinform.org . To sign-on, email theaccessproject-at-aol.com.

The President
The White House
Washington, DC 20500
Date

Dear Mr. President:

The undersigned organizations that serve and advocate for people living with and at risk for HIV/AIDS are writing to strongly urge you not to propose cuts in Medicaid funding and/or any changes in the program's structure that would alter the open-ended financing for states. We also urge you not to weaken the individual entitlement or other key consumer protections that have helped Medicaid to serve the national interest so effectively for nearly four decades.

Medicaid is the largest source of federal financing for HIV/AIDS care in the United States. The program provides access to healthcare for 55% of all people living with HIV/AIDS, and 90% of all children living withAIDS. It plays a critical role in providing access to anti-HIV drugs that forestall illness and disability, and allow people to live longer, more productive lives. While Medicare and the Ryan White CARE Act are vital components of the national system of health care for people withHIV/AIDS, they do not have the resources and are not appropriately designed to respond to unmet needs if structure changes were made to Medicaid that would result in either fewer people qualifying for coverage or if states were forced to restrict services. Thus, any cuts or changes in Medicaid's financing structure will seriously jeopardize access to HIV/AIDS care in the United States.

Furthermore, we are firmly opposed to changes in the current structure of the Medicaid program that would turn the program into a block grant or cap federal funding. The individual entitlement provided underMedicaid is essential. The reliable and consistent federal funding stream allows the program to respond to increases in demand as more people with AIDS are identified - an important goal of the Centers forDisease Control and Prevention's Advancing HIV Prevention initiative, and supports access to more effective, less toxic anti-HIV therapies as they are developed.

The health of our country's most vulnerable residents must be viewed as a priority. We ask that you create a budget proposal for FY 2006 that ensures adequate Medicaid funding and maintains the program's current structure so that it can continue to meet the needs of people with HIV/AIDS and others who rely on this lifesaving program.

Sincerely,

Texas AIDS Network has signed on to the letter and urges other organizations to do the same.

Tuesday, January 11, 2005

Who is my representative?

There are several places to go to find out who your representatives in the Texas Legislature are. (Everybody has one each in the Texas House of Representatives and the Texas Senate, by the way).

The Texas Legislature provides a locating service at http://www.capitol.state.tx.us/fyi/fyi.htm (the "fyi" used to stand for "Find Your Incumbent," but the page is now simply called "Who represents me?"). You can search for your personal representative by entering your home address. Representatives can also be searched by city and county, which can be useful if your city or county is represented by more than one person and you want to visit/contact all of them. Be sure to note that senators and representatives usually have an office in Austin at the capitol and one or more offices in their home district.

If you already know who your representatives are, you can find listings for their district offices in the blue pages of your local telephone directory.

If you don't like web searches, you can also call the voter registrar for your county to ask who represents you. However, you will still probably have to consult those blue pages for contact information.

Monday, January 10, 2005

What to do right now about appropriations

The 79th Texas Legislature convenes at noon tomorrow (January 11). For the following 140 days, legislators will consider 5000 or so bills and pass a budget for the next biennium--2006-2007. Most of the bills will die somewhere in the legislative pipeline, and a lot of attention will be given, both in the press and on the floor of both houses, to critical state issues relating to school finance and reform of child and adult protective services. Even so, at the end of 140 days, the legislature must pass an appropriations bill.

We can expect to have several opportunities to influence the decisions to be made regarding the appropriations bill. Indeed, Texas AIDS Network has already been active in testifying at hearings during the past several months to advocate for increased funding for HIV. There are, however, a number of things that individuals and organizations can do right now to help legislators to focus on HIV and its funding needs in Texas.


  • Make sure that concerned persons in your community are aware of the impending shortfall in HIV funds in the next biennium. Tell them that the Texas HIV Medication Program needs $15.9 million in new state funds in order to maintain services at the current level. Concerned persons would include:
  • People living with HIV/AIDS
  • Their family members and caregivers
  • Health professionals
  • City Council members
  • County Commissioners
  • Hospital district
  • Local AIDS service organizations
  • Ryan White planning groups
  • Faith-based organizations
  • Allied organizations (e.g., Red Cross, PFLAG, etc.)
  • Gather a group (4 or 5 at most) of people from diverse backgrounds (so you can share different perspectives on the issue) and visit the local district office of your state legislators. Meet with the staff who support the legislator in the district to talk about how HIV/AIDS affects the district (or local area/city/county) and how important the Texas HIV Medication Program is to clients in the area. Request the legislator's support for $15.9 million in new state funds for HIV.
  • Note that legislators usually stay in Austin Monday-Thursday during the early weeks of a legislative session, so that it may be possible to meet with your legislator in the district on a Friday. However, staff members are critically important in helping legislators understand the importance of some issues. You should not hesitate to meet with staff members if the legislator is not available.
  • Try to leave something in writing so that your facts and figures don't get forgotten. Providing contact information for follow up questions is also a good idea.

These are two activities that would be most helpful in the next two or three weeks. If you take any of these actions, be sure to let us know by email or in the comments.

Friday, January 07, 2005

THMP MAC meets

The Texas HIV Medication Program (THMP) Medication Advisory Committee (MAC) met today in Austin to discuss the formulary and budgetary issues.

Two new additions to staff were introduced: Felipe Rocha, MSSW, is now manager of the HIV/STD Comprehensive Services Branch (what used to be the HIV Bureau), and Janna Zumbrun, MSSW, is now manager of the Health Promotion Unit (the next organizational level above the HIV Services Branch).

Robert Kaspar, MD, provided an update on Fuzeon: THMP is currently providing Fuzeon to 50 clients, the maximum possible with current funding. There are 12 clients on the waiting list for Fuzeon. Dr. Kaspar also reported on ongoing discussions regarding the use of ritonavir as a fifth drug in combination therapies; for the time being each request for a five-drug combination will be reviewed on a case-by-case basis.

Regarding appropriations for the coming biennium, Dwayne Haught, MSN, ACRN, reported that the Legislative Appropriations Request for the medication program had been revised to reflect new data. The request is now $11,701,085 for FY 2006-2007. In addition, the Department of State Health Services is requesting the restoration a 5 percent cut imposed by state leadership. THMP's share of that 5 percent cut is $4,171,240. Therefore, the total amount in new state funds needed for the coming biennium will be $15,872,325.

Texas AIDS Network will be sending out action alerts and other advisories to members and interested members of the community. To sign up to receive these alerts, send an email to tan-at-texasaids-dot-net (using the proper email address format, of course).

Thursday, January 06, 2005

Unfortunate juxtaposition

USA Today ran a series of op/eds on Monday (January 3) that explored both the divergence of opinion about values in our country and the desire (in most cases) to find some common ground. An especially interesting op/ed came from a minister in Texas.

Congregation's values are broad and inclusive

I lead a predominantly white evangelical congregation of about 800. Each election, I urge our folks to vote their convictions. In November, most of them decided that the incumbent Republican best represented their values. Yet, for decades, these same folks have consistently voted for a Democratic congressman for the same reason.

Who doesn't vote their values? My first vote was cast for George McGovern because I wanted legalized marijuana. My values have changed, but I still vote my values. But my values and those of my brethren are much broader than those attributed to us.

Yes, we detest abortion, but our church collects furniture for young single moms. We also adopt children and serve as foster parents.

Yes, we believe that marriage is for one man and one woman, but we also have loved and cared for victims of AIDS.

A wonderful black man serves on our church board, and I cry against racial discrimination from the pulpit because we detest racism.

We are stewards of the Earth. I collect used copy paper from the office, bind the pages and reuse them as notepads to save a tree.

We care for the poor and therefore help to provide housing for homeless families.

In November, we chose the man who seemed to best resonate with our values, but please don't paint us with a Republican brush. If Sen. John Kerry had been running against McGovern, most of us would have given our vote to Kerry.

Jim Johnson, White Oak, Texas [emphasis added]


My personal values lead me to think that Jim Johnson must be a very fine person; I know a lot of people who seem to feel and act the way he portrays his congregation. My professional concern, however, is that Jim Johnson sets opposition to same-sex marriage right next to care for persons with AIDS as if the latter mitigates the other. Mitigation can only occur if the two are equivalent or nearly so. In this case, there is no equivalence, since the underlying assumption appears to be that AIDS is a gay disease, such that opposing equal rights for healthy gay persons is mitigated by caring for gay people who are ill or dying.

HIV in Texas is increasingly black or brown and increasingly heterosexual. In 2003, 35 percent of the HIV cases reported were identified as white. However, 41 percent were African-American and 22 percent were Hispanic. Of all the new cases of HIV reported in 2003, 26 percent were female. Of those cases where mode of transmission was known, more than 24 percent were due to heterosexual transmission. This rate of transmission is higher than that which can be attributed to IDU (18 percent).

While these numbers leave plenty of room to recognize that HIV infection is still a major concern to the gay community, those who are at risk for infection are increasingly people of color and women (who are often both). We increase their risk when we imply or allow others to imply that HIV is limited to the gay community.

The fine folks in Jim Johnson's congregation should be applauded for their compassion. There is great need of it in White Oak, which is located in Gregg County. Gregg County reported 21 new cases of HIV and 9 new cases of AIDS in 2003. There were 229 people living with HIV and AIDS in Gregg County on December 31, 2003. Many of them are undoubtedly gay, but there is every likelihood that some are women.

Wednesday, January 05, 2005

Alcohol May Boost HIV Risk from Oral Sex

ABS News carried a story that I missed a couple of weeks ago regarding the role of alcohol in HIV transmission. As timely as the story was during the holiday-partying-drinking season, it's still timely as we approach any given weekend or happy hour of the year. The story is based on a Reuter's report about a research study published in the Journal of Acquired Immune Deficiency Syndromes (December 1, 2004).

The study itself reports that "Lab experiments show that cells that line the mouth become more susceptible to infection with HIV when they're exposed to alcohol." Specifically, "oral epithelial cells exposed to 4% ethanol for 10 minutes showed three- to six-fold greater susceptibility to infection with HIV strain." That's the level of alcohol in a beer, by the way.

Tuesday, January 04, 2005

Hiatus

Aside from the activities of the holiday season, I have not been able to post due to a family illness. Regular posting should be back on track now.