Closing the Book on 2017

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

This year, 2017, marked the ADAP Advocacy Association's 10th Anniversary, and it certainly wasn't without new accomplishments by our efforts, as well as plenty of political fireworks in Washington. It is clear that the uncertainty present at the start of the year remains as this year comes to a close. In fact, World AIDS Day — often viewed as an opportunity to reflect and grow — was widely tempered by the uncertainly being perpetuated by the man occupying the White House. Closing the book on 2017 is bitter sweet!

Our World AIDS Day Message to President Donald J. Trump sums up the "bitter" part of that statement. It really needs no further commentary, at this time.

But the year wasn't without the "sweet" moments, and that much should be celebrated! We were proud to partner with the Professional Association of Social Workers in HIV/AIDS to educate social workers and other key stakeholders about some key issues impacting our community. They included experts presenting on various issues, such as patient assistance programs, housing, transgender health, and substance abuse. The webinar archives are available online.

Our 10th Annual Conference lived up to its reputation as being the premier event for people living with HIV/AIDS concerned about the AIDS Drug Assistance Programs. With one of our most diverse line-up of conference speakers, it certainly challenged conference attendees to think outside of the box in the Age of Trump! This year we had advocates from 23 states in attendance, while also funding 50 scholarships!

In 2017, improving access to care among transgender men & women living with HIV/AIDS under Ryan White/ADAPs was one of our focus areas. To that end, we made a available a series of important resources — including an infographic, policy white paper, and Twitter chat. We were proud to partner with RAD Remedy to accomplish these important tasks. We applauded RAD Remedy earlier this year when they issued their National Standards of Care for TGIQ Health.

Of course, there was plenty of other advocacy activities throughout the year. They can be viewed on our website at adapadvocacyassociation.org. The New Year will be upon us rather quickly, and we look forward to continuing our work with you.

You Wanna Buy Some Death Sticks?

By: Jonathan J. Pena

At the age of 15, I took a drag off of my first cigarette and like many teens it was a response to a curious nature that was coupled heavily by peer pressure. The cool menthol taste coating my throat gave me excitement knowing that in a few seconds I would be exhaling a puff of cascading smoke in front of my peers. From that point on, I can remember smoking up to two packs of cigarettes a day. My lungs hurt just thinking about it now. Smoking cigarettes, as we all know, is a terrible habit to pick up. It has many damaging chemicals and compounds that can lead to some serious illnesses that can be fatal. Living with HIV requires a focus on living a healthier life, so it begs the question: what are the consequences of lighting up while on antiretroviral treatment?

Photo Source: Star Wars: The Clone Wars

In the United States, more than 4 in 10 people living with HIV are smokers, and people within this population are at great risk of dying from lung cancer according to a recent article published in POZ magazine. They also highlighted findings from a preceding published Danish research study in 2012 indicating that those who smoked and also were HIV-positive would lose 12 years of life in comparison to nonsmokers.[1] Poof, up in smoke! 

An additional study was noted by POZ Magazine from the research team at Massachusetts General Hospital that published their findings in JAMA Internal Medicine. They were interested in finding the estimated risk of lung cancer with people living with HIV in the United States. Through computer simulation the parameter of interest also include current, former smokers and those who never smoked. The study estimated that 25 percent of people who were smokers, HIV-positive and adherent to their antiretroviral (ARV) therapy would die of lung cancer. That number is estimated to be 6 percent if a smoker quits by 40 years of age.[2]

Some additional information was published by NAM's AIDS Map that further illustrates the growing concern with smoking and being HIV-positive. They indicated that in 2015, 40 percent of people living with HIV/AIDS in the United States were smokers. This was in contrast to only 15 percent of the general public. Additionally, what their finding show is that those who are adherent to their medication are 6 to 13 times more likely to die of lung cancer instead of an AIDS related sickness.[3]

I smoked for many years even after my HIV-positive diagnosis. I can understand why so many people living with HIV smoke. As a former smoker, I saw smoking as the one vice that I was able to allot myself because, heck, I was already HIV-positive so why the hell not? Thankfully, through fantastic leaps in modern medicine and no small amount of personal maturity, I am able to light up my life with healthier alternatives like exercising, eating well and continuing to adhere to my medication.

We owe it to ourselves to be more health conscious on what we put into our bodies, especially for those of us living with the virus. Our hands have the ability to do so many great things that involve creation, innovation, and love but all of that would be diminished or lost if we decide to replace it with "death" sticks.

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates. 

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[1] POZ Magazine (2017, September 18); 1 in 4 Smokers on Successful HIV Treatment Projected to Die of Lung Cancer. Retrieved from https://www.poz.com/article/1-4-smokers-successful-hiv-treatment-projected-die-lung-cancer.
[2] POZ Magazine (2017, September 18); 1 in 4 Smokers on Successful HIV Treatment Projected to Die of Lung Cancer. Retrieved from https://www.poz.com/article/1-4-smokers-successful-hiv-treatment-projected-die-lung-cancer.
[3] Alcom, Keith. (2017, September 19). Smokers with HIV doing well on treatment now at greater risk of lung cancer than AIDS. NAM Publications. Retrieved from https://www.aidsmap.com/Smokers-with-HIV-now-at-greater-risk-of-lung-cancer-than-AIDS/page/3173651/.

A World AIDS Day Message to President Donald J. Trump

By: Brandon M. Macsata, CEO, ADAP Advocacy Association

It has been less than one year since Donald J. Trump was sworn into office as the 45th President of the United States. In that short period of time, Trump has wreaked havoc in the hearts and minds of the people living with HIV/AIDS in the United States because he has continually demonstrated a flagrant disregard for the public health system designed to help them. The hashtag #SaveOurCare has come to symbolize the very real concerns felt by people living with HIV/AIDS (and many others) in this country. However, World AIDS Day provides a unique opportunity to send a stern message to him that it will not be tolerated by the 1.1 million people in the United States living with HIV/AIDS.

Photo Source: businessinsider.com

Aside from the insistence on repealing the Affordable Care Act, or Obamacare (which certainly has its share of problems), Trump has sought to undermine the marketplace exchanges. These exchanges have proved vitally important to people living with HIV/AIDS by linking them to health insurance purchased via the AIDS Drug Assistance Program (ADAP), as well as other means. Aside from being more cost effective than direct purchase options, it also affords people living with HIV/AIDS more supports and services. Why would he want to take that away from us?

At numerous times during the debate over the healthcare law, it was even suggested that the protections for pre-existing conditions be rolled back to the pre-Obamacare era. This would probably be one of the single most detrimental changes in healthcare-related public policy for this already underserved population. According to HIV.gov, "Insurers also are prohibited from cancelling or rescinding coverage because of mistakes made on an application, and can no longer impose lifetime caps on insurance benefits."[1] People living with HIV/AIDS already face a disproportionate share of discrimination and stigma without having to worry about being denied access to care and treatment. Why would he want to take that away from us?

Trump has also sought to undermine Medicaid, which is one of the most troubling aspects of his so-called healthcare reform agenda. Again, according to HIV.gov, "Medicaid is the largest payer for HIV care in the United States, and the expansion of Medicaid to low-income childless adults is particularly important for many gay, bisexual, and other men who have sex with men (MSM) who were previously ineligible for Medicaid, and yet remain the population most affected by the HIV epidemic."[2] In fact, Medicaid serves as a lifeline for many of our peers. Why would he want to take that away from us?

To make matters worse, Trump's proposed budget was riddled with cuts to the public health safety net on numerous fronts. Our blog earlier this year, "Trump's Proposed Federal Budget Puts Bullseye on People Living with HIV/AIDS (and many other chronic conditions)," spelled out these problematic proposed cuts. Although his budget flat-funded ADAPs, it called for draconian funding cuts to numerous federal programs specifically designed to assist people living with HIV/AIDS (including some authorized under the very same Ryan White).[3] Why would he want to take that away from us?

Most recently, Trump's plan to address the opioid epidemic in this country (which we applaud) was also accompanied by a significant zinger against the HIV/AIDS community. The plan came with no new money to fund the national emergency response, rather seeking to take the needed funding from existing programs. In other words, robbing Peter to pay Paul. Drew Gibson's op-ed laid out a stinging indictment against the possibility of taking money away from serving people living with HIV/AIDS to fund this initiative.[4] Why would he want to take that away from us?

Photo Source: desicomments.com

On World AIDS Day, let us collectively send a message to our government that ENOUGH IS ENOUGH. We have lost too many lives...we have made so much progress...and we are so close to ending the epidemic! Our message is a simple one: Save Our Care!

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[1] HIV.gov. (2017, January 31). The Affordable Care Act and HIV/AIDS. United States Department of Health and Human Services. Retrieved from https://www.hiv.gov/federal-response/policies-issues/the-affordable-care-act-and-hiv-aids.

[2] HIV.gov. (2017, January 31). The Affordable Care Act and HIV/AIDS. United States Department of Health and Human Services. Retrieved from https://www.hiv.gov/federal-response/policies-issues/the-affordable-care-act-and-hiv-aids.

[3] ADAP Blog. (2017, May 25). Trump's Proposed Federal Budget Puts Bullseye on People Living with HIV/AIDS (and many other chronic conditions). ADAP Advocacy Association. Retrieved from http://adapadvocacyassociation.blogspot.com/2017/05/trumps-proposed-federal-budget-puts.html.

[4] Gibson, Drew. (2017, October 31). President Trump's Opioid Response Could Reduce Ryan White HIV/AIDS Funds by $21 Million. TheBody.com. Retrieved from: http://www.thebody.com/content/80551/president-trumps-opioid-response-could-reduce-ryan.html?ic=tbhtrump.