Wednesday, August 26, 2015
By Joseph Quinn, EI blogger
In July, the federal government released an update to the “National HIV/AIDS Strategy for the United States” that sets forth an overall vision, establishes four major goals, and projects an ambitious list of outcomes to be achieved by 2020. That Vision states: “The United States will become a place where new HIV infections are rare, and when they do occur, every person, regardless of age, gender, race/ethnicity, sexual orientation, gender identity, or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”
While great strides have been made since the beginning of the HIV/AIDS epidemic, this strategy makes clear that there is still much to be done, especially in the case of vulnerable populations where HIV is still a growing problem and access to care is limited or non-existent. Early identification and treatment are crucial in eradicating the epidemic. Annual deaths have declined, but the number of new infections has been static and the number of people living with HIV is growing. Early treatment for HIV reduces the risk of onward transmission by 96 percent. More than 90 percent of new HIV infections in the United States could be averted by diagnosing people living with HIV and ensuring they receive prompt, ongoing care and treatment.
Goal 1. Reducing New HIV Infections
Reaching this goal involves expanding screening to reach ethnic, gender, age, geographical and other demographics where HIV is still prevalent, but which have eluded testing, including people from communities that have historically been poorly served by mainstream health care systems.
This goal also includes identifying and addressing factors that frequently co-occur along with HIV, including sexually transmitted infections [STIs], substance use, depression and other mental health issues, intimate partner violence [IPV], viral hepatitis infections, heart disease, incarceration, poverty, homelessness, and unemployment. In addition it encourages expanded access to effective prevention services, including pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP).
Goal 2. Increasing Access to Care and Improving Health Outcomes for People Living with HIV
An important factor in realizing the second goal is the implementation of the Affordable Care Act, which forbids the exclusion of people with pre-existing conditions, as well as discrimination against people with HIV, and makes insurance-covered or inexpensive HIV testing widely available. Without this coverage the high cost of treating a person with HIV ($250,000 to $400,000 over a lifetime) would be prohibitive.
Despite this expanded access, there is still much to be done to ensure that everyone has access to team-based, patient-centered care from a culturally competent and skilled workforce with a range of providers such as peer navigators, nurses, doctors, case managers, pharmacists, and social workers. Health care services that are respectful of and responsive to the health beliefs, practices, and cultural and linguistic needs of diverse patients will also help bring about positive health outcomes.
Goal 3. Reducing HIV-Related Disparities and Health Inequities
HIV health-related disparities affect Black, Latino, and American Indian/Alaska Native people, transgender people (especially Black transgender women), and young people. The disparities exist in such areas as housing, education, employment, and family and social support systems. It is especially important to educate health and wellness practitioners to equip them to deliver culturally appropriate care to such underserved communities.
Promotion of disclosure of HIV status must be accompanied by protections for people living with HIV. This calls for a continued commitment to civil rights enforcement. The Americans with Disabilities Act (ADA), whose twenty-fifth anniversary occurred in 2015, is the landmark civil rights law that has proven so vital to the protection of people with disabilities, including HIV.
Goal 4. Achieving a More Coordinated National Response to the HIV Epidemic
Greater coordination is necessary across the Federal government and between Federal agencies and State, territorial, Tribal, and local governments. Also necessary is a stronger, shared data infrastructure to provide critical information, including client-level data in order to measure individual health outcomes.
These goals are admittedly aggressive and will be expensive to implement. There will undoubtedly be push back from those at all levels of government who will fight the expenditures and refuse to acknowledge the vital importance of this HIV/AIDS strategy for the overall health of the nation. But the hope is that given this inclusive, detailed plan, the strategy’s goals will be implemented, outcomes achieved, and its vision become a reality by 2020.
Note: This article is based on and includes material from the official government document, which can be viewed at: www.AIDS.gov/2020
Saturday, August 22, 2015
August 19, 2015
By Lee F. Carson
Emotional wellness is an important aspect of living a healthy life as we age. Unfortunately, many people pay much more attention to their physical health while focusing less on their emotional wellness.
For example, many who are experiencing physical discomfort of any kind will consult a medical professional rather expeditiously to find out what is going on in their body. But most do not treat their emotional health with the same urgency. We may choose to ignore it, try to work through it on our own or hope it will simply go away. The reality is that most of us in our lifetime, especially as older adults, can benefit from emotional “tune-ups.”
The World Health Organization defines mental health as “a state of complete physical, mental and social well-being, and not merely the absence of disease.” As we get older, we are more likely to experience life events that may challenge our emotional wellness. The loss of parents, siblings, partners or friends may send us into a state of emotional imbalance. Being a caretaker for a loved one who is ill can be a very difficult situation and can take a toll on our emotional well-being.
Additionally, medical reasons can contribute to a state of depression. Research suggests that mental-health conditions have a genetic component to them, so that a person could be at a genetic predisposition if he or she has a family member living with a mental illness, especially if it is a first-degree (parent, sibling) or second-degree (grandparent, aunt, uncle, etc.) family member. Having this awareness can help you realize what may be going on so you can choose to access the support you need.
The U.S. Trans Survey (USTS) is now available online. The USTS is the largest survey ever devoted to the lives and experiences of trans people. All trans-identified people, including genderqueer and non-binary people, at any stage of their lives, journey, or transition, are encouraged to participate in the USTS. The survey will be available through September 21st.
As the follow-up to the National Transgender Discrimination Survey (NTDS), the USTS will become the community’s go-to source for information about the lives and experiences of transgender individuals. The survey is designed to examine specific issue areas that disparately impact trans communities, such as unemployment and underemployment, housing, health care, HIV/AIDS, disabilities, immigration, sex work, and police interactions.
To learn more or to take the survey, please visit http://www.ustranssurvey.org/
Wednesday, August 19, 2015
A new academic research study is recruiting lesbian, bisexual, and queer women to complete a survey exploring issues that affect breast and cervical cancer screening usage of sexual minority women. Current research suggests that sexual minority women are at greater risk from breast and cervical cancer. This study will be used to gain a better understanding of the specific factors that contribute to lesbian, bisexual and queer-identified women’s breast and cervical cancer screening utilization.
Participation is anonymous and will take 10-15 minutes. More information about the study is provided on the informed consent letter on the first page of the survey. This study has been approved by the Harvard University Institutional Review Board.
Reprinted from www.theatlantic.com
By Mo PerryWhen Brett, a 69-year-old man from St. Paul, Minnesota, went to visit his dying mother in a nursing home a few years ago, he began to worry in earnest about his later years.
“I’ve been in institutions most of my life,” says Brett (his last name has been withheld to protect his privacy), who spent his teenage years in a series of foster homes and juvenile detention centers, estranged from his family. “It never scared me. But I won’t get to be in a nursing home like my mom was.” His own experience, he fears, will be much different.
Brett, who is transgender, has a full beard, a low speaking voice, and has had his breasts removed. But he never had sex-reassignment surgery, meaning that his transgender status would quickly become obvious to a nursing-home aide charged with bathing or dressing him. Like many transgender seniors, he worries what this will mean for him once he enters a nursing home or assisted-living facility.
Currently, there are more than 1.5 million LGBT people over 65 in the U.S., a number expected to double over the next 15 years as the population ages. But precise statistics on older transgender adults—or, for that matter, transgender people of any age—are hard to come by. One 2011 study using health-survey data estimated that the country’s transgender population was around 700,000; this past May, the Census Bureau published a study that analyzed the number of “likely transgender individuals” based on the people who had changed their name (around 90,000) or sex (around 22,000) with the Social Security Administration.