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Wednesday, June 07, 2017

BEYOND AIDS POSITION, HIV EXPOSURE PENALTIES; CA SB 239

The following letter to California state Senator Scott Wiener outlines the Beyond AIDS position on this controversial issue. Beyond AIDS will engage in dialog with any party in any state concerning solutions to this troublesome issue.



June 2, 2017

Honorable Senator Scott Wiener
California State Capitol
Sacramento, CA

RE: WE OPPOSE SENATE BILL 239 AND SUGGEST AMENDMENTS TO CHANGE THE BILL

Dear Senator Wiener:

Beyond AIDS opposes SB 239, because it eliminates safeguards to public health. Beyond AIDS is a national organization, based in California, which is dedicated to reversing the HIV/AIDS epidemic through sound public health policy. The wording in SB 239 substituting for existing law fails to provide a disincentive to irresponsible willful or negligent behavior that endangers unknowingly exposed persons. The bill also does not take into account scientific advances that determine the degree of communicability.

In recent years, a virtual ideology has arisen in the name of “decriminalization of HIV.” We believe that this way of thinking is dangerously erroneous, and regret that it seems to have persuaded a number of well-intentioned organizations to support this bill as well as periodic initiatives in other states.

Penalties against endangering the lives and health of others are universal and considered necessary among all societies on earth, and they are directed at dangerous behavioral abuses rather than at a state of being. Thus, shooting at someone without cause is illegal, but this does not “criminalize” gun ownership or serve as a disincentive to it. Similarly, dangerous acts in a vehicle such as driving a car into a crowd of pedestrians, or negligently running someone over, are illegal, but that does not “criminalize” or serve as a disincentive to driving, car ownership, or obtaining a driver’s license. 

Similarly, behaving in a dangerous manner that exposes others to a significant risk of HIV infection must be illegal, and that does not “criminalize” HIV or serve as a disincentive to being tested.
Another invalid argument against penalties for dangerous behavior exposing others to HIV is that they somehow add to the stigma of HIV, or of minorities that have higher HIV prevalence rates. The opposite is more likely and logical, i.e., people with HIV, gay men, etc. should be less subject to stigma as a source of danger, if it can be noted that they are unlikely to endanger others since there would be penalties for that. Dangerous behavior may be committed by anyone, and cannot be attributed only to one group.

We shall take this opportunity to address the various things that SB 239 would do, so that we can explain our specific objections and some alternative proposals that take into account recent scientific evidence. The statements about existing law come from the Legislative Counsel’s statements in the bill itself.

      A. Existing law makes it a felony punishable by imprisonment for 3, 5, or 8 years in the state prison to expose another person to the human immunodeficiency virus (HIV) by engaging in unprotected sexual activity when the infected person knows at the time of the unprotected sex that he or she is infected with HIV, has not disclosed his or her HIV-positive status, and acts with the specific intent to infect the other person with HIV.  SB 239 would repeal this provision.

There are valid criminal justice and public health justifications for this provision of law. This type of egregious behavior should be treated similarly to assault with intent to inflict death or grievous bodily harm. Although current treatment helps most patients with HIV to live for many years, HIV/AIDS is still an often-lethal disease. The number of deaths attributed to HIV in 2014 was 6721, more than a sixth as high as the number of new HIV infections in 2015, 39,513 https://www.cdc.gov/hiv/statistics/overview/ataglance.html). The public health concerns are amplified by the likelihood of secondary infections. Although it is difficult to prove intent, and such prosecutions are rare, having such a provision for felony prosecution in the law serves as a warning against intentional acts to infect another person with HIV/AIDS. Softer approaches such as education will have no effect, since the perpetrator is already aware of his infection. This provision should not be repealed. Some of our Board members, however, would be comfortable with reducing the offense from a felony to a misdemeanor.

B. Existing law makes it a felony punishable by imprisonment for 2, 4, or 6 years for any person to donate blood, tissue, or, under specified circumstances, semen or breast milk, if the person knows that he or she has acquired immunodeficiency syndrome (AIDS), or that he or she has tested reactive to HIV. SB 239 would repeal this provision.

There are valid criminal justice and public health justifications for this provision of law. We need to safeguard the life-saving blood bank supply. Anyone who violates this provision has lied in the course of the blood donation process, and has endangered the public health, as well as wasting the time and resources of blood bank and laboratory staff. Knowingly donating blood or tissue if one knows one is HIV positive is a reckless endangerment of the life and health of the potential recipient. The public health concerns are amplified by the likelihood of secondary infections. There are screening tests for donated blood, but they are not foolproof, and there are some false negatives. This provision should not be repealed. Some of our Board members, however, would be comfortable with reducing the offense from a felony to a misdemeanor.

      C. Also as per the Legislative Counsel, existing law provides that a person who is afflicted with a contagious, infectious, or communicable disease, who willfully exposes himself or herself to another person, or any person who willfully exposes another person afflicted with the disease to someone else, is guilty of a misdemeanor. SB 239 would repeal this provision, and replace it with a misdemeanor penalty, but only if the exposure actually caused infection.

Negligently exposing someone to HIV is still a great public health problem, and there should be a penalty because the infected patient is already aware of his status, so further education is highly unlikely to be of any help. However, the current law is unfair in that it does not specifically require that the infected person be aware of the infection, and that the exposed person not have been informed. It is also unscientific, in that it does not mitigate punishment to the extent that and that precautions have been taken to reduce infectiousness, and it treats all contagious diseases as if they were equally dangerous and contagious. Someone with the flu who went out in public could theoretically be charged with a misdemeanor under the current wording. SB 239 would replace this with a misdemeanor penalty of up to 6 months incarceration, but only for intentional infection that actually occurred. As mentioned above, it is almost impossible to prove intent, and this would leave no recourse to persons who had been negligently exposed without their knowledge, regardless of whether they were actually infected.

The following amendments to the current provision (not in legal language) are therefore proposed:
1)   Since HIV is incurable and is so much deadlier and more serious than most other contagious diseases, many of which resolve spontaneously or are curable with treatment, it would be reasonable to limit this provision to HIV. Should it continue to apply to all contagious diseases, a clause should be added whereby the court should take into account the severity, spontaneous resolution, or curability of the infection in determining any penalty.
2)      This provision should require that the infected person be aware of the infection, and that the exposed person(s) not be informed.
3)      There should not be a requirement that the exposed person(s) actually become infected. However, the penalty could be cut in half if infection did not actually occur. This is in keeping with Penal Code Section 664, whereby an unsuccessful attempt to commit a crime generally results (upon conviction) in a penalty half that if the attempt were successful. A similar reduction in penalty for willful or negligent endangerment (as with willful exposure to HIV) seems reasonable.
4)      There should be a clause whereby the court should take into account as mitigating factors any protective measures taken by the infected person, including: a) barrier protection; b) the use of medication that reduces infectiousness; c) any recent test that gave evidence of non-contagiousness; d) the concurrent administration to the exposed person(s) of prophylactic medication that reduces the risk of acquiring the infection.
  
      D. Under existing law, if a defendant has been previously convicted of prostitution or of another specified sexual offense, and in connection with the conviction a blood test was administered, as specified, with positive test results for AIDS, of which the defendant was informed, the previous conviction and positive blood test results are to be charged in any subsequent accusatory pleading charging a violation of prostitution. Existing law makes the defendant guilty of a felony if the previous conviction and informed test results are found to be true by the trier of fact or are admitted by the defendant. SB 239 would repeal this provision.

There are valid criminal justice and public health justifications reasons for this provision of law. Even though the clients of prostitutes are violating other provisions of law, they should not be at risk of unknowingly acquiring a highly dangerous and potentially lethal infection. The public health concerns are amplified by the fact that such clients are likely to infect wives and other partners, keeping the HIV epidemic expanding. This provision in existing law should not be repealed. However, it could be made more fair and scientific. The following amendments to the current provision, and their rationale, are hereby proposed (not in legal language):

1)      If the prostitute has warned all of her clients about her infection, AND insists on the use of condoms for sexual intercourse, AND is taking antiretroviral medications and has received a most recent viral load result showing an undetectable level of virus, the heavier penalty in this provision should be waived. This provides an incentive for safe practices for the prevention of HIV, which helps to protect the public health. It also is an incentive for helping to assure that clients are not exposed without their knowledge.
2)      If the prostitute has warned all of her clients about her infection, AND EITHER insists on the use of condoms for all sexual intercourse, OR is taking antiretroviral medications and has received a most recent viral load result showing an undetectable level of virus, the offense should only be a misdemeanor, not a felony. This provides a partial incentive for safer practices, which are of benefit to public health. It also is an incentive for helping to assure that clients are not exposed without their knowledge.
  
E. Existing law requires the court to order a defendant convicted for a violation of soliciting or engaging in prostitution for the first time to complete instruction in the causes and consequences of acquired immunodeficiency syndrome (AIDS) and to submit to testing for AIDS. Existing law requires such a defendant, as a condition of either probation or participating in a drug diversion program, to participate in an AIDS education program, as specified. SB 239 would repeal this provision.
This provision should be retained, because it has benefits to public health and is not excessively burdensome.

F. SB 239 would also vacate any conviction, dismiss any charge, and legally deem that an arrest under the deleted provision never occurred. The bill would require any court or agency having custody or control of records pertaining to the arrest, charge, or conviction of a person for a violation of the deleted provision to destroy, as specified, those records by June 30, 2018. By imposing this duty on local agencies, the bill would impose a state-mandated local program. The bill would also authorize a person serving a sentence as a result of a violation of the deleted provision to petition for a recall or dismissal of sentence before the trial court that entered the judgment of conviction in his or her case. The bill would require a court to vacate the conviction and resentence the person to any remaining counts while giving credit for any time already served.

This provision of SB 239 is unwise. It is important for both public health and criminal justice to retain a record of repeat offenses that endanger public health and safety.
Beyond AIDS is willing to join in negotiations on amendments to SB 239. We suggest that this become a two-year bill, and that stakeholders discuss the above considerations during the coming months. Please notify us of any proposed amendments, as this bill moves through the Assembly.

Sincerely,

Ronald P. Hattis, MD, MPH
President, Beyond AIDS

Saturday, December 10, 2016

ANNUAL MEETING HIGHLIGHTS, NOVEMBER 13, 2016

The Annual Meeting of Beyond AIDS, and an open Board meeting of the Beyond AIDS Foundation, were held on Sunday, November 13. The central meeting place was in Redlands, California, supplemented by conference call participants from across the country.

Two of the topics discussed at the Annual Meeting, legislative activities in California this year, and reports from the International AIDS Conference in Durban, South Africa, have already been reported in separate articles. 

A special feature at the meeting was a report from Richel Strydom, the current Treasurer, about her recent work in the small African country of Lesotho (pronounced "lesutu"), which is entirely surrounded by South Africa.


Dr. Strydom, a native of South Africa, is also a Loma Linda Preventive Medicine resident. She did a residency rotation at the Maluti Adventist hospital in July 2016. She expressed appreciation to Loma Linda University and to the hospital for the opportunity. The HIV prevalence rate for ages 15-49 in Lesotho is estimated at 23.4%, second highest in the world, with higher rates in females under age 40. Partly as a result, there is a high rate of cervical cancer.

The Health Ministry adopted a “test and treat strategy” to take effect the month she was there, and she attended the introductory training. HIV meds will be offered immediately after a positive test result. This strategy, already implemented in the U.S., was endorsed by UN AIDS in 2015, but Lesotho is the first country in sub-Saharan Africa to implement such guidelines. Assistance has been assured from the Elisabeth Glaser Pediatric AIDS Foundation, and from the U.S. government President's Emergency Plan for AIDS Relief (PEPFAR) fund.

Richel discussed a plan for cervical cancer testing – every 5 years for sexually active women. However, Pap testing and high risk HPV screening are not yet routinely available there. She gave presentations at the hospital and at the school of nursing, on the importance on cervical cancer screenings, using a more primitive technique, visual inspection during a pelvic examination with acetic acid application to the cervix to identify abnormal tissue. Women with positive findings currently need to be referred by the hospital elsewhere for biopsy and treatment. She also assisted in HIV and TB care, prevention, and community education.

At the Foundation Board meeting (which followed the Annual Meeting), Dr. Strydom was presented with a certificate for having recently completed a 2-year part-time fellowship with the Beyond AIDS Foundation. Her research study, a survey of state and regional AIDS Directors, is still ongoing.

 Also still pending completion is an earlier survey of local jurisdictions in California concerning their practices for HIV partner services.

The Foundation recognized Michael Weinstein, President and founder of the AIDS Healthcare Foundation, for its annual Nettie Award, citing his courageous and innovative advocacy for HIV prevention and treatment. The award is to be presented in Los Angeles in December.

Cesar Reis was accepted as a new fellow, and Camila Araujo as a new intern. Their first duties will involve helping to complete research studies. They have also expressed interest in helping to organize an educational webinar under guidance from Beyond AIDS Vice-President Jeffrey Klausner. Further information and the application form for the Beyond AIDS Foundation's internship and fellowship program is available on the Beyond AIDS web site.


BEYOND AIDS 2016 LEGISLATIVE ACTIVITIES, CALIFORNIA

Beyond AIDS legislative activities for 2016 have focused on California. We supported a new bill that passed and was signed. In addition, we supported a voter initiative that failed, and continued follow-up on a bill that had passed recently but had not been implemented.

AB 2439 (Nazarian) will establish a pilot program to study HIV testing in hospital emergency departments. This passed, was signed into law, and will take effect January 2017. The bill was sponsored by the AIDS Healthcare Foundation and supported by Beyond AIDS. It was watered down from originally requiring all ERs to offer HIV testing. In its final version, it established a study at up to 4 hospitals to determine effectiveness.

Proposition 60, a statewide voter initiative also sponsored by AIDS Health Care Foundation, would have required condoms for adult film industry, and testing at employer expense. Beyond AIDS was named in TV ads and listed as a supporting organization in the voter booklet sent to millions of Californians. Beyond AIDS activists Gary Richwald and Jeff Klausner were both named in the booklet as spokespersons. It failed to pass at the November 8 election, 53 – 47% against with another million votes to be counted.

OSHA CA (Cal-OSHA)’s interpretation of the bloodborne pathogen standard issued years ago for healthcare institutions is that it also requires condom use for workers and employees that are exposed. The industry (producers, but with support from some actors) has fought this for years, initially stating that the actors were independent contractors and not employees, however they were found to be employees in a court case. Their fear is that if condoms are portrayed, fewer films will be sold.

Those involved in the industry, as well as the HIV/AIDS community, are also sensitive to anything involving the government telling anyone how to have sex. However, this argument fails to distinguish bedroom from "industrial" sex. From a public health perspective, we were disappointed that organized medicine (CMA) opposed the initiative out of concern for excessive litigation, because it would have allowed citizens to sue the companies. The power to sue was added to the wording because no one seems to want to enforce rules requiring condoms or involving this industry. Los Angeles voters approved a proposition similar to this one a few years ago, but there has been no enforcement; and Cal-OSHA only acts on complaints.

Beyond AIDS has been in favor of condom requirements for the adult film industry for years, and has been working on this issue for a long time. Several years ago, Denise Bleak and Ron Hattis attended CAL OSHA hearings, but no regulation was ever issued. Peter Kerndt was also an early champion. CAL OSHA has been dragging its feet, but now is talking about once more holding hearings. This issue is important not only to protect workers, but to set a standard for safe sex, since millions of people watch porn and are tempted to emulate what they see. Monica said that this may be a national issue, not just a California thing.

The number of actors in the industry over time is actually fairly large, with considerable turnover, and each performer may have thousands of exposures. There is potential transmission to the general community.

Follow-up of AB 466 of 2013, HIV Test Offering in California Primary Care Clinics

This bill passed in 2013, and has been in effect since January 2014. This law requires HIV testing to be offered if doing blood tests for something else, and if there is no recent test result on record. However, there was virtually no effort to inform the clinics or providers affected, and many still do not know about or follow it. Beyond AIDS has reached out to the California Primary Care Association and received a recent encouraging message from Dr. Mike Witte, Chief Medical Officer. The issue has also been raised at the California Public Health Medical Leadership Forum, of which Ron Hattis is Secretary.

For 2017, Beyond AIDS will look for opportunities to support any legislation and regulations in California, other states, and federally, that could enhance the control and prevention of HIV/AIDS.


Thursday, December 08, 2016

IMPRESSIONS FROM DURBAN, SOUTH AFRICA: 21ST INTERNATIONAL CONFERENCE ON AIDS, JULY 18-22, 2016

Deanna Stover, Beyond AIDS Foundation President, and Marsha Martin, Advisory Council member, represented Beyond AIDS at this conference in South Africa. They discussed their impressions at the Beyond AIDS Annual Meeting, November 13, 2016.


Marsha Martin reported that the conference had been in Durban before, in 2000. This was an opportunity to come back and see how things have moved along after 16 years. There were about 20,000 attendees, and the mood was optimistic and people were feeling good. Treatment is available, much more is being done. Science is being used on the ground. At the earlier International AIDS Conference in Durban, this was not the sentiment.

Marsha coordinated a satellite conference call/meeting with a new organization she is working with – a global network of black people working on HIV, including UN AIDS, leadership of the conference, and a network of professionals from organizations working in Africa and with African Americans. National and local people need to be involved, not from the outside but from the inside, and including vertical leadership. The resources exist to impact the epidemic, so the challenge is to harness them and improve outcomes.

The message behind key populations – gay males, injection drug users, sex workers, and transgender persons – was evident. These “key populations” have been emphasized in the latest funding, including the recent announcement of a $100 million U.S. government’s PEPFAR (Presidential Emergency Fund for AIDS Relief) grant, at a high level UN meeting in June. This can be understood, because these groups have been ignored by some governments. However, there was some tension between these groups and those working with women and girls, who now account for 62% to 71% of new cases in various countries. Two years ago, the Dreams Initiative, funded by PEPFAR, the Gates Foundation, and other NGOs, had emphasized young women and girls in east and southern Africa, and is ongoing. Most transmission in Africa, unlike in the U.S. and some other developed countries, is among heterosexuals.

Martin said that there was a consensus that after 15 years of PEPFAR, the time has come for national “ownership” of the epidemic, with local governments and national NGOs taking more responsibility. Collaborations and partnerships need to be established.

Deanna Stover addressed maternal child transmission rates, which have decreased in South Africa, through the use of community health workers – from the “community.” Six countries reported that they now had no or almost no perinatal transmission. Deanna attended discussions on PrEp (pre-exposure prophylaxis) for discordant partners, and treatment as prevention. Funders spoke about the future of funding and the need to have outcome metrics moving forward. Overall, she said it gave a profound overview of the epidemic, and of the challenges for the future.

Ron Hattis, who did not attend, mentioned that if the prevalence rate could be gradually be reduced, particularly through successful “test and treat” programs, the current high levels of funding could eventually be reduced; if not, they will be needed indefinitely.

Jeff Klausner also did not attend, but mentioned that there was a sobering presentation in Durban regarding the “real world” effectiveness of “test and treat” in KwaZulu-Natal (the South African province in which Durban is located), funded by French ANRS group. The outcome was that fewer than 1/3 were virally suppressed in one year, and incidence did not decrease, compared with a control group. This was a well-done trial and speaks to the limitations of “test and treat” and the need for additional strategies such as newborn circumcision and PrEP. The weaknesses of the effort appeared to be in keeping the positive patients on treatment.

Wednesday, November 30, 2016

BEYOND AIDS LEADERS FOR 2016, 2017



In its biennial election on November 15, 2015, Beyond AIDS selected the following officers and directors to serve during 2016 and 2017:

President:  Ronald P. Hattis, MD, MPH (California)
Vice-Pres:  Jeffrey Klausner, MD, MPH (California)
Secretary:  Deanna C. Stover, PhD, FNP (California)
Treasurer: Richel Strydom, MD, MPH (California)
Directors:  Adriana Andaluz, MPH (New York)

                   Franklyn N. Judson, MD (Colorado)
                   Elizabeth Kidder, MD, MPH (Washington, DC)

                   Monica M. Sweeney, MD, MPH (New York)

Past-Pres.: Cary Savitch, MD (California)


The Advisory Council will consist of:

Camila Araujo, intern (California)
Denise Bleak, MSN, PHN (California)
I. Jean Davis, PA, DC (California)
Peter Kerndt, MD, MPH (California)
Marsha Martin, DSW (Washington, DC)
Cesar Reis, MD, fellow (California)
Gary A. Richwald, MD, MPH (California)                               


The subsidiary Beyond AIDS Foundation, a 501(c)3 charitable corporation, will be governed by the following Board (elected by the membership of Beyond AIDS):

President:   Deanna C. Stover, PhD, FNP (California)
Vice-Pres.:  Monica M. Sweeney, MD, MPH (New York)

Secretary:   Ronald P. Hattis, MD, MPH (California)
Treasurer:   Richel Strydom, MD, MPH (California)
Directors:    Adriana Andaluz, MPH* (New York)

                     Franklyn N. Judson, MD, MPH (Colorado)
                     Elizabeth Kidder, MD, PhD, MPH (Washington, DC)

                     Jeffrey Klausner, MD, MPH (California)
  Cary Savitch, MD (California)
                    
              
The Scientific Committee is assigned by Beyond AIDS  to work with the Foundation. Members, as of April 2017:

Franklyn N. Judson, MD, MPH (Colorado) and
Monica M. Sweeney, MD, MPH (New York), Co-Chairs
I. Jean Davis-Hatcher, PhD, PA, DC (California)
Ronald P. Hattis, MD, MPH (California)
Elizabeth Kidder, MD, PhD, MPH (Washington, DC)
Peter Kerndt, MD, MPH (Mozambique)
Jeffrey Klausner, MD, MPH (California)
Gary A. Richwald, MD, MPH (California)
Cary Savitch, MD (California)
Colin Shepherd, MD (China)
Deanna C. Stover, PhD, FNP (California)

The memberships of this and other committees are subject to change and available on request.

BRIEF BIOGRAPHIES OF BOARD MEMBERS OF BEYOND AIDS, 2016/2017

RONALD P. HATTIS, MD, MPH, President

Ron Hattis is continuing as President of Beyond AIDS, and Secretary of our subsidiary tax-deductible Foundation.  When the organization was founded, he was the first Vice-President, and later but before his current offices served as Secretary, as well as President of the Foundation. He has been active in contacts with federal leaders, and in Beyond AIDS' legislative efforts in California, and has represented our organization in consultations with the California Office of AIDS. He developed the original Bylaws for both the membership organization and the foundation, and has mentored many of our past interns. 

He is a physician, board-certified in Public Health/Preventive Medicine, and lives in Redlands, California.  He was formerly the Chief of Medical Services at a large state hospital, where in addition to medical management, he was in charge of HIV testing and training HIV educators for 20 years, and he treated HIV/AIDS patients at the infectious disease clinic.  Since retiring from that position, he has worked part-time in clinical medicine, currently including student health and primary care. He has been an HIV clinician/specialist. 

Dr. Hattis is an Associate Professor of Preventive Medicine Loma Linda University School of Medicine, where he has lectured on HIV as a representative of our Foundation.  He spent 23 years with a disaster medical assistance team, serving at the World Trade Center, Hurricane Katrina, Hurricane Ike, and the Northridge earthquake.

Other past positions in reverse order have included teacher of family medicine, county health officer, country family physician (on Kauai in Hawaii), and Epidemic Intelligence Service Officer for the Centers for Disease Control and Prevention (assigned through field services to the Hawaii Department of Health). 

His goals for Beyond AIDS over the next two years include developing proposals for more effective implementation of the National HIV/AIDS Strategy; and continuing to be involved with legislation in California and important states, as well as at the federal level. In particular, he plans to continue to work to promote the HIV care continuum; to utilize HIV reporting to trigger outreach for referral of patients to treatment, partner services, and other services to prevent transmission; and to enhance HIV prevention science. 


JEFFREY D. KLAUSNER, MD, MPH, Vice-President
Jeffrey D. Klausner is a UCLA Professor of Medicine and Public Health. He is a physician, board certified in Internal Medicine and Infectious Diseases. He served as a CDC Epidemic Intelligence Service Officer 1995-1997, Deputy Health Officer and Director of STD Prevention and Control Services, San Francisco Department of Public Health, 1998-2009, and Branch Chief for HIV and TB, CDC South Africa, 2009-2011. 

Dr. Klausner has been a leader in implementing the public health approach to HIV prevention and control through policy and programmatic activites resulting in the streamlining and evaluation of routine HIV testing, early HIV case detection with HIV RNA screening, linkage-to-care and contact tracing and partner notification services.  In addition Dr. Klausner through his epidemiologic research, identified the role that bacterial STDs, the Internet, sex clubs, methamphetamine and Viagra played in augmenting the risk of HIV tranmission and implemented successful population-based programs to mitigate those risk factors. In collaboration with community leaders and organizations, he inititated sexual health campaigns and peer-led sexual health services for sex workers and gay men in San Francisco which have been replicated globally. 

Dr. Klausner has been conducting research in laboratory-based diagnostics for HIV infection and other STDs since the early 1990s and is considered an expert in infectious disease detection and management. He has a busy clinical HIV/AIDS practice in Los Angeles and regularly attends on the infectious diseases consultation service at UCLA Ronald Reagan Hospital.  Dr. Klausner brings nearly two decades of public health, clinical and research experience to the Board, much of it specific to HIV prevention. 


DEANNA STOVER, PHD, RN-BC, FNP-BC, CNS, COHN-S, Secretary

Deanna Stover is the Executive Director, Community Based (Outreach) Programs and Services, at Redlands Community Hospital, with responsibility for the provision of healthcare to the community with a focus on low-income and underserved populations. She began her nursing career in 1979 while serving in the United States Air Force in Europe, and she earned her PhD in Nursing, Health Policy from Loma Linda University in 2011. She holds board-certification as a family practice nurse practitioner, medical-surgical nurse, and occupational health nurse specialist.

Prior positions include Director, Medical Services, City of Los Angeles, and Chief of Clinical Operations, Center for Employee Health and Wellness, County of San Bernardino. She has actively worked in the medical arena for over 30 years with training and expertise in community-based healthcare, health policy, HIV/AIDS health care, occupational medicine, and advance practice nursing as a family nurse practitioner and clinical nurse specialist.

She holds a certificate as an Advanced HIV Nurse Clinician from USC Medical Center, AIDS education training center (1995) and has provided HIV/AIDS training for healthcare providers.

She has served on organizational boards at the state and local level and is a current board member for a local non-profit community service organization, Building A Generation, located in Redlands California, in addition to being the current Secretary, Beyond Aids, Inc, and the President of the organization’s Foundation.


RICHEL STRYDOM, MD, MPH, Treasurer



Richel Strydom, MD, MPH, the current Beyond AIDS, Inc. and Beyond AIDS Foundation Treasurer,  is presently a third year Loma Linda University (Loma Linda, CA) Preventive Medicine Resident Physician.  Prior to beginning her current Preventive Medicine Residency Training, Richel obtained a Masters degree in Public Health, with a Global Health Concentration, at the Loma Linda University School of Public Health.  Prior to her MPH studies, Richel completed a couple of years of Family Medicine Residency Training, in Tallahassee, FL.
Dr. Strydom was born and raised in the country of South Africa.  The HIV burden of the South African population, as well as the HIV burden within many African and other countries, including within the U.S.A., have contributed to a strong, persistent public health problem.  In July 2016, shortly following the June 2016 launch of   the “Test and Treat” HIV care approach in Lesotho, the first country in sub-Saharan Africa to formally adopt this strategy recommended by UNAIDS in 2015, Richel had the privilege of attending a briefing on the new program while doing a rotation in HIV and Tuberculosis care and prevention, at Maluti Adventist Hospital, in Lesotho.
While a Family Medicine Resident in training, in Tallahassee, FL, Richel worked as a volunteer to provide education and comprehensive support to people who are living with HIV, within an eight-county area of Florida. Earlier, while attending medical school at the American University of the Caribbean School of Medicine, she worked with students and faculty members to actively promote knowledge about, and the prevention of, HIV and STIs. Prior to that, while attending North Carolina State University, she worked with the Alliance of AIDS Services – Carolinas (AASC) as a volunteer “care partner” for a young woman living with HIV.

Richel feels compelled to work to improve HIV care and prevention policies and practices. Serving with Beyond AIDS furthers that aim.


ADRIANA ANDALUZ, MPH, Director (New Addition to the Board) 

Adriana Andaluz originally hails from Los Angeles, CA, where she studied Microbiology along with a minor in Spanish Literature at the University of California, Los Angeles. She began her path in public health as an undergrad while working with Dr. Helen Rodriguez-Trias at the Pacific Institute for Women’s Health, an incubator for programs designed to further women’s health in the US, Africa, Latin America, the Middle East, and Asia.
Largely inspired by Dr. Rodriguez-Trias’ dedication to health policy and increasing access to care, Ms. Andaluz’s first post-collegiate job was in the Public Affairs department at Planned Parenthood Los Angeles. During her tenure, she was able to work on many politically charged state and federal campaigns, including California’s historic Reproductive Privacy Act.

Ms. Andaluz later moved to New York to pursue a master in public health and work at the New York City Department of Health, where she has been since 2007. She currently serves as the Director of External Affairs for the Bureau of HIV/AIDS Prevention and Control where she oversees the development of priority policy initiatives, is responsible for the Bureau’s interactions with the Mayor’s Office, other inter- and intra-governmental agencies and key-stakeholders including the agency’s press office, and also oversees the Bureau’s social marketing and social media activities.


FRANKLYN N. JUDSON, MD, MPH, Director 
 
Frank Judson received his BA from Wesleyan University in 1964, his MD from the University of Pennsylvania in 1968, and his house staff training from the University of Wisconsin Hospitals (internal medicine) and the University of Colorado (infectious diseases).  He was an Epidemic Intelligence Service officer with the Centers for Disease Control assigned to the Colorado Department of Public Health  (1970-72), and Scientific Liaison, Global Program on AIDS, Geneva (1990 -91).  He is board-certified in internal medicine, infectious diseases and preventive medicine. 

For over 41 years, his research interests have concentrated on the epidemiology and control of sexually transmitted infections including hepatitis B and HIV.  His public health policy interests have run the gamut from childhood and adolescent vaccine programs, to urban air pollution, bioterrorism preparedness, and tobacco, tuberculosis, influenza, and HIV prevention and control.  He has authored or co-authored more than 270 scientific publications. 

Dr. Judson has served as President of the American STD Association (ASTDA), President of the International Society for STD Research (ISSTDR), President of the International Union Against the Sexually Transmitted Infections (IUSTI), Chairman of the Board of the American Social Health Association (ASHA), Chief of Infectious Diseases for the Denver Health Medical Center (1983-2002), and Director of the Denver Public Health Department (1986-2004). He has been a member of the Presidential Advisory Council on HIV/AIDS (PACHA), the CDC/HHS Advisory Committee on Immunization Practices (ACIP), the Board of Regents of the American College of Preventive Medicine, and the Colorado State Board of Health. Currently, he is a member of the Colorado Governor’s Expert Emergency Epidemic Response Committee (GEEERC) and Professor, Department of Medicine (Infectious Diseases) and the Colorado School of Public Health, University of Colorado, Denver.


ELIZABETH (BETSY) KIDDER, MD, PhD, MPH, Director
Elizabeth (Betsy) Kidder, MD, PhD, MPH received her Master's in Public Health, Medical Degree, and PhD in Public Policy and Health Policy from the George Washington University. She is currently in the last year of her residency in the Internal Medicine and Primary Care program at the George Washington University Hospital.  Her career and research interests focus on access to quality health care by underserved communities, improving access to addiction treatment, and implementing innovative and patient-centered cancer screening options.  Her dissertation research investigated self-administered HPV testing as a cervical cancer screening option for underscreened women.
Betsy joined Beyond AIDS in 2001 as an intern, and has served as a Board member since 2003. She received her Master's in Public Health in 2004 and her Medical Degree in 2011, both from the George Washington University. She also completed a doctorate there in health policy.

As a public health professional, she has worked in Rome, Italy with the United Nations on the development team for the "Initiative to End Child Hunger" - a collaboration between the World Bank, the United Nations Children's Fund, and the World Food Program. Previous to that, she worked with the Global Health Council in Washington, DC on issues related to HIV/AIDS and child health, as a part of a national PBS media and outreach campaign in global health. She has also worked at the Department of Defense's HIV/AIDS Prevention Program as well as the Futures Group, where she assisted with the research and writing of a "What Works" program guide for developing country policymakers on evidence-based practices in HIV/AIDS/STI prevention.
Her interest in issues related to HIV was initially sparked by the case of Nushawn Williams, a young man who knowingly spread HIV in her small hometown community and high school. After that incident, she traveled to South Africa, where she studied the epidemic in the Eastern Cape, taught an HIV/AIDS education class, and volunteered in a pediatric HIV clinic, all of which deepened her commitment to staying involved with HIV advocacy through her career.


MONICA SWEENEY, MD, MPH

Monica Sweeney is Vice Dean for Global Engagement and Chair, Dept. Health Policy and Management, School of Public Health, State University of New York (SUNY) Downstate Medical Center.  Additionally, she is the chair of the SUNY Downstate Medical Center's Association of Council Members and College Trustees.

Before that, she was the Assistant Commissioner of Health for New York City. Previously, for six years, she was in charge of the NYC Bureau of HIV/AIDS Prevention and Control. Her responsibilities there included oversight of programs and budgets for prevention; care and treatment (Ryan White); Housing Opportunities for People With AIDS (HOPWA); and the epidemiology/Field Services Unit.

Previously, she was the medical director and vice president for medical affairs in a Federally Qualified Health Center in Bedford Stuyvesant, Brooklyn NY.  The community served was medically and economically deprived and HIV/AIDS was one of many challenges she addressed daily during her 17 years in Bedford Stuyvesant.  During her tenure there, in addition to direct patient care, she became involved in policy and advocacy and had the opportunity to work with Assemblywoman Nettie Mayersohn to get her historic legislation (the Baby AIDS Bill, and Named-based Reporting) passed -- over almost insurmountable opposition.

Dr. Sweeney is a board-certified internist and geriatrician with a masters degree in public health.  She has always combined individual and public health in her practice, by working with the Medical Society for the State of New York (MSSNY), the National Association of Community Health Centers (NACHC), and the American College of Physicians (ACP) and by serving on the President’s Advisory Council on HIV/AIDS (PACHA).  Prior to election to the position of Vice-President, she was a Director on the Beyond AIDS Board, and before that she served on the Advisory Council. Her goals as Vice-President include working diligently to broaden the reach of the only AIDS organization that has always used sound public health policy to fight the epidemic.


CARY SAVITCH, MD, Immediate Past-President

Cary Savitch was one of the Founding Members of Beyond AIDS, organized its founding meetings, and was elected its first President. He has served on the Board of Directors since the founding of the organization.  He recruited many of the early members of the organization by speaking to friends, colleagues, and patients about the need for HIV reform, writing a book about the subject, and giving talks on HIV, especially in Ventura County and the surrounding area where the founding meetings were held. 

He is an infectious disease physician, and has taken care of AIDS patients for the past 33 years (starting even before the disease had a name). In 1997, he published a book, “The Nutcracker is Already Dancing,” which highlighted the lack of application to HIV of sound public health practices that had been successfully utilized for diseases such as syphilis and tuberculosis. He believes strongly that the mission of Beyond AIDS, to stop the transmission of HIV, is the direction we must take in order to save lives in this epidemic.

He expresses pride in the time he has already spent with Beyond AIDS, which he believes is the only organization willing to stand up and support the necessary public health policies needed to contain HIV. His goals are to continue these efforts in every and any capacity needed, and to encourage others to join our battle for HIV/AIDS prevention.