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Thursday, December 30, 2010

BEYOND AIDS MEETING PLEDGES POLITICAL, SCIENTIFIC ACTION FOR 2011

On December 12, 2010, Beyond AIDS held an Annual Meeting, with its hub in Ventura, California and conference call participants from across the country. Later the same day, in conjunction with this gathering, the Boards of Directors of Beyond AIDS and its subsidiary Beyond AIDS Foundation, and the Executive Committee of an allied group, Physicians for HIV Control, also met in Ventura.  Each meeting charted courses of action for 2011 to achieve further advance in HIV control and prevention.

Drs. Dennis Thompson, Peter Kerndt, and Cary Savitch confer in Ventura, 12/12/10



DECLARATIONS OF PRINCIPLES

Beyond AIDS updated its declarations of principles, which had originally been developed in 1998-99. These were organized under three basic statements:
  • Decades into the HIV/AIDS epidemic, victory is not yet in sight and therefore better approaches are needed for better results.

  • All of humanity is threatened by HIV/AIDS and should be involved in the struggle to control it. 

  • Public Health, healthcare providers, and people with HIV share responsibility for control and reversal of the epidemic.

The organization's ultimate mission remains the reversal of the course of the HIV epidemic, through sound public health policy. For the complete listing of principles, along with the organizations's goals, and objectives, see Beyond AIDS Mission and Principles.

LEGISLATIVE VICTORIES AND SHORTFALLS, CALIFORNIA AND NEW YORK

The Beyond AIDS membership celebrated the passage of bills in California and New York that the organization had strongly supported. At the same time, disappointment was expressed about the limitations imposed by watered-down final language in both bills.

California's Assembly Bill 2541, initiated by the AIDS Healthcare Foundation, will make it easier for public health departments to discuss treatment and prevention with patients and their physicians. The legality of such communication had been in question because of strict confidentiality requirements and fines for unauthorized disclosure of information. This bill is an advance toward overcoming barriers to communication. However, because of objections by civil liberties groups including the ACLU, some intended wording was deleted, making it appear that the bill might only apply to cases in which a patient has both HIV and tuberculosis or a second sexually transmitted infection. 

Beyond AIDS believes in direct communication and interventions where indicated, by public health workers and healthcare providers. The organization wants to assure the availability, for all persons with HIV, of partner notification services, assistance in changing behavior so as to prevent further transmission, and referrals to medical care and other services. At the meeting, the organization voted to seek further legislation if needed to assure that free communication can apply to all HIV cases.

New York's bill A11487 was intended to allow HIV testing without written consent. It was a partial victory in a multi-year effort by Beyond AIDS' Vice-President Nettie Mayersohn, a member of the state Assembly, to promote routine HIV testing. Unfortunately, this bill was similarly watered down, so that in the end it did not enable opt-out routine testing, and only eliminated the requirement for written consent in the case of rapid testing, where the result can be available within an hour of specimen collection. Clinics or phlebotomy stations drawing a blood specimen to be sent out for later testing, and laboratories not offering rapid testing, must still use a written consent form. 

One positive provision in the bill, not present in any other state's legislation to our knowledge, is that health care providers must offer an HIV test at least once, to every patient ages 13-64 who might be at risk of acquiring the disease. The bill provides for an evaluation process of its effectiveness. At the meeting, Beyond AIDS voted to await this evaluation, and then to press for any needed legislation to enable opt-out testing without written consent in all health care settings.

PUBLIC POLICY INITIATIVES: SAFER SEX IN PORN FILMS, HELP WITH HIV TESTING

The Beyond AIDS Foundation has been taking an active role on a committee advising the California Occupational Safety and Health Administration (Cal/OSHA) on regulations to protect worker safety in the adult film industry. Denise Bleak and Ron Hattis have alternated in representing the Foundation at meetings in Los Angeles and Oakland. Beyond AIDS is advocating for mandatory condom use, expanded screening for sexually transmitted and bloodborne infections, and coverage of treatment for such infections under Workers Compensation. The industry has been resisting such requirements. The membership meeting, as well as the Foundation Board, endorsed continued participation and efforts on this project.

The Foundation has also submitted a draft checklist to facilitate compliance with California's HIV testing law, which does permit opt-out testing without written consent, but imposes some detailed informing and documentation requirements that many physicians are not aware of. The California Department of Public Health is reviewing the form and may post a version on its Web site. Follow-up on this effort was endorsed by the membership and by the Foundation Board.

AWARDS ANNOUNCED

The "Nettie" Awards for 2010 went to two of Beyond AIDS' own, Denise Bleak and Yvonne Pover. The selection of award honorees is made each year by the Beyond AIDS Foundation Board. 

Bleak was honored "for tireless advocacy of improved public policies for the control of HIV infections." Over the past several years, she has contributed her own resources to travel to Washington, DC for meetings with government officials, and more recently to state advisory meetings on the adult film industry issue in Los Angeles and Oakland (see "Public Policy Initiatives," above). As an authority on infection control, she adds credibility to many of our positions, and is an effective spokesperson for Beyond AIDS. She is also a former Secretary of the organization, and services on the Advisory Council. 

Pover was recognized "for continued devotion of graphics, communications, and fiscal services to the cause of HIV prevention." A dental hygienist by training, as well as an accomplished graphics artist and actress, she is a founding member of Beyond AIDS. Pover developed the organization's logos and other graphics, produced the Lifeline newsletter 1999-2003, and has served for many years as Treasurer.

Denise Bleak (L) and Yvonne Pover (R) with Beyond AIDS President Ron Hattis, Alexandria, VA

For descriptions of past awards 2001-2009, see Beyond AIDS Awards.

SCIENTIFIC ISSUES

The Beyond AIDS Foundation Board reaffirmed the following as topics of interest. The Beyond AIDS Scientific Committee serves the Foundation and will consider these issues as indicated. 

  • The role and safety of immediate onset of treatment (as soon as infection is identified) as a component in strategy for HIV transmission control

  • The role of pre-exposure prophylaxis for prevention of HIV infectionThe development of lab test panels for multiple bloodborne and sexually transmitted diseases 

  • The development of panels of laboratory tests for multiple bloodborne and sexually transmitted infections 

PHYSICIANS FOR HIV CONTROL

The Executive Committee of Physicians for HIV Control (PHC), on the afternoon of December 12, 2010, voted to work together with Beyond AIDS on a number of issues. A motion was passed to support "clean-up" legislation in 2011 in California to simplify testing requirements and to assure the legality of communication among public health staff, physicians, and patients about HIV cases, to facilitate prevention, control, epidemiological investigations, referrals to care, and assurance of adequate treatment and adherence.

Another motion was passed to support regulation or legislation for the adult film industry, to require condoms and other worker safety precautions.

The groups also voted to follow the issues of test panels for multiple bloodborne and sexually transmitted infections, and early treatment and pre-exposure prophylaxis for HIV, in cooperation with the Beyond AIDS Scientific Committee.