Across The Nation

New Jersey Lawmakers Lobby Against Plan To Close No-Cost HIV Testing Clinic

[May 05, 2009]

Three New Jersey lawmakers last week sent a letter to Bergen County Executive Dennis McNerney and the county's Board of Freeholders urging them to reconsider plans to close the Bergen County Counseling Center in Hackensack, which is the only clinic in the county that provides no-cost HIV testing, NorthJersey.com reports. In the letter, Sen. Loretta Weinberg (D) and Democratic assembly members Valerie Huttle and Gordon Johnson questioned why the county would close the center, saying that doing so could jeopardize the $4 million in federal funding that Bergen and Passaic counties receive through Ryan White Program grants.

According to Weinberg, the counseling center "is an important program for people who don't have other places to go." In addition, closing the center "could definitely jeopardize the Ryan White money," she said, adding, "I don't understand why or how this decision was made." Catherine Correa, director of the Ryan White Grants Division of the Paterson Department of Human Services, agreed that eliminating the counseling center could threaten the grant money. "The federal government perceives any decrease in dollars negatively," she said.

Tara Balsley, spokesperson for HHS' Health Resources and Services Administration, said continuing the Ryan White funding requires a "maintenance of effort" from grant recipients. According to Larry Ganges -- assistant commissioner of the state Department of Health and Senior Services' Division of HIV/AIDS Services -- Bergen County would be in violation of the "maintenance of effort" if it eliminates funding for the counseling center. However, Ganges said he does not think the federal government will terminate support for all HIV programs in Bergen and Passaic counties. "I don't really think if this scenario plays out this money will be in jeopardy," he said, adding, "Nor do I think a penalty will be imposed."

According to Brian Hague, Bergen County spokesperson, closing the counseling center would save $104,000 for taxpayers in the county. Hague added that the North Hudson Community Action Corporation -- which would provide HIV screenings in the absence of the counseling center -- would receive $106,000 of state funding originally allocated for the counseling center. "To me, this is cut and dry," Hague said, adding, "I think that's what the taxpayers want us to do" (Gartland, NorthJersey.com, 5/1).

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Global Challenges

HIV-Positive People at Increased Risk of New Flu Strain, WHO Says

[May 05, 2009]

HIV-positive people worldwide are at an increased risk of the H1N1 flu strain, the World Health Organization said on Saturday in guidelines for health workers published on its Web site, Reuters India reports. According to WHO, people with immodeficiency diseases, such as HIV/AIDS, likely will be vulnerable to complications related to the flu strain, just as they are from the seasonal flu, which results in about 250,000 to 500,000 deaths annually. According to WHO, the H1N1 strain and HIV could prove to be a hazardous combination, similar to HIV and tuberculosis. "Although there are inadequate data to predict the impact of a possible human influenza pandemic on HIV-affected populations, interactions between HIV and A(H1N1) influenza could be significant," WHO said, adding that HIV-positive people "should be considered as a high risk and a priority population for preventive and therapeutic strategies against influenza, including emerging influenza A(H1N1) virus infection."

According to WHO, countries with high HIV/AIDS burdens, many of which are in Africa, should ensure that vulnerable people have drug access, including to medicines such as Tamiflu and Relenza. The agency added that it is best if people with the flu strain take antiviral drugs within 48 hours of the onset of symptoms. In addition, there are no known issues with taking flu medications with antiretroviral drugs, according to WHO (MacInnis, Reuters India, 5/2).

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Iran's Health Ministry Releases Figures on HIV/AIDS Cases

[May 05, 2009]

At least 19,435 HIV cases have been reported in Iran, with more than 1,000 cases recorded since December 2008, according to a report recently released by the country's Ministry of Health, AFP/Google.com reports. Of the 19,435 cases, 1,875 cases have progressed to AIDS. The health ministry estimates that about 80,000 people are living with HIV in the country -- or four times the number of reported cases -- and that limited testing facilities and stigma are preventing people from accessing testing or reporting their status.

The highest HIV burden at 40.2% of recorded cases was among people ages 25 to 34, while 93.3% of cases were recorded among men. The report found that the most common mode of transmission was injection drug use, accounting for more than 77.5% of reported cases, followed by sexual contact, which accounted for about 13.1% of cases. In addition, mother-to-child transmission accounted for 0.9% of recorded cases. The health ministry said that there is concern that the sexual transmission of HIV could reach an epidemic level because about 60% of the country's almost 71 million population is under age 30, according to the 2006 national census (AFP/Google.com, 5/3). Health Minister Kamran Bageri Lankarani in December said that Iran aims to address the growing number of HIV/AIDS cases with an approach that includes harm reduction among injection drug users; a sexually transmitted infection education program for young people; and counseling and therapy programs (Xinhuanet, 5/4).

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Opinion

Recent Criticism of Washington, D.C.'s Whitman-Walker Could 'Undermine' Clinic, Editorial Says

[May 05, 2009]

Washington, D.C., Council Member David Catania's recent criticism of the Whitman-Walker Clinic could "undermine the very institution he says he's trying to save," a Washington Post editorial says. According to the Post, Catania has "embarked on a destructively aggressive campaign to oust [the clinic's] leadership." Catania has "accused the agency of financial mismanagement" and "alleges" that the clinic is "getting away from its core constituency."

The editorial adds that although there are "legitimate questions about what's happening with the 31-year-old clinic," the "clinic's efforts to branch out beyond serving gay men and lesbians are both an economic necessity and an appropriate response to the changing nature of the HIV/AIDS epidemic" in the district. In addition, the clinic has been able to "secure additional federal financial support" by "[p]romising to serve as a primary-care health center open to all, while continuing to offer HIV/AIDS services." Although Whitman-Walker was "created by the gay community for the gay community," as the "demographics of the disease have changed, so must the clinic, if it and the critical services it provides are to survive," the editorial says. Catania's "efforts to hound out" the clinic's chief financial officer, who was hired last month to "put Whitman-Walker on a more secure path only undermine the institution's stability," according to the editorial. The editorial adds that it "took three years for the organization to find a chief financial officer who wasn't spooked by its shaky financial infrastructure," concluding, "Imagine how long it would take to find a new chief executive willing to endure a torrent of abuse that distracts from the clinic's important mission" (Washington Post, 5/5).

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Eliminating Rhode Island's HIV Test Signature Requirement Would Boost Prevention, Treatment Efforts, Opinion Piece Says

[May 05, 2009]

Rhode Island's legislature currently is considering a bill (H.B. 5415) that would eliminate a requirement that a person sign his or her name before undergoing an HIV test, which "would essentially make getting an HIV test more like getting any other medical test," Brian Alverson, assistant pediatrics professor at Brown University's Alpert Medical School and head of the Section of Pediatric Hospitalists at Hasbro Children's Hospital, writes in a Providence Journal opinion piece. According to Alverson, although opponents contend that the bill "would lead to more people being tested against their will," the "problem ... is that people who need the test aren't getting it." He continues that the "evidence is overwhelming that eliminating the signature would decrease the burden of HIV in Rhode Island" because "[w]hen people know their HIV status, they are much less likely to spread the disease."

Although HIV clinics typically do not encounter difficulty obtaining signatures for tests, some people do not receive HIV screenings until they develop late-onset disease "because in hospitals, emergency rooms and primary care offices, getting the form and signature are bothersome and an impediment to testing," Alverson writes. He continues that if physicians detect HIV early, "one can expect to live well into old age." However, testing delays "incur a grave risk of death" and can lead to the development of AIDS, he writes.

According to Alverson, Rhode Island three years ago passed a law eliminating the signature requirement for HIV tests for pregnant women. Alverson writes that "[t]his simple change to the law works" because HIV testing rates for pregnant women rose from 53% to 93% and Rhode Island went from having the sixth highest rate of HIV-positive infants to having zero new cases. In addition, the bill not only prevented HIV among infants, it also saved Rhode Island about $5 million in health care expenditures, Alverson writes.

According to Alverson, Rhode Island has reported about 150 new HIV cases since the state General Assembly last year delayed the current bill for further consideration. He continues, "There is more HIV in Rhode Island now than ever before, and we have to move to stop this horrible disease. We cannot afford to put this off another year." Alverson concludes, "Clearly, the legislature must pass this bill" (Alverson, Providence Journal, 5/1).

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