Seeking New Horizions

Little Rock Cooling Centers Open

As the heat continues to break records as well as could be life threatening, the city has set up some cooling centers to assist those who may not have accessed to such a facility or air conditioning. The Living Affected Corporation encourages citizens to utilize these services and check on seniors or those who may be affected by this stressful heat wave.

Alert Center addresses:

•East of Broadway Alert Center - 500 East 21st St.
•West Baseline Alert Center - 9209 Mann Rd. South End Alert Center - 1100 West 33rd
•Willie Hinton Neighborhood Resource Center - 3805 W. 12th St.
•Valley... Drive Alert Center - 5621 Valley Dr.
•West Central Alert Center - 4200 John Barrow Road
•Upper Baseline Alert Center - 3623 Baseline Rd.
•Wakefield Alert Center - 7414 Doyle Springs Rd.
•Central High Alert Center - 1108 S. Park St.
•Capitol View/Stifft Station Alert Center - 2715 W. 7th St.

Little Rock's Community Centers locations:

•Dunbar Community Center - 1001 w. 16th St.
•East Little Rock Community Center - 2500 E. 6th St.
•Southwest Community Center - 6401 Baseline Rd.
•Stephens Community Center - 3720 W. 18th St.

Interactive Webinars on the Health Care Law

Hosted by the HHS Center for Faith-Based and Neighborhood Partnerships

National Webinars

July 19, 12:30 pm ET – The Health Care Law 101 (in English)

July 24, 2:00 pm ET – The Health Care Law 101 (in Spanish)

Regional Webinars

July 12, 3:00 pm ET – Region 3 (Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia)

July 12, 3:00 pm MT/4:00 pm CT – Region 8 (Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming)

July 17, 10:30 am CT – Region 7 (Iowa, Kansas, Missouri, Nebraska)

August 8, 11:00 am ET – Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)

To participate in one of the webinars, please select your preferred date from the list above and submit the necessary information.

Please e-mail any questions to ACA101@hhs.gov. For more information, go to www.hhs.gov/partnerships.

You are subscribed to The Partnership Center Newsletter for U.S. Dept. of Health & Human Services. Learn more about The Partnership Center.

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The Data Dump Week

Training and Strategic Development Rolls Out for Living Affected


The Living Affected Corporation is continuing its effort in exploring training modules ranging from HIV testing and Counseling to being certified for the D-UP HIV diffusion of innovation intervention. Facilitated by ETR (Education, Training, Research) Associates, Rafiki Rama Franklin, M.Ed. and Carnelius Quinn, CBA Specialist and Project Coordinator, the group achieve graduate status after four intensive days ( June 19-22, 2012) of working through the in depth understanding of the intervention. These modules will be apart of the foundation of the organizations emerging Black MSM group, Strilite, which will forge a course to further "message" within the Black community through social networks and friendship circles. With the completion of these modules, this positions LA Corp with staffing that will be empowered with available personal for "one on one"  in- home testing opportunities, expansion of circulating harm reduction kits as well as position individuals directly within friendship circles who have been educated and trained on the transmissions of HIV and AIDS. As apart of the core elements of the program, each newly trained facilitator will seek and identify opinion leaders within the at risk population, raise their awareness of how negative social and cultural factors impact Black MSM and teach the opinion leaders the elements of effective behavior change resulting in more condom usage.
A innovative approach such as this has not been done in the state of Arkansas during the course of the disease, no other agency directly serves this population nor has reached this competency level as a consumer driven entity.

As a sub-grantee of the Arkansas Department of Health, The Living Affected Corporation has been striving to offer as many prevention outlets possible including participating in outreach opportunities and most notably collaborations such as providing leadership in crafting the states Comprehensive HIV/AIDS Plan that will serve as the official community jurisdictional piece regarding the impact of federal dollars extended to Arkansas for HIV and AIDS.  The group continues to pursue its media track while releasing it's next version of the Holistic Health Guide, periodicals, "Our Lives, Our Stories," and another forthcoming first in the guise of a LGBTQ health journal entitled, OMNIBUS slated for a mid summer release. Also in the works are website upgrades, launching a new STRILITE portal webpage, webcasting, podcasting and other new media activities.

Furthermore the group wishes to intensify its stance that the "human condition" must become paramount with the paradigm of linking or retaining individuals in HIV and AIDS care. The basic human rights framed by the groups "HEFTE" ( Housing, Employment, Food, Treatment and Education") concept has become the unifying element that will be instrumental in the care continuum. The impending HELP fair slated for September 28 will allow the members of STRILITE to showcase their community involvement to connect people to services within a AIDS Awareness format.
The groups new bold and concise vision statement of "We are the statewide organization that is informed and connected to change the social construct of the community we serve by providing basic human rights," is also propelled by the groups reaffirmed commitment of refocusing its mission statement which now reads: "Transforming communities through holistic health by providing education and advocacy." Although the strategic development is still unfolding, The Living Affected Corporation is preparing itself to engage the community on many new frontiers with new programs, services and initiatives that will eventually lead to the organizatrion being a premiere Well Being Institute.

Raising the Living and Affected

Increasing HIV Testing, Including Rapid Testing, in Substance Abuse Treatment Programs

By Ronald Valdiserri, M.D., M.P.H., Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

Although the U.S. has made progress in reducing the number of new HIV infections among injection drug users and their sexual partners, CDC estimates that injection drug users represented 9% of new HIV infections in 2009 and 17% of those living with HIV in 2008. Since the U.S. HIV/AIDS epidemic began, more than 175,000 injection drug users with AIDS have died, including an estimated 4,759 in 2009.
With one in five of the estimated 1.2 million individuals in the U.S. who are HIV-positive unaware of their infection, and the majority of new HIV infections transmitted by these individuals, it is imperative that we enhance efforts to make HIV screening—and linkage to care for those found to be infected—more readily available, particularly among the most affected subpopulations.. According to the CDC, in 2009, an estimated 4,172 diagnosed HIV infections were attributed to injection drug use (IDU) (.ppt) in the 40 states and 5 U.S. dependent areas with confidential name-based HIV infection reporting since at least January 2006. Approximately 52% of IDUs living with a diagnosis of HIV infection at the end of 2008 were black/African American and 27% were Hispanic/Latino.
By offering HIV testing, including rapid HIV testing, to patients in substance abuse treatment programs, providers can help more individuals to become aware of their infection and seek care and treatment to protect their health and reduce their potential of transmitting the virus to others. The National HIV/AIDS Strategy (NHAS) recommends coupling HIV screening with substance abuse treatment programs as a key action step in our Nation’s overall efforts to prevent the spread of HIV in communities where it is most heavily concentrated. Advances in rapid HIV testing technology allow for HIV testing to be offered in a wider variety of settings, including substance abuse treatment programs. Several recent Federal activities are lending support to the implementation of such efforts.
NIDA Study Finds Onsite Rapid HIV Testing Works in Treatment Programs
First, a recent study from the National Institute on Drug Abuse (NIDA) demonstrated the value of on-site rapid HIV testing in drug treatment centers. Conducted by the NIDA Clinical Trials Network, the multisite HIV Rapid Testing and Counseling Study showed that offering onsite rapid testing in substance abuse treatment programs substantially increased testing rates and receipt of HIV test results. Onsite testing was found to be more effective than referrals for offsite testing—more than 80% of those tested onsite received their test results, as compared with only 18% who followed through when referred to another site for testing. A related study also showed that rapid testing can be implemented for less than $40 per test and is cost-effective.
The co-lead investigator, along with Lisa Metsch, Ph.D., of the University of Miami Miller School of Medicine, was Grant Colfax, MD, formerly the Director of the HIV Prevention Section in the San Francisco Department of Public Health and now the Director of the White House’s Office of National AIDS Policy.
NIDA and SAMHSA Partner to Promote Rapid HIV Testing in Treatment Programs
NIDA and the Substance Abuse Mental Health Services Administration’s (SAMHSA) Addiction Technology Transfer Center Network have partnered to create the “Blending Initiative,” a program to help move findings from drug abuse research into practice in front-line clinical settings. The Initiative has produced several user-friendly tools and products on the importance of onsite rapid HIV testing in substance abuse treatment programs. These products can be found on the Blending Initiative’s HIV Testing in Substance Abuse Treatment Programs website and include:

• Video interviews with researchers, treatment providers, and others about the value of onsite rapid HIV testing.
• A fact sheet that details the urgent need to provide HIV testing for people in substance abuse treatment programs due to high HIV prevalence among that population and information about findings from NIDA’s HIV Rapid Testing and Counseling Study.
• A resource guide with links implementation guidelines, funding information, and other testing resources.

SAMHSA Strengthens Efforts to Integrate Rapid HIV Testing in Substance Abuse Treatment
To complement and extend these efforts still further, in December 2011 SAMHSA published Rapid HIV Testing in Substance Abuse Treatment Facilities and disseminated it to its grantees, technical assistance providers, and others in the field of substance use disorders. The resource contains information about the benefits of and requirements for incorporating rapid HIV testing into substance use disorder treatment programs. Through its Minority AIDS Initiative Targeted Capacity Expansion: Integrated Behavioral Health/Primary Care Network Program SAMHSA awarded $14.2 million in new grants at the end of Fiscal Year 2011 to support behavioral health services in communities most impacted by HIV/AIDS. Funds awarded under these agreements can be used to support HIV testing, including rapid testing, and counseling located onsite at mental health and substance abuse community-based organizations.
I encourage readers to access these valuable resources and to learn more about how to connect people in substance abuse treatment programs to the vital care they need, including screening and treatment for HIV infection. If you currently provide HIV testing, consider sharing these resources with partners, or potential partners, who provide substance abuse treatment in your community to help them start or scale up their HIV testing activities.

LA CORP RISING to New Heights

Living Affected Ramps Up Training

This week The Living Affected Corporation will continue its month long effort in exploring training modules ranging from HIV testing and Counseling to being certified for the D-UP HIV diffusion of innovation intervention. These modules will be apart of the foundation of the organizations emerging Black MSM group, Strilite, which will forge a course to further "message" within the Black community through social networks and friendship circles. With the completion of these modules, this positions LA Corp with staffing that will be empowered with available in- home testing opportunities, harm reduction kits and first hand corrective information on the transmission and incidence rates of HIV and AIDS within Pulaski County. Such a innovative approach as this has not been done in the state of Arkansas during the course of the disease, especially since shifts in infection rates have reached an alarming 48% increase among Blacks 13-30. As a sub-grantee of the Arkansas Department of Health, The Living Affected Corporation has been striving to offer as many prevention outlets possible including participating in outreach opportunities, collaborations, providing media such as it's health guide, periodicals and another forthcoming first in the guise of a LGBTQ health journal entitled, OMNIBUS slated for a mid summer release. Furthermore the group wishes to intensify its stance that the "human condition" must become paramount with the paradigm of linking or retaining individuals in HIV and AIDS care. The basic human rights framed by the groups "HEFTE" ( Housing, Employment, Food, Treatment and Education") has become the unifying element that will be instrumental in the care continuum Internally the organization is also drilling down on its organizational structure by beginning assessing its future through strategic development exercises via Mr. Damon Jackson, of the Damon Jackson Group which specializes in organizational management and development. Through this work, LA Corp has begun the process to retool, re-think and reposition it's strategies and time lines including a impending 5 year plan. Central to this growth has been redeploying its new mission and vision statements that clarify the groups forward momentum, relevance to the community and destination of becoming the premiere consumer driven organization in a Wellness Institute sphere.

Under the guidance of the Jackson group, LA Corp staff surmised that the new vision statement would be bold and concise to support the groups work ethic. It reads: "We are the statewide organization that is informed and connected to change the social construct of the community we serve by providing basic human rights."  Building upon that statement, the group reaffirmed its comittment by refocusing its mission statement which now reads: "Transforming communities through holistic health by providing education and advocacy." Although the strategic development is still unfolding, The Living Affected Corporation is also preparing to re-brand itself with new logo's, tag lines and assorted marketing materials to reflect a refreshed entity. A new board of directors is being sought to answer the challenges and assist the organization in its mission to be a dynamic force within the community. Financial compliance and transparancy has been at the top of the list of internal mechanism that propel the organization which included securing new financial experts to handle record keeping and filings. The Living Affected Corporation has resloved that since its inception its' been the organization that had staying power despite setbacks, mis-steps and external attacks that actually strengthen the organization and has given it new purpose and drive to continue to build human capital and answer the humaity call to transforming our community from a holistic approach. If you wish to assist us in this endeavor, please feel free to donate through our secure Paypal website at www.livingaffected.org or by mail at P.O.Box 46558, Little Rock, Arkansas 72214  Every amount of support is important as we continue the struggle to address HIV and AIDS.

Living on the Edge

Reaching Them Where They Are: A Guide for Using Online and Social Media to Conduct Sexual Health Outreach with Youth.

The National Alliance of State and Territorial AIDS Directors (NASTAD) is pleased to release Reaching Them Where They Are: A Guide for Using Online and Social Media to Conduct Sexual Health Outreach with Youth. With over 90 percent of youth and young adults, from every racial, ethnic and socio-economic background, utilizing the internet and social media as a means of communication and a health information resource, it is important that health providers actively engage them with sexual health and prevention information where they are. This guide provides key strategies for developing simple, low-cost and powerful interventions that use online and social media to reach LGBTQ youth with sexual health and HIV/AIDS prevention messages. The Living Affected Corporation has been at the forefront of implementing outreach message via social media and other associated platforms. Its has been the organizations long withstanding premise that new media will be vital in the sturggle to "message" to targeted populations especially those hard hit by HIV and AIDS. The guide is available from The Living Affected Corporation by contacting us at www.lacorponline.org or by contacting www.nastad.org

Countdown to the Supreme Court ACA Decision
The Supreme Court is nearing issuing a decision on the Patient Protection and Affordable Care Act (ACA) that is likely to create a political firestorm (no matter what the ruling is) and thrust health care issues back onto the nation’s political agenda in the midst of a Presidential election year.  HIV advocates are considering potential responses to make sure that the long standing needs of people living with HIV are met no matter what system emerges from the decision.

There are several potential outcomes that seem likely to observers.  At least one likely outcome, despite tough questioning from the court, is that the ACA is upheld and remains in force.  To reach this outcome, the court would likely rely in part on its line of commerce clause cases allowing Congress to regulate interstate affairs.  This is the outcome that AIDS United would prefer as it would keep the Medicaid expansion intact and help many more people to move into insurance exchanges, potentially increasing the access of people living with HIV to treatment and care and perhaps helping people to gain access to increased testing.

A second outcome that seems very possible is that the Supreme Court strikes down the individual mandate portion of the law, but leaves the rest of the law in place.  This is a potentially interesting situation since patient protections such as an end to pre-existing condition qualifications and other limitations on health care would remain.  However, some healthy individuals who would help insurance companies and exchanges to maintain their solvency could opt out of the system.  Consequently this potentially sets up a system in which many insurers would be driven from the system or would seek ways to raise prices, thereby driving consumers out of the system.  However, the Medicaid expansion beginning in 2014 would remain intact.

It is possible that the Medicaid expansion itself could also be struck down.  This seems an unlikely outcome.  No court ruling has struck down a part of Medicaid since it was established more than 70 years ago.

Finally the court could strike down the entire law, leading to the loss of access to care and ending some of the changes that have already been enacted.  This last outcome would likely lead to confusion in the current markets and a rush back to maintaining the pre-ACA status quo.  AIDS United strongly opposes this outcome.

For more information on the Supreme Court arguments, please click here. Videos on Supreme Court arguments begin with, “March 16: Part 1: The Affordable Care Act in the Supreme Court.”

That the ruling will be controversial is clear from remarks published June 6th in Roll Call in which House Majority Leader Eric Cantor (R-VA) stated that, unless the court ruled to strike down the entire law, the House would put forward legislation to repeal the entire bill.  The Republicans have stated that they would replace the ACA with another plan but have not yet put an actual replacement plan into legislative form.  Democrats are likely to rise in defense of the bill if it is struck down or to try to propose their own solutions if parts are ruled unconstitutional.  AIDS United continues to monitor the situation in anticipation of the Court’s ruling.




Enough is Enough: No More Cuts to Non-Defense Spending
The “fiscal cliff” continued to be a key topic of discussion this week in the media, in Congress and among policy wonks and advocates.  As we noted in last week’s Update, the fiscal cliff refers to the potential year-end fiscal and economic crisis that could result from the expiration of the Bush-era tax cuts, the payroll tax “holiday,” extended unemployment insurance benefits, the Medicare “doc fix” and the automatic spending cuts mandated under the Budget Control Act (BCA). These cuts will take effect in the New Year if Congress does not act on an alternative proposal to reduce the long-term deficit.

The desire to avoid the automatic spending cuts (sequestration) is a particular focus, especially among Members of Congress.  Much of that discussion is on the need to avoid the cuts to defense spending.  Little attention has been given to the cuts that would be made to non-defense discretionary (NDD) spending, which includes spending on health care and all HIV/AIDS programs, domestic and global.  To reverse the silence and lack of attention to NDD spending cuts, the Coalition for Health Funding has organized a “coalition of coalitions,” called the “NDD Summit.” An NDD town hall meeting was held in Washington, DC, on Monday that was attended by several hundred people.  An essential message coming from the meeting is that NDD spending already has been cut substantially under the provisions of the BCA and no further NDD cuts should be included in any proposal to avoid sequestration.

A community sign-on letter has been developed and is being circulated.  AIDS United has signed on to the letter and we encourage other organizations, national, regional and local, to sign on also.  Click here to read the letter and click here to sign on.

Click here to read an analysis by the Center on Budget and Policy Priorities on the fiscal cliff and the reality of its implications if Congress cannot reach an agreement by January 1, 2013.



Announcements
 

2012 HIV/AIDS Law & Practice Conference

The American Bar Association (ABA) AIDS Coordinating Committee will convene its sixth biannual HIV/AIDS Law and Practice Conference on July 20-21, 2012, at the Renaissance Hotel in Washington, DC, immediately preceding the XIX International AIDS Conference in DC.  Conference topics and participants will be multi-disciplinary and reflect both domestic and international issues in HIV/AIDS-related law, policy and practice.

Click here to register for the conference!

XIX International AIDS Conference - Deadline for Registration and Late Breakers Abstract Submissions
The XIX International AIDS Conference, to be held July 22-27 in Washington DC, will host an expected 200 countries, 2,000 journalists, and 25,000 participants to address this year's theme of "Turning the Tide Together." The conference is now open for late breakers registration.

Find out more information about registration.

Find other important deadlines.

July 24th HIV Mobilization Planned at International AIDS Conference
Large scale actions have traditionally taken place at each International AIDS Conference to draw public and media attention to HIV prevention, treatment and research. As the time for the International AIDS Conference in Washington D.C. approaches, some local and national HIV groups are continuing this tradition by calling for a community mobilization around human rights and economic justice on July 24th.

More information about the mobilization can be found here.

Ryan White 2012 Grantee Meeting and 15th Annual Clinical Conference
This year’s Ryan White Program Meeting and 15th Annual Clinical Conference will take place November 27-29 in Washington, DC, at the Marriott Wardman Park Hotel. The conference theme is “Navigating a New Era in CARE,” and will examine changes in the health care system and explore how changes impact those living with HIV. Over 2,500 participants are expected to attend, including direct care providers, members of planning councils, board members, federal staff, and more.

Important Deadlines for the conference:

Grantee Meeting Registration – September 24, 2012, 12:00 AM ET
Clinical Conference Registration – September 24, 2012
Washington Marriott Wardman Park Discounted Room Rate – October 24, 2012
For more information on the conference, abstracts, registration, and hotels, click here.

Save the Date: 2012 National HIV and Viral Hepatitis Summit
The 2012 National HIV and Viral Hepatitis Summit will take place in Washington D.C. from November 26-28. The Summit will feature public health leaders addressing the importance of improving HIV and viral hepatitis testing, prevention, and linkage to care. The summit will identify the best strategies for the National HIV/AIDS Strategy (NHAS) and the Health and Human Services (HHS) Action Plan for Prevention, Care and Treatment of Viral Hepatitis.

Click here to learn more and keep up-to-date as more details become available.

AIDS United Hiring Regional Field Organizer

AIDS United seeks a Regional Field Organizer to work with its grantees, partners, and allies to implement a coordinated national organizing strategy. The Regional Field Organizer will help mobilize grassroots state and federal HIV/AIDS-related advocacy to achieve the goals of the National HIV/AIDS Strategy. The Regional Field Organizer will be located in Texas.

Learn more about the Regional Field Organizer position.


 

Reaching New Visions

Historic New Media Call to Action at AIDS 2012

By Miguel Gomez, Director, AIDS.gov, and Senior Communications Advisor, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services

Download MP3

We sent our first tweet in on August, 2008 from the International AIDS Conference in Mexico City. Four years and 3,265 tweets later, we are gearing up for yet another International AIDS Conference. At this year’s conference, we will be hosting a satellite session titled “The State of New Media and HIV.” During the session, panelists will reinforce the reasons why it is essential to assess how new media can extend the reach of your work. Together, we will call for a declaration for the HIV community to use new media to move us towards an AIDS-free generation.

We’ve been working with a planning committee of representatives from the Gay Men’s Health Crisis ; ISIS, Inc.[external-link]; Metro Teen AIDS ; POZ Magazine , and the San Francisco AIDS Foundation to develop an agenda that will demonstrate how HIV/AIDS organizations can and are using social media and other emerging technologies to extend the reach of their programs
Todd Park, White House Chief Technology Officer, will moderate the session. Participants will hear from a panel of speakers on new media and HIV research, policies, and programs aimed at preventing and treating HIV. Confirmed speakers include Oriol Gutierrez, Deputy Editor of POZ Magazine ; (an official AIDS 2012 media sponsor); Ingrid Floyd, Executive Director of Iris House ; Venton Jones, Communications and Education manager of the National Black Gay Men’s Advocacy Coalition ; and Susannah Fox, Associate Director of Digital Strategy at the Pew Internet & American Life Project . Susannah will discuss the Pew Internet Project’s latest data on social media use in the U.S. We’ll be announcing additional speakers in the next few weeks.
To help us get ready, the National Minority AIDS Council (NMAC) has developed a survey to better understand how the HIV community is using new media. Whether your organization has a social media presence or not, your input is important! Please take a few minutes to respond to the survey .
New media has come a long way in the HIV community! If you are planning to attend the conference, we hope you will join us. And if you’re not able to attend in person, we encourage you to use new media tools to let us know how you’re using new media to extend the reach of your programs. Ask us questions and participate in the discussion leading up to and during the satellite session. We’ll be using the hashtags #AIDS2012 and #newmediaHIV.

Holistic Living and Affected

Harm Reduction in Needle Exchange Program

Advocates of harm reduction argue that HIV transmission through blood can be effectively averted through needle exchanges as they empower IDUs to protect themselves and others from HIV.⁴ Studies have found that through offering an accessible alternative to needle sharing, HIV transmission within IDU communities can be brought under control.^{5 6} However, this form of harm reduction can be controversial and the scale of implementation varies between countries. The Living Affected Corporation embraces the concept that such programs should be considered for their respective areas and implementation of these programs are vital in the battle to thwart continuing infections. Unfortunately Arkansas has no "official" program however LA Corp does provide printed material and navigation to access harm reduction kits.

How does a needle exchange operate?

Needle exchange schemes provide access to sterile syringes and other injecting equipment such as swabs and sterile water to reduce the risk of IDUs coming into contact with other users' blood. Needle exchange programmes that offer safe syringe access may be run by NGOs, hospitals or medical facilities, and local or national governments. Needles may be provided at drop-in centres, outreach points or from vans that service different points within a city or area. In some places, vending machines are used to distribute needles, functioning as a 24-hour service when other sites are shut.

A video about a harm reduction facility in America.

Sometimes a needle exchange may only distribute the same number of syringes that they receive from a user, whereas others may require a lower return rate or not require any return at all. Some needle exchange programmes may provide a high number of sterile syringes to a single user so they in turn can distribute them among IDU populations not accessing such programmes.⁷
As well as providing clean needles, a needle exchange scheme can also act as a gateway through which users learn about safe injection practices and equipment disposal, safer sex education, access to other prevention services such as substitution therapy, and referral to treatment. The World Health Organisation says that without such complementary measures, needle exchange programmes will not control HIV infection among injecting drug users.⁸
The UK’s medical advisory body recommends that needles are provided in different sizes, and are distributed in a quantity that meets need rather than being limited arbitrarily.⁹

Where do needle exchanges exist?

Many countries that report injecting drug use and HIV among their injecting populations do not have needle/syringe exchanges.¹⁰ Globally, only 82 countries have needle exchange programmes.¹¹ Moreover, it is evident that although countries report having NSP sites, injecting drug users are still not accessing enough needles/syringes. For example, in Germany there are 250 needle/syringe exchanges, yet injecting drug users only receive an average of 2 needles/syringes each, per year. It is recommended that in order for needle exchanges to prevent HIV transmission and to make an impact on the HIV epidemic a distribution rate of 200 needle/syringes per IDU, per year is needed.^{12 13} So far this target has only been met by three low- and middle-income countries - Bangladesh, India and Slovakia.¹⁴
Low numbers of NSP sites and low distribution rates can be due to a variety of reasons; for example, the lack of resources, public and/or political opposition to harm reduction, as well as laws which criminalise harm reduction.¹⁵

A mobile needle exchange in Berkeley, California

Overall, Western European countries and Australia are the leaders in harm reduction, and some of the highest distribution levels in the world are among these countries. In 2009, Australia distributed an average of 213 needles/syringes per IDU, per year.¹⁶ However, many countries are failing to deliver an adequate harm reduction service.
As of March 2009, only 184 needle exchange programmes existed in 36 US states, plus Washington DC and Puerto Rico.¹⁷ For over two decades, the US government forbade funding for such services, but in 2009 the federal funding ban was lifted. This should lead to needle exchange services becoming far more widespread throughout the United States. Currently, the needle/syringe rate is 22 per IDU, per year - far below the recommended rate and one of the lowest in the world.¹⁸
Throughout Eastern Europe and Central Asia, a promising scale up of harm reduction services has occurred in recent years in many countries, notably Ukraine (which increased the number of NSPs by nearly a thousand to 1,323 between 2008 and 2010).¹⁹ A study focusing on 14 European countries, including Estonia, Slovakia and Belgium, found a 33 percent increase in the number of syringes distributed by needle and syringe programmes between 2003 and 2007.²⁰ However, distribution levels remain low across this region.
Despite an average of one in six IDUs in Asia living with HIV,²¹ most Asian countries have a long way to go before the needle exchange services which exist make an impact on their HIV epidemics. Whilst some countries have many NSPs, in several cases they are only reaching a very low percentage of the country’s injecting drug users, who receive very few clean needles/syringes per year.²² Despite increasing the number of NSPs from 92 in 2006 to 901 in 2010, syringe distribution in China remains very low, at an average of 32 needles/ syringes per IDU, per year.^{23 24}
Apart from a few notable exceptions needle exchanges across Latin America and the Caribbean, Africa and the Middle East are largely non-existent or where they exist inadequate. Brazil, Mauritius and Iran are some of the countries which have the most advanced NSPs throughout these regions, although the number of syringes they distribute is low.²⁵

Evidence of the effectiveness of needle exchanges

There is clear evidence that needle exchange programmes have reduced HIV transmission rates among injecting drug users in areas where they have been established. One of the most definitive studies of needle exchange programmes was carried out in 1997, focusing on 81 cities worldwide. It found that HIV infection rates increased by 5.9 percent per year in the 52 cities without needle exchange programmes, and decreased by 5.8 percent per year in the 29 cities that did provide them.²⁶

“While NSPs (needle and syringe programmes) can help reduce the harm caused to people who inject drugs, the consequent reduction in the prevalence of blood-borne viruses benefits wider society.”²⁷

England and Wales National Institute for Health and Clinical Excellence

A study of HIV among IDUs in New York between 1990 and 2001, found that HIV prevalence fell from 54 percent to 13 percent following the introduction of needle exchange programmes.²⁸
According to an Australian government study, investment in needle exchange programmes from 1991 to 2000 averted 25,000 HIV infections and 21,000 hepatitis C infections.²⁹ A later Australian study examining the impact of needle exchanges in the following decade revealed they had prevented 32,000 HIV infections and almost 100,000 hepatitis C infections. Furthermore, it is believed the needle exchanges led to healthcare cost savings of over AU$1 billon, equating to a five-fold return on investment for every dollar spent.³⁰
The effectiveness of needle exchanges in preventing needle reuse and the potential transmission of HIV has been reflected in a Canadian report.³¹ The study found that between 2008 and 2009, needle sharing increased from 10 to 23 percent following the closure of Victoria's only fixed needle exchange. On the other hand needle sharing among those studied in Vancouver, which has a number of needle exchanges, remained at less than 11 percent.
The World Health Organization (WHO) released a report in 2004 that reviewed the effectiveness of needle exchange programmes in many countries, and examined whether they promoted or prolonged illicit drug use. The results produced convincing evidence that needle exchange programmes significantly reduce HIV infection, and no evidence that they encourage drug use.³²

Pride in Living Affected

In response to recent news from the FDA regarding the use of the drug Truvada for prevention, Mapping Pathways U.S. partners AIDS United and AIDS Foundation of Chicago are presenting a webinar focusing on the ARV-based strategy PrEP (pre-exposure prophylaxis.) Please join us on Tuesday, June 19th at 3:00 pm EST for this webinar by emailing zfellows1@aidsunited.org to register. During the webinar, key findings from the Mapping Pathways online survey and stakeholder interviews will be presented to help illuminate the wide-ranging perspectives of advocates, clinicians, people living with HIV, policy makers and others regarding PrEP. While the U.S. context will be highlighted, comparisons/contrasts will be drawn with the opinions of individuals in South Africa and India. Following the presentation, a moderated discussion will ask webinar participants to reflect on their particular jurisdictions and to share their own PrEP assessments. We hope you will be able to join us for this timely conversation. Community Education Group Speaks by A. Toni Young I've Been Thinking... We are a little more than six weeks away from the opening of the International AIDS Conference, which takes place July 22-27 in Washington, DC. The abstracts have been submitted. The meetings have been scheduled. The speakers have been selected (congratulations to Phill Wilson and Linda Scruggs). Marches have been planned and fundraising is nearly complete. But what happens on July 28th? The theme of this year's conference is "Turning the Tide Together." The President and the National HIV/AIDS Strategy have called upon us to "end the epidemic." But when we wake up on July 28th it's unlikely that our resources will be any greater. Collaborations may or may not be any more imminent, and there's no guarantee that we'll be any closer to a cure. However, there is one thing we can do on the morning of July 28th. We can think more strategically about the future. If we are to end HIV/AIDS in the United States, we must take a different approach. TEAM NMAC has been hosting a series of workgroups to look at how we actually end the epidemic. What datasets do we need? How much will it actually cost? How long will it take to get to zero? This is an amazing real-world exercise to get to what we "really" need to be doing. As Dr. David Holtgrave recently said, "if you say 'here is how we end the epidemic,' you have to be willing to pay for it." Don't get me wrong. I think ending the epidemic is possible; but it will not be cheap. And when I describe the costs of ending the epidemic, I'm not counting solely in dollars and cents. The costs include the time and energy needed to develop systems of expanded health care and service provision for the most disenfranchised Americans - the poor, women, and people of color. We must develop systems that will not only link Americans to care but will ensure that they stay in care. After all, ending the epidemic is not just a matter of science; it's also about behavior. Disparities among America's poor, women and people of color are expansive whether they have HIV, Hepatitis, Diabetes, Cardiovascular Disease, hypertensive disorders, or mental health ailments. We must also contend with the disparities in education, employment and housing if we're going to end HIV and create a healthier America. On July 28th, our organizations must take the first steps to expand to meet the growing needs of our communities. This may mean greater partnerships, collaborations and expansion into other disease areas. Only then will we truly turn the tide together. Sincerely, A. Toni Young Community Education Group

Register Now: “HIV Testing for an AIDS-Free Generation” Webinar/Call

By Deb LeBel, Partnerships Specialist, AIDS.gov

To support the 2012 observance of National HIV Testing Day (NHTD), AIDS.gov (on behalf of HHS) will host a webinar/conference call “HIV Testing for an AIDS-Free Generation” on Tuesday June 26, 2012 from 2-3 p.m. (EDT).
Register for this event, which is open to the public, by June 22. Federal staff, grantees and stakeholders working with domestic HIV/AIDS programs are encouraged to participate.
Dr. Ronald O. Valdiserri (Deputy Assistant Secretary for Health, Infectious Diseases, and Director, HHS Office of HIV/AIDS and Infectious Disease Policy) will moderate. Several of the U.S. government’s leading voices on HIV/AIDS will provide updates on the state of HIV/AIDS in the U.S. Speakers include:

• Dr. Grant Colfax (Director, White House Office of National AIDS Policy) (invited)

• Dr. Jonathan Mermin (Director, Division of HIV/AIDS Prevention, CDC)

• Mr. Richard Klein (Office of Special Health Issues, FDA)

• Dr. Deborah Parham Hopson (Associate Administrator, HIV/AIDS Bureau, HRSA)

• Mr. David Vos (Director, Office of HIV/AIDS Housing, HUD)

• Dr. Caroline Ryan (Director of Technical Leadership, OGAC)

• Dr. Linda Youngman (ONDCP Liaison, SAMHSA)

• Dr. Maggie Czarnogorski (Deputy Director, Clinical Public Health Programs, Office of Public Health, VA)

This is the third year that AIDS.gov has organized a webinar to support the messages of National HIV Testing Day. As in the past, participants will be encouraged to submit questions using the hashtag #NHTDwebinar on Twitter. There will also be an opportunity for live questions during the event.
Want to find an HIV testing site and other services near you? Use the HIV/AIDS Prevention & Service Provider Locator.

STRILITE Cotinues to Grow Forward

The emerging entity STRILITE, the newly founded organization formed under the auspices of the D-Up HIV/ AIDS prevention program being facilitated by The Living and Affected Corporation has been formally reconized as a registered non profit by the Secretary of States office. According to information released from the group, the effort was pursued to complete the structure process of the organization including a new office contact number. Since being notified, the group was able to submit proposals to the Arkansas Department of Health in response to their HIV Awareness Day Request for Proposals. The proposal is based around their impending HELP Fair scheduled for September 28, 2012. Pictured from left: Will T., Kevin H., ADH Program Manager Ms. Courtney Hampton, J. Griggs, D. Lopp.

Under the prevention grant awarded to The Living and Affected Corporation, the group Strilite was designed to continue to address ongoing issues and barriers of HIV and AIDS, especially in the people of color communities that have been disportionately impacted by the disease. Within the scope of that award the prevention programming attached was centered on a diffusion of evidenced based platform entitled the D-Up program better known as "Defend Yourself." The basis of the community based intervention called for a group of black gay men to serve as conduits within the same gender loving community to discover "Opinion Leaders" who will facilitate communicating prevention messages to their inner and extended networks. As the program has developed, the core group has agreed that the branding and group philosophy will be central in their appeal and ability offer positive images that they have idenitifed as "missing in action" among Black gay men. During the course of their training, the men of Strilite have also received additonal training resulted in being certified HIV testers as well as introduction to the elements of the peer to peer certification program.

The name is rooted in the foundation that each participant had a shared vision of "striving for enlightenment." "We have to deal with our present as it begins to impact our future," said J. Griggs about the group. "It's really important that we be apart of decision processes and the policy making that will affect our lives." he concluded. Although the genesis of the organization evolved from the D-Up curriculum, group participants felt it imperative that they forge a self identified group that would resonate among its peers. Esepcially since such a viable group didn't exist in the city. Also the group wanted to play a significant role in becoming involved with raising consciousness concerning the messages and services being crafted to serve Black gay men living and or affected by HIV and AIDS. A aggresive and developing schedule of events including launching a in-house support group model, plus participating in HIV Awareness programs and utilizing social media outlets as a medium to share their organizational information and future programming. The organization can be contacted via the LA Corp's office phone 379-8203, at strilite@gmail.com or Strilite Incorporated, P.O. Box 242281 Little Rock, Arkansas, 72227 The group will be based at 401 North Maple, Suite A, North Little Rock, Arkansas 72214

Moving Foward in Living and Affected

Winning the Fight Against HIV in Children

By Rajiv Shah, Administrator, United States Agency for International Development (USAID)

Over thirty years ago, when the fight against HIV first began, the outlook for tackling the pandemic was bleak. Across the world, AIDS was seen as a death sentence. Within just a few years, it had devastated communities from the United States to South Africa. Arkansas now has over 5700 cases of indivdiuals living with either HIV or AIDS. Of these some 4.617 are still not living in care continuums and strategies to deal with this population are still unclear or determined.
But the world continued to fight, and the past three decades have seen tremendous progress in HIV research, prevention and treatment, thanks in large part to the leadership of the United States. Today, we can build on that strong legacy to answer President Obama and Secretary Clinton’s call for an AIDS-free generation.
The XIX International AIDS Conference (AIDS 2012) conference will be an opportunity to renew our commitment to this incredible goal. It also marks an historic moment, as the United States hosts the conference for the first time in over 20 years now that people living with HIV and AIDS are able to visit the U.S. to attend in-person.
We know that we have a long way to go to win the fight against HIV–especially for children.
Through the President’s Emergency Plan for AIDS Relief (PEPFAR)–the largest international commitment to a single disease by any individual country–the U.S. Agency for International Development (USAID) and other U.S. government agencies provide lifesaving HIV and AIDS services to millions of children, women, and families worldwide.

Rajiv Shah

These investments in the global AIDS fight are paying off. Together with PEPFAR, our efforts have made a significant difference in promoting access to prevention of mother-to-child transmission (PMTCT) services, helping to cut new pediatric infections in half in the past decade. We’ve also helped support 9.8 million pregnant women with HIV testing and counseling and provided PMTCT services to more than 660,000 HIV-positive women. As a result, approximately 200,000 infants were born free of HIV.
That means that 200,000 more children have had the opportunity to live to celebrate their 5th birthday.
This milestone is an extraordinarily important one in the development of all children, and it is the impetus behind the Every Child Deserves a 5^th Birthday campaign–an awareness-raising effort that brings together dozens of partners and educates a broader community on how to save children’s lives. The campaign also sets the stage for the Child Survival Call to Action in June. Co-convened by the Governments of the United States, India and Ethiopia, and in close collaboration with UNICEF, the Call to Action will bring together public and private constituencies to chart the course towards the end of preventable child deaths–including deaths caused by AIDS or AIDS-related causes.
The Call to Action will also build on ongoing global efforts, including PEPFAR and UNAIDS’s global plan (PDF 785KB) to end virtually all new HIV infections in children in the next few years while keeping mothers alive and healthy.

Still, we need to do better in the fight against HIV and AIDS. Today, we know what works in the effort to save children’s lives and now, more than ever, we are in a position to virtually eliminate pediatric AIDS. Together, we can give all children the chance to celebrate their fifth birthday

Living for the Weekend

Social Media Twitter's On and On

The Living and Affected Corporation has been an ardent believer in the usage of social media as a platform in the mission to zero infections of HIV and AIDS. This forum and the organizations other social platforms such as Facebook, website and YouTube portals are being scaled for more intense usage as vehicles to forward crafted prevention messages and information. Reports such as the following support the power and influence of the internet within targeted populations It is LA Corps desire to deploy organizati.onal agendas and future fundraising efforts to stakeholders and allies via all social media platforms and thresholds.

Last week, the Pew Internet & American Life Project released the 2012 version of their annual report on Twitter use. As soon as I read the news about the report (via Twitter!), I shared it with the rest of the the AIDS.gov team, released an AIDS.gov tweet about it, and decided to write this blog post.

Since AIDS.gov’s first tweet in 2008, Twitter has been an important tool for us, helping us to reach a wide audience and have an instant conversation. And we’re clearly not alone. Last week we hosted a conference call about social media among communities of color. When we asked the panelists what their f and favorite new media tool was, the majority answered Twitter.
Pew found that more people (who are already online) are using Twitter, and that some are using Twitter more often. Here are some summary points from the report (you can read the full report on the Pew website):

• 15% of online adults use Twitter, and 8% do so on a typical day (the rise of smartphones might account for some of the uptick in usage because smartphone users are particularly likely to be using Twitter).
• Twitter use among 18 to 24-year-olds increased dramatically between May 2011 and February 2012, both overall and on a typical day basis.
• 26% of 18-29 year old internet users are on Twitter.
• 28% of African American internet users are on Twitter.

As an example of how powerful a tool Twitter is for AIDS.gov, just last week we tweeted about updated information from the CDC on HIV among gay and bisexual men. We linked to a fact sheet on that page, and the link in that tweet alone received more than 400 clicks. We are fortunate to have Twitter to help us share new information such as this with anyone, anywhere in the world, with one click.

Just as the number of Twitter users has been on the rise since its launch in 2006, Twitter itself continues to develop new features and resources. Last month Twitter debuted a weekly email digest that summarizes tweets and articles shared by Twitter accounts that you follow and are following you. This is another way to receive information most-talked about by the HIV community.

Interested in HIV/AIDS updates, and don’t yet follow AIDS.gov on Twitter? It’s not too late to start . The HHS Center for New Media also has a directory of HHS accounts and more resources on