January End Post

2012 Year End Review
Living Affected Takes a Licking and keeps on Ticking

The Living Affected Corporation continued it forward momentum in 2012 with an array of programming, events, partnerships and collaborations based on its mission to be a statewide organization that is informed and connected to change the social construct of the communities we serve by improving basic human rights. Our committed efforts also support our Mission Statement of "transforming communities through holistic health by providing, education and advocacy". To these means as an organization we have pursued courses of actions that will intensify our stance that the "human condition" must become paramount within the paradigm of linking or retaining individuals in HIV and AIDS care. We believe that the frame of basic human rights is firmly rooted in the societal determinants of our "HEFTE" concept in which we cite, "housing, employment, food, treatment and education" as unifying elements that will be instrumental in the health care continuum.
Although 2012 presented challenges ranging from testifying before legislative audit members to navigating funding shortfalls, as an organization it our position that "we may have taken a licking, but we kept on ticking."

We kicked off the year with an aggressive calendar of events which began in February with providing technical assistance in producing its recognition of Black HIV AIDS Awareness Day during its "Sex Week" activities. The organization provided and distributed a range of prevention materials while interacting with the student body to further understand issues surrounding the disease.

Later that month our team joined other area entities by participating in the Mid South Summit Black Expo which featured the theme “I am the Picture of Health.” During the expo, Living Affected offered HIV prevention literature, highlighted our periodical "Our Lives, Our Stories The Untold Stories of Women with AIDS," and supported on site testing done by the Future Builders, Inc organization. During this month we also engaged students at Arkansas Baptist College to provide educational materials during the campus recognition of Black Women and Girls HIV Awareness Day. (pictured left)

In the second quarter of 2012, LA Corp was fielding a host of request from our speakers bureau, information on our STRILITE initiative regarding efficacy and empowerment of young black gay men and further testing opportunities. We discovered the remnants of Arkansas AIDS Quilt project which revealed individuals who we personally knew and inscribed messages that reaffirmed our that our work should not be deterred. Summer 2012 included reaching out in to neighboring communities with support for PRIDE events in Conway and Fayetteville. LA Corp team members set up a concession stand to serve attendees with both refreshments and health information during the Conway Pride event in conjunction with upstart "People of Unity." Additional request came into The LA Corp offices during the third quarter of 2012 to participate in community forums, public round tables, capacity building meetings and scheduled travel throughout the country. 2012 for The Living Affected Corporation was one of maximizing our services throughout the area while utilizing marginal resources. This post only touches the tip of the spear of the work that has been accomplished in our bold move to accelerate our promotion of positive sexual health, addressing dismantling social and economic barrier while demanding social justice equity in marginalized communities. Much was completed in 2012 but the best is yet to come in 2013. Come join us or share a contribution that will support our work. Do it today at www.livingaffected.org  or purchase a periodical on this site.
 

Keeping it Real the Living Affected Way

The Aging Face of AIDS in the 21st Century

By 2015 more than half of all people living with HIV in the United States will be older than 50. A fair number of people are simply living much longer with HIV, and that’s a good thing. The Living Affected Coporation (www.livingaffected.org)  continues its mission to highlight the various layers in the complicated HIV/AIDS mix. As an organization we've determined that the aging issues juxtaposd to homophobia, stigma and the overarching elements of an individuals social determinants must be apart of an individuals health continuum. It is our premise that those living longer will require additional attention and unique needs that will be added to the HIV/AIDS paradox.
Too many, however, are contracting HIV when they’re older than 50, and their health needs will be different from someone who tested positive at a younger age. What’s more, research increasingly shows that diseases that typically strike HIV-negative people in their 60s and 70s are occurring in people with HIV in their 40s and 50s. These concerns have brought the issue of aging with HIV to center stage.
Right now one of the biggest unanswered questions is why this is occurring. There’s no doubt that many age-related diseases and conditions are popping up at much higher rates—and at younger ages—in people with HIV compared with HIV-negative people. Whether it’s heart attacks, bone fractures, kidney disease or certain cancers, the rates of these conditions in HIV-positive people are alarming. What’s unclear, however, is how much HIV contributes to these conditions, how much is explainable by other factors (such as smoking, HIV drugs and coinfection with other viruses) and what to do about them.
Researchers are working furiously to answer these questions, but in the meantime, lessons are being  designed to explain:

• How aging works in a general sense
• What we know about HIV and the aging process
• What steps can be taken to reduce the risk of aging-related diseases, and
• What kinds of experimental treatments are on the horizon

The good news is that most HIV-positive people can do quite a lot to slow the aging process and guard against the onset of age-related illness. Before we get to that, however, it’s important to understand how aging works in the first place and understanding the personal responsiblity involved with each person's health. LA Corp offers the following as a primier or refresher for our readers. This is not offered as a subsitute for your health provider but rather a empowerment awareness piece to encourage individuals to be engaged consumers.

Don’t Smoke TobaccoSmoking tobacco is one of the most harmful things that people can do to their bodies—and to their chances of living a long (and healthy) life. Most people know it can cause lung cancer and other lung diseases. Some even know that it can increase the risk for heart attacks and strokes. What many don’t know is that it is also associated with numerous other age-related ailments—including bone mineral loss, muscle wasting, problems with memory and concentration—and age-related cancers, such as anal, breast, cervical and prostate cancer. Click here for some tips on quitting smoking.

Minimize Alcohol and Drug UseConsistent data suggest that moderate alcohol consumption might actually protect the heart and lower blood pressure. However, the American Heart Association recommends that men who drink alcohol should consume no more than two drinks per day and that women should consume no more than one. Studies have found that people who regularly drink more than that are at increased risk of strokes, diabetes, obesity and serious accidents. People with HIV who have liver problems have to take particular care with alcohol.

Data are less clear about how various recreational drugs affect the aging process, though chronic amphetamine (“crystal”) and cocaine use have been implicated in thinking and memory problems, bone mineral loss and heart disease. In addition, excessive use of most drugs is associated with shorter life spans, increased risk of depression and suicide, and other serious health consequences.

ExercisePeople who exercise regularly, on average, are far healthier in numerous respects than people who don’t exercise. As bad as smoking is on just about every part of the body, exercise is good for it. Benefits of regular exercise include reductions in the risk of:

• cardiovascular disease, diabetes and metabolic syndrome
• age-related cognitive decline
• bone-mineral and muscle loss

Exercise also reduces inflammation throughout the body, improves symptoms of depression and anxiety, and hastens recovery when illness strikes. Not everyone is equally able to exercise, and a doctor should sign off on any exercise plan, but there are a number of ways to get moving. Click here for some suggestions.

Eat WellAside from exercise, diet also helps determine who will live longest and healthiest. Experts are divided on the ideal diet. Some argue against the consumption of almost any fat. Others say that fats (at least healthy fats from nuts and fish) aren’t the problem, but that sugar is. Some argue for a vegetarian way of life, while others say meats are just fine. Fad diets that come and go just confuse matters further. All of this can make it quite difficult to decide on the best diet.
What most reputable diets have in common is watching caloric intake, along with an emphasis on including lots of fruits, vegetables, whole grains and beans, and then enjoying everything else in moderation. Most also stress the importance of eating the healthiest types of fish and limiting meat consumption to the leanest meats, such as from chicken and turkey, whenever possible. When it comes to fats, there is growing consensus that “healthy” fats—for example, from olive oil, nuts and avocados—are actually good for you.
What the most reputable diets also agree on is that too much sugar and too many processed and fried foods are a primary driver of diabetes, cardiovascular disease and a host of health problems in the United States. Switching from an unhealthy to a healthy way of eating is hard for many people—that’s why diets so often fail. For tips on how to overcome some of those challenges, click here.

Treat HIVCurrent HIV treatment guidelines recommend starting ARV therapy at least as soon as your CD4 count drops below 500 (see our "When Should I Start Treatment, and What Should I Take First?" lesson). The primary rationale for this advice comes from data showing that untreated HIV, and the resulting high level of inflammation, can greatly increase the risk for cardiovascular disease, liver disease and other conditions. Some experts on the DHHS panel that creates U.S. treatment guidelines, and experts who’ve developed guidelines elsewhere now recommend treating at even higher CD4 counts for the same reason, especially in those with a high underlying risk for cardiovascular disease, liver disease or other health problems.
Not everyone has the same underlying risks for the kinds of diseases that the panel was most concerned with, however. For instance, people with no family history of heart disease, who have never smoked and who don’t have hepatitis C or B have a low baseline risk for becoming ill with cardiovascular, liver or kidney disease. For such a person, the decision about when to start treatment might be different from that of a person who does have a family history of heart disease, or who smokes or has HCV. In that regard, the guidelines offer some flexibility.
What is clear, however, is that the longer people wait after their CD4s drop below 500, the greater their risk for developing age-related illnesses will likely be. In fact, one of the most potent predictors of a higher risk for the majority of age-related diseases is a CD4 count under 200.

Treat Other InfectionsCurrent HBV and HIV guidelines recommend that people with both infections should begin HIV therapy (with a backbone of treatments that also fight HBV) as soon as possible. This is because treating HBV early significantly reduces the risk of liver cancer and other liver problems, without significantly increasing the risk of side effects from the medication.
Deciding when to treat HCV is a little harder. Though many new medications are in development, the cure rate for HCV therapy in the majority of people infected with both HIV and HCV in the United States is still relatively low and the side effects of the treatment can be serious and unpleasant. When HCV therapy does work, however, it significantly reduces the risk of developing not only liver disease, but also other related conditions.

Follow Disease Prevention and Screening GuidelinesResearchers have begun to question whether certain age-related screening guidelines might need to start at a younger age in people with HIV. For instance, some have questioned whether the most popular screening tool to assess heart attack risk, based on data from the long-running Framingham study, should be modified for people with HIV.
Experts have questions whether others tools, such as the FRAX score for assessing bone mineral loss, might also need to be adjusted for HIV-positive people. In fact, some now recommend that HIV infection alone counts enough as a risk factor that bone screening ought to begin at a younger age, particularly for HIV-positive men, than is typically recommended. There are, however, no consistent guidelines yet in this area.
Studies are being conducted to help identify whether current disease screening guidelines for people older than 50 are sufficient for people with HIV. While we wait for the results of those studies, however, it is important to ask your doctor what types of disease prevention and screening guidelines are in place for a person of your age and medical background and to insist on following those guidelines in your own care. The U.S. Preventive Services Task Force produces disease screening and management guidelines and may be found here.

Stay Socially and Mentally ConnectedNumerous studies have found that people who maintain social connections with their family, friends and colleagues and who engage in activities that they feel add meaning to their lives not only live longer, but also remain healthier than people who are socially isolated and who do not engage in meaningful activities. There are a variety of ways to get connected socially if you aren’t close to family and don’t have many friends. Many local AIDS service organizations (ASOs) have support groups for people with HIV to connect with one another. Volunteering with a charity that works on causes you believe in, or with a political campaign, can also help you connect socially. Finding local groups of people to exercise with would accomplish two goals: social connection and fitness. The website meetup.com can be a way to find others who share your interests and hobbies.

If you are unable to get out of your house easily, or if you live in a rural area without many opportunities meet like-minded folks, it is possible to connect with others online in forums. Check the AIDSmeds Forums for topics that interest you, and begin connecting with others today. Consider volunteer opportunties at the Living Affected Corporation, contact us at info@livingaffected.org

Celebrating Life in Rainbow Colors

Got Condoms!?
Condoms Still Considered Viable Tool in HIV Infections

The Living Affected Corporation (www.livingaffected.org) has an established history with supporting the use of condoms as a prevention method in the LGBTQ community and beyond.
Since its inception the group has provided access as well as distributed over 75,000 condoms during testing events, in safe sex kits and in collaboration with the Arkansas HIV Planning Group's condom distribution committee. Furthermore the organization also scaled up female condiment use via its "Sexy, Healthy, Encounters," which was a ground breaking initiative and a Arkansas first. The product is still available at the groups offices.

Through an cooperative agreement the organization has also partnered with the AIDS Health care Foundation as a resource to assist with its distribution network. As a HIV prevention collaborator, LA Corp facilitated evidenced based programming to address the issue of stigma and homophobia amidst growing HIV/AIDS infections among young gay Black men. In an effort to continue to educate and empower the public,this blog offers a snapshot on condom use and stresses the importance of using them as a direct prevention and family planning method. 


Male Condoms

Several studies have demonstrated that male condoms made of either latex or polyurethane are effective barriers against HIV. The theory behind using condoms is clear: they cover the penis and provide an effective barrier to secretions such as semen and vaginal fluids, thereby blocking sexual transmission of HIV infection.
Studies have also demonstrated that other common sexually transmitted viral infections, such as herpes simplex virus (HSV) and hepatitis B virus (HBV), can be prevented with the use of latex or polyurethane condoms. While condoms can help prevent the transmission of human papillomavirus (HPV), a virus that can cause cervical and penile warts, lesions and cancer, there is still a risk of infection.
Condoms made of "natural" materials—such as lambskin—are not a consistently effective barrier against many viruses. This is because they contain microscopic holes through which HIV can pass.

The key to effective protection is consistent and correct use of condoms. To learn more about correct condom use, click here.

Incorrect use of condoms can increase the risk of condom slippage or breakage, which diminishes their protective effect. Inconsistent use—for example, failure to use condoms with every act of vaginal or anal intercourse—can lead to HIV transmission.

A word about polyurethane condoms: They are an effective alternative to latex condoms, especially for people with an allergy to latex. However, some studies have found that polyurethane condoms are more likely to break than latex condoms. Still, if used consistently and correctly, they are considered to be a highly effective barrier against the sexual transmission of HIV.

Female Condoms

The female condom, approved in 1993 for use in the United States, is a polyurethane pouch with flexible polyurethane rings at each end. It is inserted deep in the vagina, much like a diaphragm. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vulva (vaginal opening). If inserted properly, it lines the vagina and the cervix, which helps to prevent pregnancy, along with HIV and other sexually transmitted infections.

While female condoms are not approved for use during anal intercourse, some men and women have reported using them for anal sex. However, at least one study has uncovered problems for the receptive partner using the female condom, during anal sex, including difficulty inserting the condom, discomfort and rectal bleeding (removing the inner ring may alleviate some of the problems experienced during anal insertion and removal).

A Word About Lubricants

Only water-based and silicone-based lubricants should be used with latex condoms. K-Y Jelly, Wet and Astroglide are three examples of water-based lubricants that can be used with latex condoms. Examples of silicone-based lubricants include Millennium ID and Eros Bodyglide.

Never use oil-based lubricants, including hand or body lotion, baby oil, vegetable oil or shortening, massage oil, mineral oil, or petroleum jelly (e.g., Vaseline) with latex condoms. Oil-based lubricants can damage latex and cause latex condoms to tear more easily. If you must use an oil-based lubricant, it should only be used with polyurethane condoms.

Some pre-lubricated condoms and separately sold lubricants contain a chemical called nonoxynol-9. While nonoxynol-9 has been shown to kill sperm (and potentially reduce the risk of pregnancy) and various sexually transmitted infections, some men and women are allergic to this chemical. This can cause irritation inside the vagina and anus, which can increase the risk of HIV transmission if the condom breaks.

The HIV Paradox of Living Affected

Introducing the HIV Justice Network         

By Edwin Bernard

Today marks an important step forward in global advocacy towards a fairer, just, rational, proportionate and limited use of laws and prosecutions for HIV non-disclosure, potential or perceived exposure and transmission.

The new HIV Justice Network website is intended to be a global information and advocacy hub for individuals and organisations working to end the inappropriate use of the criminal law to regulate and punish people living with HIV. Here you will find the latest news and cases, searchable by date, country, and case type, plus all kinds of advocacy resources (including video). The information on the website is also classified by 25 topics, under six headings: Advocacy; Alternatives; Impact; Law Enforcement; Laws and Policies; and Science.

Hopefully this will make it easier to find the information you need for your work, whether it be research into the impacts of HIV criminalisation; advocacy to prevent, reform, repeal or modernise existing HIV-specific criminal statutes or to limit the use of the law through prosecutorial and police guidance; or in promoting alternatives such as a supportive legal and policy environment via a human rights framework; restorative justice via a criminal justice framework; or Positive Health, Dignity and Prevention via a public health framework.

At the same time, we will also be launching the HIV Justice newsletter. As well as including the latest international news and analysis relating to cases, laws, policy and advocacy, it is an opportunity to promote the work of advocates and researchers, such as highlighting upcoming events and new resources. If you have already signed up for it via the Homepage, or supported the Oslo Declaration on HIV Criminalisation, you are already subscribed. If not, you can sign-up here.

The new HIV Justice Network website incorporates all the posts from my blog, Criminal HIV Transmission, which I began in 2007. Little did I know at the time that it would become an important global resource, filling a much-needed gap by capturing what is happening in real time. It was only when I attended AIDS 2008 in Mexico City, and discovered how many people knew of me and my work, that I realised how useful a resource it had become for advocates, researchers, lawyers and others from all over the world.

Knowing that the blog served as an international information and advocacy hub placed enormous pressure on my time and personal resources. Until the beginning of 2012, the blog and its associated advocacy work received no funding - save the few wonderful individuals who donated via Paypal and a small grant from IPPF (thank you!). So I'm very grateful to The Monument Trust for its generous support which has allowed me to sustain, develop and expand the blog into the HIV Justice Network. I'd also like to thank Kieran McCann and Thomas Paterson from NAM, who designed and developed the site, as well as NAM's Executive Director, Caspar Thompson, for his support and guidance.

This past year hasn't only been about developing the new website and newsletter, however. In February, the HIV Justice Network co-organised the civil society caucus meeting that created the Oslo Declaration on HIV Criminalisation. The Oslo Declaration, hosted on the HIV Justice Network website, has become a potent global advocacy tool. And with more than 1600 supporters from more than 110 countries around the world, it has helped to galvanise a global movement advocating against the inappropriate use of the criminal law to regulate and punish people living with HIV.
In July, the HIV Justice Network was very active prior to AIDS 2012 in Washington DC. We held an HIV criminalisation caucus meeting just before the main conference, attended by 36 smart and experienced advocates from 16 countries; co-ordinated a seminar at the MSMGF pre-meeting; and attended both the Positive Justice Project convening and LIVING 2012.

During the conference itself, we presented data in several sessions and satellites, co-organised a press conference, and hosted a panel featuring three courageous individuals who had previously been involved in criminal cases and who are now passionate advocates against the use the inappropriate use of the criminal law to regulate and punish people living with HIV. You can watch most of these sessions in the Video section of the new website.

Our biggest project to date was working with our video advocacy consultant, Nick Feustel, to produce the 30 minute advocacy and educational video, Doing HIV Justice: Clarifying criminal law and policy through prosecutorial guidance, which had its premiere at AIDS 2012.
The video demystifies the process of how civil society worked with the Crown Prosecution Service of England & Wales to create the world's first policy and guidance for prosecuting the reckless or intentional transmission of sexual infection. It explains how the guidance was developed, what challenges the key stakeholders faced and overcame, and what benefits have resulted - fewer miscarriages of justice and a better understanding of HIV throughout the entire criminal justice system.
As well as thanking the three interviewees - Lisa Power, Policy Director, Terrence Higgins Trust; Yusef Azad, Director of Policy and Campaigns, NAT; and Arwel Jones, Head of the Law & Procedure Unit, Crown Prosecution Service Strategy & Policy Directorate - we'd also like to gratefully acknowledge the financial contribution of UNAIDS.

Doing HIV Justice had its European debut at the one-day seminar on HIV Criminalisation that the HIV Justice Network co-ordinated on behalf of Deutsche AIDS-Hilfe, EATG, IPPF and the HIV in Europe initiative. The meeting was an opportunity to build on the momentum of advocacy from AIDS 2012 and create a more cohesive pan-European (and Central Asian) movement against laws, policies and practices that inappropriately criminalise people living with HIV.

As the HIV Justice Network moves forward we hope to continue to inform, support and connect individuals and organisations - activists, networks of people living with HIV, lawyers, researchers, clinicians, civil society organisations, and multilateral and UN agencies - in their work to end inappropriate prosecutions of people living with HIV.

Please let us know via the Contact Us form what you like (or don't like) about the new site; how you use it in your work; and what we can do improve. And, of course, if are working to end inappropriate laws and prosecutions and have news, information or resources to share, we'd also like to hear from you.

Here's to a whole new chapter in the global movement towards a more tolerant and supportive environment for people living with HIV, so that we can live long, healthy, empowered, dignified lives - surely a better and more effective way to prevent new infections than a punitive, disabling environment inherent in a criminal justice system approach.

In solidarity,
Edwin J Bernard
Co-ordinator, HIV Justice Network
PS You can 'like' us on Facebook and follow us on Twitter, too!

UPdating in Living and Affected

LA Corp Continues Testing Initiative

The Living Affected Corporation in cooperation with the Arkansas Department of Health will engage in additional testing opportunities in the first and second quarter of 2013. "This ADH support will allow our agency to continue a course of testing not only in Pulaski County but move into at lest two delta areas," said D. Levi, LA Corp CEO.

She concluded, "its imperative that we have more outreach into counties such as Chicot and Lee where testing hasn't been concentrated." Studies have demonstrated that testing is prevention with community based organizations and AIDS service organizations being an intricate element in reducing infection rates. Unfortunately reports from the CDC cite increases in the African American community most notably among young Black MSM's 13-24. The groups STRILITE program was designed as a conduit to educate Black gay males in HIV 101 and self efficacy. The organization will also collaborate with area partners in its outreach effort as well as continuing to offer "free"testing at the groups North Little Rock offices at 401 North Maple. Call 379.8203 or contact info@lacorponline for an appointment.

NASEM Conference on AIDS.gov





The 2013 National African American MSM Leadership Conference on HIV/AIDS and other Health Disparities was held in Los Angeles, CA from January 17– 20, 2013. Unfortunately there were no participants from Arkansas but the conference sought to introduce the fifth Creating Responsible Intelligent Black Brothers (CRIBB) Fellowship participants.

Also a H3 conference took take place the day before the 2013 conference with the purpose to:

1) explore the current research, examining the intersection of behavioral, psychological, socio-cultural, and biomedical risk factors contributing to the HIV epidemic, as well as protective and resiliency factors among Black MSM
2) Develop and sustain local and national relationships between current and aspiring investigators, and community based participatory research collaborative to advance research and training aimed at reducing HIV among Black MSM
3) Generate reports, monographs and manuscripts that document key issues and provide recommendations for future research, programs and funding opportunities.

“10 Years and the Dialogue Continues” – HIV Prevention as Social Justice for Black Gay Men/MSM 2013 and Beyond was the theme/charge!  The 2013 conference was to renew a sense of unity and commitment to an end of HIV. According to organizers, there is strength in our diversity and we have seen that we, as a community are a powerful force to be reckoned with. During the 2012 conference we witnessed again how our youth/young Black brothers are maturing and stepping into more prominent leadership roles; as they keep moving forward, we must continue to provide them with encouragement and meaningful opportunities for engagement and leadership.

This newest generation of leaders comes with inspiration, innovative ideas and the drive to make lasting change among Black Gay men, as well as the overall Black community. We must remember our fallen brother Dr. Colomb and encourage, as he did, many young leaders to be the best they can and also keep community in mind and not self. I ask that we all take a pledge to be our brother’s keeper and each teach one and/or become a mentor to a young Black gay man. With that said, “10 Years and the Dialogue Continues” HIV Prevention as Social Justice for Black Gay Men/MSM 2013 and Beyond. Without doubt, we can remove HIV/AIDS and other health disparities from our community.
 

Fast Tracking in Living and Affected

New Video Illustrates HIV Treatment Cascade

A new animated video provides a brief overview of HIV in the United States and illustrates how improvements along each step of the treatment cascade can help us achieve an AIDS-free generation. We are grateful to Gilead for sharing the video, which debuted last fall at the 2012 U.S. Conference on AIDS , the nation’s largest domestic HIV/AIDS conference.

The two-minute video calls viewers to action, focusing on a number of key steps that are consistent with the National HIV/AIDS Strategy. The Living Affected Corporation fully embraces the use of new media and the full force of video messaging in the fight to end HIV and AIDS. Please check out our new webpage at www.livingaffected.org  If you have interesting video content or concepts that you would like to share, please forward them to info@lacorponline.org  Do it Today!!!

Countdown to Affordable Health Insurance
 By Kathleen Sebelius, Secretary of Health and Human Services
Cross-posted from HealthCare Blog

Editor’s note: We have cross-posted HHS Secretary Sebelius’ blog , “Countdown to Affordable Health Insurance” for our readers from the HealthCare.gov blog. For information on the Affordable Care Act and people living with HIV, read this fact sheet in English (PDF) and Spanish (PDF).

Secretary of Health and Human Services Kathleen Sebelius

January is the perfect month for looking forward to new and great things around the corner.

I’m feeling that way about the new Health Insurance Marketplace. Anticipation is building, and this month we start an important countdown, first to October 1, 2013, when open enrollment begins, and continuing on to January 1, 2014, the start of new health insurance coverage for millions of Americans. In October, many of you’ll be able to shop for health insurance that meets your needs at the new Marketplace at HealthCare.gov.
This is an historic time for those Americans who never had health insurance, who had to go without insurance after losing a job or becoming sick, or who had been turned down because of a pre-existing condition. Because of these new marketplaces established under the Affordable Care Act, millions of Americans will have new access to affordable health insurance coverage.
Over the last two years we’ve worked closely with states to begin building their health insurance marketplaces, also known as Exchanges, so that families and small-business owners will be able to get accurate information to make apples-to-apples comparisons of private insurance plans and, get financial help to make coverage more affordable if they’re eligible.

That is why we are so excited about launching the newly rebuilt HealthCare.gov website, where you’ll be able to buy insurance from qualified private health plans and check if you are eligible for financial assistance — all in one place, with a single application. Many individuals and families will be eligible for a new kind of tax credit to help lower their premium costs. If your state is running its own Marketplace, HealthCare.gov will make sure you get to the right place.
The Marketplace will offer much more than any health insurance website you’ve used before. Insurers will compete for your business on a level playing field, with no hidden costs or misleading fine print.

It’s not too soon to check out HealthCare.gov for new information about the Marketplace and tips for things you can do now to prepare for enrollment. And, make sure to sign up for emails or text message updates, so you don’t miss a thing when it’s time to enroll.
There is still work to be done to make sure the insurance market works for families and small businesses. But, for millions of Americans, the time for having the affordable, quality health care coverage, security, and peace of mind they need and deserve is finally within sight.

Keeping the Living Affected Communications Open,2.0

Regional Conference Comes to Hot Springs

Jefferson Comprehensive Care System, Inc. (JCCSI) will be hosting their 5th Regional HIV/AIDS Conference in Arkansas, March 7-8, 2013. The conference will discuss the unique epidemic of HIV/AIDS in the South amongst youth, gay Black men and communities of color. The conference will feature Paul K. Halverson, Director and State Health Officier of the Arkansas Department of Health and Patricia Nalls, Founder and Director of the Women's Collective of Washington, D.C. The two day event will also feature a planned schedule of topics ranging from substance abuse to HIV policy issues.

CorneliusOnPoint, Executive Producer Cornelius Mabin has been secured for a plenary session on "Reaching Gay Men through Social Media." The session will explore the burgeoning use of the Internet of gay men and the various platforms utilized to develop community connections as well as personal relationships.

JCCSI was awarded a grant from Health Resources and Services Administration (HRSA) for the Part D program in August 1999. Part D is unique from other HRSA funded programs because our focus is on women, infants, children, and youth (WICY) and their families who are infected and affected by HIV/AIDS. As part of our commitment to fulfill the goals of Part D, we have begun planning for this monumental occasion to take place on March 7-8, 2013. The theme for the conference is entitled, “Uniting In The Fight To End HIV/AIDS.”

This event will be held at the Hot Springs Convention Center/Embassy Suites Hotel in Hot Springs, Arkansas. For more information contact:www.jccsi.org or 870.534.3448

Linkage to Other Medical and Social Services Webinar

The webinar "Linkage to Other Medical and Social Services" is scheduled for Thursday, February 7 from 1:00 to 2:00 p.m. CT. Getting an HIV positive individual to link into medical and social services is very important, but it's also proven to be a challenge to many HIV/AIDS service providers.

 

This webinar will cover:

 

1. Define what is meant by "linkage to other medical and social services."

2. Understand the relevance of successfully linking HIV positive individuals to other medical and social services within the context of a TLC-Plus framework.

3. Identify at least two linkage strategies that have been implemented successfully in the field.

4. Access resources to assist with linkage activities.

 

This webinar is presented by Shared Action, an AIDS Project Los Angeles CBA Program for CBOs implementing HIV prevention programs including DEBIs and Public Health Strategies. To learn more and to register, visit the webinar website.

 

 

 

Keeping the Living Affected Communication Open

HHS Releases Inventory of Initiatives and Prevention Programs Aimed at Reducing HIV Infections among African Americans

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

The Department of Health and Human Services (HHS) recently released a report [PDF] describing findings of an interagency collaboration to identify, review, and assess the effectiveness of HHS-funded, discretionary initiatives and programs to reduce HIV infections among African Americans. The report describes relevant prevention programs and initiatives, identifies future opportunities, and provides insights that will help inform strategies to reduce HIV infections among vulnerable African-American populations.

The inventory was one of the tasks assigned to HHS in the National HIV/AIDS Strategy (NHAS), which notes that prevention efforts must acknowledge the heavy burden of HIV among Black Americans and target resources accordingly. Based on the most recent data from CDC, African American men and women represent 14 percent of the total U.S. population, but account for a disproportionate 44 percent of all persons living with HIV in the United States.

The cross-departmental working group responsible for the effort agreed that programs/projects for inclusion in the review would be those that had been funded within the past five years with the intention of reducing HIV infections among African Americans or to support related program efforts, like capacity building. Surveillance activities, international prevention programs, and NIH research activities were not included in this analysis. Information was self-reported by individual agencies and offices using standard spreadsheet software.

The report summarizes data for 56 HHS-funded HIV prevention programs and initiatives serving African Americans that were active between Fiscal Years (FY) 2009 – 2011. The programs reflect an average annual investment of nearly $293 million in prevention programs and initiatives to reduce HIV infection among African Americans. It is noteworthy that racial and ethnic minorities also benefit from other HHS programs that provide HIV prevention, treatment, or care but do not target any single subgroup of the population.

“Curbing the HIV epidemic in the U.S. requires a robust national response to the prevention needs of African Americans, who are disproportionately affected by HIV/AIDS,” said Dr. Andrew Forsyth, Senior Science Advisor in the HHS Office of HIV/AIDS and Infectious Disease Policy, who oversaw data collection and analysis.

According to the report, programs provided HIV prevention and related services (71.7 percent); mental health/substance use services (11.8 percent); outreach and education (5.2 percent); family planning services (3.8 percent), and capacity building/technical assistance (2.2%) among other activities.

Although the report found that program investments generally follow the epidemiology of the HIV epidemic among African Americans it also suggests areas where targeting of services might be enhanced—particularly in disproportionately affected subgroups (e.g., young men who have sex with men and women) and in hard-hit U.S. regions (i.e., South, Northeast). As stated in the report: “A systematic review of the effectiveness and regional distribution of effective HHS-funded services may help to ensure that resource allocations are optimized. This may be especially important for preventing new HIV infections in subgroups of African Americans with the highest incidence rates, including adult and adolescent MSM, injection drug users, and women, including transgender women.”

The inventory was conducted by the African American Program Inventory Working Group, an interagency effort led by the HHS Office of the Assistant Secretary for Health (OASH), with representatives from the Departments of Housing and Urban Development (HUD), Justice/Bureau of Prisons (DOJ/BOP), and Veterans Affairs (VA); Centers for Disease Control and Prevention’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (CDC NCHHSTP); Health Resources and Services Administration’s HIV/AIDS Bureau (HRSA HAB); National Institutes of Health Office of AIDS Research (NIH OAR); Substance Abuse and Mental Health Services Administration’s (SAMHSA) Centers for Substance Abuse Prevention (CSAP), Treatment (CSAT), and Mental Health Services (CMHS); and OASH Offices of Minority Health (OMH), Population Affairs (OPA), Women’s Health (OWH), and HIV/AIDS and Infectious Disease Policy (OHAIDP).
Though the report is a “snapshot” of a short period of recent time (FY09-FY11), efforts to develop, deploy, and support HIV prevention interventions that serve African Americans are ongoing. Examples of ongoing efforts include the cross-agency Care and Prevention of HIV in the United States (CAPUS) project and SAMHSA’s Targeted Capacity Expansion Program: Substance Abuse Treatment for Racial/Ethnic Minority Populations at High-Risk for HIV/AIDS. Read more about current CDC activities addressing HIV among African Americans.

Given the disproportionate impact of HIV among African Americans, ongoing evaluation of federal investments and support for high-impact prevention are needed to fully achieve the National HIV/AIDS Strategy goals of reducing new HIV infections, increasing access to care and improving health outcomes for people living with HIV, and reducing HIV-related health disparities

Straight Talking and Living OUT Loud

Family Planning Providers Key in Fight Against HIV

By Vanessa A. White, MPH, Public Health Advisor, Office of Population Affairs, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services and Christine Brazell, MS, MPH, Public Health Advisor, Office of Population Affairs, Office of the Assistant Secretary for Health, U.S. Department of Health and Human Services

C. Brazell (L) and V. White (R) of the HHS Office of Population Affairs

The Title X Family Planning Program, administered by the HHS Office of Population Affairs (OPA), provides funding to more than 4,000 service delivery sites across the country to support voluntary, confidential, and low-cost education, counseling, testing, and related preventive health services that allow individuals and couples to plan and space births. The family planning service sites funded through this program are key allies in the nation’s response to HIV, providing family planning and related preventive health services—including HIV prevention and testing—to more than 5 million low-income or uninsured men, women, and adolescents each year. All Title X funded agencies are required to provide, at a minimum, HIV/AIDS prevention education, including education on HIV risks and infection prevention, and HIV testing, either on-site or by referral.

Number of HIV Tests Increases Over Time

The table below highlights the trend in on-site HIV testing at Title X service sites over a nine-year period from 2003-2011. The number of HIV tests has more than doubled over this period, rising to 1.3 million in 2011, with more than 1,600 clients testing positive in 2011.

However, because of limited resources, not all service providers have been able to offer on-site HIV testing. So, since September 2001, with funding from both the Secretary’s Minority AIDS Initiative Fund (SMAIF) and the Title X Family Planning Program’s annual appropriation, OPA has provided supplemental funding through a competitive process to select Title X sites to enable them to expand the availability of on-site HIV counseling, testing, and linkage to HIV care and treatment services. Consideration was given to key variables such as the HIV prevalence rates in the applicants’ communities. These supplemental funds currently support 437 Title X service delivery sites across 34 states in areas that have need, but limited resources, for these important health services.
Historically, Title X sites that have offered on-site HIV testing were required to refer HIV-positive clients for care and treatment services. In addition, since 2010 the OPA-supported HIV testing projects have been required to go one step further and put in place systems and structures to ensure that clients who test positive for HIV are actually linked to care, meaning the client was seen in a health‐care setting by a physician, nurse practitioner, or physician assistant within three months of a positive HIV test. In 2011, 81% of clients who tested positive in these projects were linked to HIV care. The projects regularly review their data on linkage to HIV care, using it to improve systems to ensure linkage to care, increase the number of formal referral agreements with HIV service providers, and improve systems and processes for documenting linkage episodes.

Reaching Women at Risk for or Living with HIV

Title X family planning sites play a particularly important role in reaching many women at risk for or living with HIV because these sites often serve as vital entry points to the health care system for women in need of subsidized care. In fact, more than 60% of women of reproductive age who receive health care in a publicly-funded family planning service site (including both Title X and non-Title X sites), report that the site is their usual source of health care ^[i]. In addition, 41% report that the site is their only source of health care^[ii].
The HIV prevention and testing services women receive at these sites are especially critical given that the implementation of recommendations for universal prenatal HIV counseling and testing, antiretroviral (ARV) prophylaxis, scheduled cesarean delivery, and avoidance of breast feeding has dramatically decreased perinatal HIV transmission to less than 2% of all births to HIV infected mothers in the U.S.^[iii].

Serving Populations Disproportionately Impacted by HIV/AIDS

Title X family planning sites also play an important role in reaching populations that have long been disproportionately impacted by HIV/AIDS. This includes racial and ethnic minorities who represent the majority of new infections in the U.S., as well as new AIDS diagnoses, people living with HIV/AIDS, and AIDS deaths. In 2011, racial and/or ethnic minorities comprised 77% of all the clients tested in OPA-supported HIV prevention projects and 82% of all the clients who tested HIV-positive.
In addition, HIV prevalence has been notably higher among heterosexuals in many low-income communities. A recently published CDC report^[iv] found that heterosexuals in 24 large U.S. urban areas with annual household incomes at or below the poverty level had an HIV prevalence rate of 2.3%, compared with an HIV prevalence rate of 1.0% among those with incomes above the poverty level. This led the authors to conclude that in urban areas with high AIDS prevalence, HIV prevention activities aimed at heterosexuals should focus on low-income communities. Low-income populations are given priority for services in Title X service sites. In 2011, two-thirds of Title X users had family incomes at or below the Federal poverty level and 89% had family incomes at or below 200% of the poverty level.
As highlighted above, Title X family planning service sites across the nation are active partners in efforts to achieve the goals of the National HIV/AIDS Strategy (NHAS). OPA is committed to continuing and expanding these important HIV prevention, testing and linkages to care efforts. We look forward to working with our partners across HHS and in states and communities in the coming year to raise the bar on these efforts and to share both successes and promising practices^[v].

Stayin Live and in Living Color

5 Years, 900 Blog Posts, 1 Million Page Views

  By Michelle Samplin-Salgado, New Media Strategist, AIDS.gov
 

Editors Note: The Living Affected Corporation congratulates the producers of the AIDS.gov blog which has been a content source for our organizational blog. It is our goal to mirror their success by offering the latest updates, links, videos and original content to our readers and beyond. We believe that harnessing the power of the Internet will be instrumental in end game of HIV and AIDS.

Today marks an important milestone for the AIDS.gov blog.

Five years ago today, we launched this blog with the intent of reaching audiences with information on how to use new media. In 2009, we extended our content to include Federal policies and resources. Today our blog continues to address these topics and more.

While we have seen many new online communication platforms emerge over the past five years, we feel that blogs are still relevant, as they continue to help us reach our audiences. Our blog allows us to go in depth into topics and then share and repurpose that content on other platforms, such as Twitter , Facebook , and YouTube . Over the last five years, the AIDS.gov blog has:

• Published more than 942 posts
• Surpassed 1 million page views
• Sparked new discussions, with 1,696 comments from readers

And while we’re pleased with these numbers, we ultimately don’t measure success by the numbers. We measure our success by what we have learned from the conversations new media helps facilitate. We feel successful because we can answer “yes” to these questions: Are we a tool to assist entities assess how to use new media to extend or improve the reach of their HIV prevention and care programs? Are we a source and/or link to federal resources, programs and policies?

Success is also about engaging our readers. We looked back through some of our blog posts with the most comments and here’s what some of you had to say:

“Blogs, social networks, text messaging, forums and groups are a fantastic means of education people about HIV AIDS and other health related issues. People can not only support each other but offer advice as to what worked for them and thus educate the public at large.”
-From A Wake-up Call for All of Us: How Can New Media Help? (2008)
“I’m from Puerto Rico, and we are part of 12 cities. This [initiative] represents a great opportunity to all the stakeholders to do something regarding this [disease], not just in our city, but throughout all the Nation. “Unity make us stronger in any setting”
- From The 12 Cities Project (2011)

“As someone who is living with [AIDS], this push to write about it in blogs inspired me to create my own blog. Although my blog will be more than just about [HIV/AIDS] it will be a part of it. I am looking forward to reading and finding everyones blogs posts. Is there a best practice on finding the blog posts?”
- From The Power of Blogs: Bloggers Unite on World AIDS Day (2008)

On this 5-year anniversary we want to THANK YOU for your readership and engagement. We also want to know, what is it that makes you continue visiting this blog? In addition, how can we improve our blog? We look forward to hearing from you!

Keeping the Infomation Portal Living

Arkansas HIV Planning Group launches FACEBOOK page

In an effort to continue to fulfill it mission of outreach and open source communication, the Arkansas HIV Planning Group formerly known as the "Arkansas Community Planning Group," has moved forward with its media strategy.
Using its marketing committee, the group sought to engage growing trends in new media while still utilizing various elements of old media such as standard mail.

The group's Facebook page (www.facebook.com/ArkansasHPG ) was launched two week ago in conjunction with the creation of a new signature logo as well as updating information on ADH''s web portal to refresh the groups position in the community. Co-chaired by COP 24/7's Executive Producer C. Mabin and ADH representative, C. Hampton, the group's overall mission is to decrease HIV infections in the state through collaborations with the Arkansas Department of Health on its jurisdictional plan which details prevention programming throughout the state.

For meeting information go to the page and add your "like" to those who have given a thumbs up on the project. Watch this platform for more news and press releases from AHPG.


On the Road to an AIDS-Free Generation

By Eric Goosby, Ambassador, U.S. Global AIDS Coordinator
Cross-posted from DipNote U.S. Department of State Official Blog

As of September 30, 2012, PEPFAR directly supported lifesaving antiretroviral treatment (ART) for nearly 5.1 million people — a nearly three-fold increase since 2008. PEPFAR also supported drugs to prevent mother-to-child transmission for nearly 750,000 HIV-positive women in 2012 alone, allowing approximately 230,000 infants to be born HIV-free, and HIV testing and counseling for more than 46.5 million people over the same time period.
These are not just statistics but they represent lives saved, and hope renewed for millions of families and communities. A decade ago, almost no one in Africa was receiving treatment. Today, over 8 million men, women, and children in developing countries are on ART, with the vast majority of them being in sub-Saharan Africa.
Every American should be profoundly proud of the United States’ role in supporting this progress. Both President Obama and Secretary Clinton have repeatedly reaffirmed America’s commitment to the global fight against AIDS through PEPFAR. In November 2011, the Secretary declared that the world is at the point where an AIDS-free generation is in sight. On World AIDS Day 2011, the President announced ambitious new PEPFAR prevention and treatment targets, which we are on track to reach by the end of 2013.

This past July, the 19th International AIDS Conference came to the U.S. for the first time since 1990. During the Conference, Secretary Clinton called on PEPFAR to develop a blueprint to inform the next Congress, the next Secretary of State, and all of our partners about all that we have learned, and how the U.S. will contribute to creating an AIDS-free generation moving forward. And in recognition of World AIDS Day 2012, the Secretary unveiled the PEPFAR Blueprint: Creating an AIDS-free Generation (PDF 2.6MB), which sends an unequivocal message that the U.S. commitment to the global AIDS response will remain strong, comprehensive, and driven by science.

Through the contributions of many partners, a new day has dawned in the global AIDS response. New HIV infections and AIDS-related deaths are on the decline, and national health systems have been strengthened to deliver a broader range of essential health services to the populations that they serve. Partner countries are increasingly assuming the central leadership in coordinating their AIDS response. Thankfully, long gone are the overcrowded medical wards that I witnessed as a clinician in San Francisco in the early 1980s, when we had little to offer patients beyond a more dignified death; or the time just a decade ago when AIDS was wiping out an entire generation in Africa. Today, while the fight is far from over, we are on the road to achieving an AIDS-free generation.

Now, we must redouble our efforts to get there. As outlined in the PEPFAR Blueprint, we will continue our focus on: saving lives by investing in proven HIV interventions; making smart investments by targeting interventions to populations at greatest risk; promoting sustainability, efficiency, and effectiveness across our programs to maximize the impact of each dollar we spend; partnering with countries in a joint move to country-led, managed, and implemented responses, and working closely with the Global Fund to Fight AIDS, Tuberculosis and Malaria and other partners around a shared global responsibility to reach more of those in need; and driving results with science by using the knowledge we already have, and supporting continued innovation.

As we enter the tenth year of PEPFAR, we do so filled with great hope for a future where an AIDS-free generation is, as Secretary Clinton stated, not just a rallying cry — it is a goal within our reach. And I am confident that 2013 can be another extraordinary year.

New Year in Living Affected

New Year, New Congress

On January 3, 2013, the 113th Congress convened for the first time and welcomed 95 new members into its ranks. Although the November elections did not significantly alter the parties’ power, the makeup of the 113th Congress is much different from any of its predecessors. There are now 20 female Senators, many of which are newly elected. In fact, New Hampshire is the first state to send only women to both chambers of Congress. For the first time in history, white men no longer constitute the majority of Democrats in the House. Although the overall majority of Members of Congress continues to be white men, the 113th Congress has among its ranks 41 African-Americans, 36 Hispanics, 10 Asian Americans, and two Native Americans. Senator Tammy Baldwin (D-WI) is the first openly gay Senator, and Representative Kyrsten Sinema (D-AZ) is the first openly bisexual Member of Congress. The 113th Congress will make decisions on many issues relevant to the HIV/AIDS community, including striking a deal on the sequester, the budget, and possibly the Ryan White CARE Act. AIDS United will continue to work on behalf of those living with and affected by HIV/AIDS throughout the 113th Congress. Click here to see some Committee Assignments relevant for the HIV/AIDS community.    Syphilis and HIV: A Dangerous Duo Affecting Gay and Bisexual Men   By Gail Bolan, M.D., Director, Division of STD Prevention, Centers for Disease Control and Prevention Trend data released today in CDC’s 2011 STD Surveillance Report show that primary and secondary syphilis rates are increasing among gay and bisexual men, who now account for more than 70% of all infections. During the 1990s, syphilis primarily occurred among heterosexual men and women of racial and ethnic minority groups. However, the tide shifted and cases began to increase among gay and bisexual men, referred to as men who have sex with men (MSM) in CDC data systems. A growing number of these cases have been reported among young MSM, with the highest rates being found in men 20-29 years old. What is causing this shift? And what should we be doing differently? Syphilis & HIV Annual syphilis surveillance data published in the just released 2011 STD Surveillance Report continue to emphasize the disproportionate burden of disease among gay and bisexual men. While the health problems caused by syphilis in adults are serious in their own right, it has been shown that the genital sores caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present, and studies have also shown that syphilis will increase the viral load of someone who is already HIV infected. This is especially concerning, as data from several major cities throughout the country indicate that an average of four in 10 MSM with syphilis are also infected with HIV. The stakes are too high to ignore these health disparities. It is critically important that syphilis infections among MSM be promptly diagnosed and treated in order to decrease the rates of subsequent HIV infection. Moving Forward: MSM and Syphilis Prevention If we are to tackle the root causes of health disparities among gay and bisexual men, we must confront the underlying conditions that place this population at greater risk for STDs. Risk behavior alone does not explain the disproportionate STD burden these men face—complex issues like homophobia and stigma also help fuel the infections. CDC is working with program partners to take action to confront the underlying causes of STD disparities. One example is the movement to go beyond disease-specific prevention approaches and provide more comprehensive, holistic sexual healthcare through Program Collaboration and Service Integration—an effort to organize and blend interrelated health issues (like HIV and STD prevention), activities, and prevention strategies to facilitate comprehensive delivery of services. Action plans guided by the best available science and input from partners are also being implemented to help individuals and communities overcome environmental forces that increase the risk of acquiring an STD. However, governments’ efforts cannot do it alone—broader action is also needed by all parties involved. Many Americans are reluctant to discuss sexual health issues, though STDs are very common. Together we can bring these conversations out of the shadows: Health Care Providers should… Assess their patients’ risk for STDs, especially MSM Test patients according to CDC’s STD testing recommendations at the site of exposure Individuals should… Talk openly with your doctor or health care provider and ask to be tested–your health depends on it Talk openly with partner(s) about STDs and testing Get tested for STDs—go to FindSTDTest.org or call 800-CDC-INFO to find a site near you Use a condom correctly each time you have sex and/or practice mutual monogamy with an uninfected partner to reduce your risk of getting syphilis Community leaders should… Engage other sectors (business, transportation, housing) to help promote STD prevention and sexual health Speak out about STDs and fight stigma With timely diagnosis and appropriate treatment, syphilis is curable. By remaining vigilant and promoting greater awareness and action, we can turn the tide against this disease and help stop the spread of HIV. We can help ensure good health for gay and bisexual men who are disproportionately impacted by STDs as well as HIV.

New Year in Living Affected

The National AIDS Strategy 2013 Updates

The Living Affected Corporation has been a full supporter of the the National HIV/AIDS Strategy since its inception in 2010. This ambitious plan is the nation's first-ever comprehensive coordinated HIV/AIDS roadmap with clear and measurable targets to be achieved by 2015. As an organization it is our belief that the tenants involved are decisive measures that support our groups internal "HEFTE" (housing, employment, food, treatment and education) concept to deal with individuals as "whole persons" not merely a diagnosis. This is most important in the disproportionately impact population of Black gay men from 13-24, especially since in Arkansas they represent the largest increases of infections despite being only about 1% of the overall population.

The endgame vision of the United States to become a place where new HIV infections are rare and when they do occur, every person regardless of age, gender, race/ethnicity, sexual orientation, gender identity or socio-economic circumstance, will have unfettered access to high quality, life-extending care, free from stigma and discrimination. Our organization vows to continue to be the experts in the field while we move forward with our goal to transform communities through holistic health by providing education and advocacy.