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To end AIDS, we must address the forces driving it

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The following article was originally published by The Hill.

By Raniyah Copeland, President and CEO of the Black AIDS Institute, and Chris Beyrer, Desmond M. Tutu Professor of Public Health and Human Rights at Johns Hopkins University.

Recently, the CDC released data showing that declines in HIV rates have stalled in the U.S., after about five years of substantial declines. The new report — looking at trends from 2010-2016 — reveals what many of us working in the field already know: prevention efforts are not reaching all communities equally.

The overall leveling off in new HIV infections includes declines among some groups and increases among others. Rates dropped by about 17 percent among heterosexuals and about 30 percent among people who inject drugs, but remained stable among gay and bisexual men — who account for about 70 percent of new infections. Further, among gay and bisexual men, new infections decreased by 16 percent among white men, but remained stable among Black men, and increased by 30 percent among Latino men.

During his State of the Union earlier this month, President Trump announced a bold new plan to end HIV in the U.S. over the next decade. HHS has since specified targets of a 75 percent reduction in new HIV infections in five years and at least a 90 percent reduction in ten years. This goal is affordable and feasible but will only succeed with meaningful engagement of people living with HIV and a focus on the underlying factors driving the epidemic.

First, the good news. The plan will focus for the next five years on 48 counties with the highest burden of HIV as well as Washington, D.C., San Juan, Puerto Rico, and 7 rural states that have substantial HIV incidence. We welcome the Administration’s approach, focusing on the epicenter of an epidemic is tested and effective public health strategy. Half of new infections occur in the South, a rate that is not improving. In 2017, HIV diagnoses declined by 17 percent in the Northeast, yet remained stable in the South.

Rates also vary greatly by race. Nationwide, Black people make up 13 percent of the U.S. population but account for 42 percent of new HIV diagnoses annually. Ending the HIV epidemic among Black communities and the South would effectively end the epidemic as we know it.

To achieve this, we must dismantle the forces driving HIV, including racism, homophobia and mass incarceration. These inequities threaten our country’s credibility as a leader in the global HIV response. We must continue to raise awareness, increase access to pre-exposure prophylaxis (PrEP) and increase access to treatment in communities that are most affected in the U.S. — including women and Black and Latino gay and bisexual men.

If the administration is serious about ending the HIV epidemic then they must expand access to the Affordable Care Act, particularly in the southeastern U.S. People living in these states need better and more affordable health coverage options to prevent and treat HIV. Of course, the Administration is unlikely to support expansion of the ACA. This is the Administration that is pursing anti-trans policies in the military, dismantling government LGBTQ health initiatives, normalizing racist rhetoric, and supported cuts to HIV funding.

To accelerate progress at home, we can draw inspiration from global policy. Established under President George W. Bush and reauthorized for the third time this past December, the President’s Emergency Plan for AIDS Relief (PEPFAR) remains one of our country’s greatest bipartisan success stories. Today, the program supports 24 million people with antiretroviral therapy, has provided 15.2 million men with voluntary male circumcisions which have been proven to reduce HIV risk, and drove a 25-40 percent decrease in HIV diagnoses among adolescent women in PEPFAR focus countries.

The International AIDS Conference in 2020, to be held in Oakland and San Francisco offers a platform for U.S. officials to demonstrate global leadership. This gathering will return to the US at an important political moment, ensuring that HIV will be at the top of the policy agenda in 2020. A coalition of HIV and human rights organizations have voiced concern around hosting the conference in the US citing the dangerous rhetoric and policies of this administration. This only further reiterates how critical ensuring human rights are to implementing HIV strategies.

Our call to action for lawmakers is to authorize funding for the new US HIV strategy — and to remove harmful policies that will undermine progress. These include the ban on trans people in the military, criminalizing HIV transmission, harmful rhetoric and racist drug policies. What’s more, they must expand the ACA. That the new Congress is younger and more reflective of the communities hardest hit by HIV than ever before gives us hope that this is possible.

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Frequently Asked Questions

  • To determine the location for each International AIDS Conference, the International AIDS Society (IAS) conducts an extensive, open-bid process that begins 18 months before a decision is made. For the 23rd International AIDS Conference (AIDS 2020), IAS also conducted proactive outreach to more than 20 cities worldwide to encourage them to submit a bid, starting in 2016.
  • The process involves an extensive evaluation of each city’s ability to house the meeting and its delegates, commitment to supporting scientific research and implementation, and inclusion of civil society and communities living with HIV in their local response. Each city is required to include a cross-section of policy makers, scientific researchers and civil society as part of the bid.
  • The leadership demonstrated by the State of California in bidding for AIDS 2020 was unparalleled. We received 33 letters of support from local AIDS organizations, local key population networks, leading activists and political leaders, all willing to support the mission of the conference. These included:
    • Senators Dianne Feinstein and Kamala Harris
    • Democratic Leader Nancy Pelosi
    • Congresswoman Barbara Lee
    • Leaders of the State Legislature’s LGBT Caucus
    • Governor Jerry Brown
  • For AIDS 2020, only cities in the global North chose to submit bids. Even after extensive outreach from IAS staff and site visits to potential hosts in the global South, we did not receive any applications.
  • Experience tells us that locations with significant challenges frequently offer the greatest opportunities for change. AIDS 2000 in Durban is a good example. We went in fully aware that the South African president was in denial that HIV even caused AIDS; that gathering marked a turning point for our movement.
  • The US Government plays a vitally important role in addressing the epidemic both globally and domestically, and yet, year after year, we see attempts to dismantle and de-fund these programmes.
  • In its bid, the State of California and the cities of San Francisco and Oakland have jointly shown their willingness to leverage the conference as a platform to resist discriminatory policies, in partnership with conference organizers.
  • Holding AIDS 2020 in the Bay Area will allow us to showcase innovations that have helped San Francisco nearly eliminate new infections and to examine new strategies being employed in Oakland, a city tackling very different challenges.
  • Beyond the Bay Area, AIDS 2020 will shine a spotlight on communities across the US where the HIV epidemic is far from over. People of colour in the US continue to face disproportionate barriers to accessing prevention and treatment and if current trends persist, one in two black gay men will acquire HIV in his lifetime.
  • The Centers for Disease Control and Prevention (CDC) estimates that roughly 1.2 million people in the US are living with HIV – and nearly one in eight of those are not aware that they are infected.
  • The opioid crisis has fuelled a resurgence of new infections. In 2015, an outbreak was discovered in Indiana, and in 2018, the CDC announced another cluster in Massachusetts linked to injecting drug use.
  • Partners in both San Francisco and Oakland are committed to using the conference to make HIV science and policy front-and-centre election year issues.
  • With the selection of the Bay Area for AIDS 2020, we have the chance to elevate US and global HIV concerns to the national and international stage. That includes shining a spotlight on and working to reform unjust policies that restrict entry into the country and perpetuate a climate of stigma and fear.
  • This is a rare moment to put HIV and those most affected, including people of colour, minorities and the economically disadvantaged, at the centre of the election discussion.
  • Key community and political leaders in San Francisco and Oakland recognize the benefit of the conference in solidifying collaborations between the two cities that will play an important role during the election year.
  • We think that hosting AIDS 2020 in the US at this time will potentially give HIV a much bigger platform than it would otherwise have in important national and political debates that will be happening then.
  • Through the unique partnership of Oakland and San Francisco, we can examine two very different epidemics.
  • San Francisco and Oakland represent a tale of two cities, and two diverging experiences that offer insights relevant to the broader HIV community.
  • San Francisco and Oakland represent a tale of two cities and two diverging experiences that offer insights relevant to the broader HIV community.
  • San Francisco was one of the first cities to embrace the UN 90-90-90 targets, and to launch a Getting to Zero effort involving a citywide collaboration of stakeholders from all sectors. It is on track to end new HIV infections by 2020.
  • Across the Bay, Oakland continues to face racial and economic disparities and disproportionate rates of HIV. The city signed onto the Fast-Track Cities Initiative in 2015 and is strengthening policies and programmes tailored to communities most affected by HIV, specifically those that reduce social and economic barriers to HIV prevention and care, in order to reach the 90-90-90 targets.
  • he Bay Area is a hub of top-line, multi-disciplinary, global HIV/AIDS research, led by UCSF, SFDPH, the Gladstone Institute of Virology & Immunology, UC Berkeley School of Public Health and Stanford University.
  • Conference organizers are committed to ensuring that programming and activities are equally represented in both cities.
  • No decisions have been made yet about how to split programming across the cities. The Conference Coordinating Committee will take on this responsibility, seeking input from partners throughout the decision process.
  • Since 2014, we have doubled the number of scholarships for conference attendees. We are committed to continuing to increase the number of scholarships available to those who otherwise could not afford to attend.
  • San Francisco has agreed to waive the cost of the conference venue. These significant savings will allow us to increase our investment in scholarships and keep to the commitment we have maintained for the past decade to not raise registration fees.
  • Local partners are also helping to secure low-cost accommodation by working with universities, hotels and hostels.
  • While there are many reasons for holding AIDS 2020 in the Bay Area, we recognize that an HIV conference in the United States faces serious practical challenges. We have strong political commitment that we believe will help us in finding creative ways to address these issues.
  • AIDS 2012 in Washington DC is an important model for preparing for AIDS 2020. Early engagement from policy experts and advocates helped address a large number of access issues for delegates travelling internationally. This successful model will be put in place for 2020.
  • Given the additional challenges we face under this US administration, for AIDS 2020, we are committed to taking that a step further. We have already convened a high-level, multidisciplinary, bipartisan working group to address specific immigration challenges, of which safe and unimpeded entry for key populations – even beyond the conference – is a priority. This working group will coordinate with migration experts to examine existing laws and advise attendees on how to navigate them.
  • We are working with our partners to come up with creative solutions to make AIDS 2020 virtually accessible to participants in other countries and to ensure that the voices of those who cannot attend in person are heard at the conference. We are actively pursuing support from the many leading technology companies in the Bay Area to enhance our remote access options.
  • This planning has only just begun and is a priority of the Conference Coordinating Committee.
  • All countries have immigration restrictions and, as with each conference, we work with civil society, governments, private sector partners and others to find innovative ways to ensure maximum participation in the conference – especially for key populations and people living with HIV.
  • We pledge to use the conference platform to continue advocating against discriminatory and stigmatizing policies and practices in all countries to effect change on our shared concerns, such as visa and immigration issues. Although many of these challenges are not just US-specific, they are particularly challenging under the current administration.
  • There are, however, specific events that would automatically be grounds for moving the conference. If, for example, the HIV travel ban is reinstated, the reintroduction of this policy would not allow for the GIPA Principle – one of the key markers in the HIV movement – to be realized and, as such, would be a catalyst for moving the conference.
  • Medical conditions and evidence of financial security for entry are requirements from all governments, including “friendly” administrations, such as The Netherlands and Canada. In anticipation that a strict administration would likely affect the interpretation and enforcement of these criteria, we commissioned a report from a subject matter expert to better understand current US immigration law related to non-immigrant travel into the US (Business B-1 and Tourism B-2 Visas) and the implications for AIDS 2020.
  • The report will be used to help guide the work of the national advisory group and local leaders to help us leverage this moment for change.

More information is available and will continue to be updated at www.aids2020.org.

AIDS 2020 offers excellent opportunities for corporate partners to demonstrate their support for the HIV response and to showcase their HIV-related work. Please check our sponsorship brochure to find out more details on available packages.

For further information, please contact Jeanne Mencier who is also available to discuss customized sponsorship packages tailored to best meet your specific needs.

To end AIDS, we must address the forces driving it

posted on

The following article was originally published by The Hill.

By Raniyah Copeland, President and CEO of the Black AIDS Institute, and Chris Beyrer, Desmond M. Tutu Professor of Public Health and Human Rights at Johns Hopkins University.

Recently, the CDC released data showing that declines in HIV rates have stalled in the U.S., after about five years of substantial declines. The new report — looking at trends from 2010-2016 — reveals what many of us working in the field already know: prevention efforts are not reaching all communities equally.

The overall leveling off in new HIV infections includes declines among some groups and increases among others. Rates dropped by about 17 percent among heterosexuals and about 30 percent among people who inject drugs, but remained stable among gay and bisexual men — who account for about 70 percent of new infections. Further, among gay and bisexual men, new infections decreased by 16 percent among white men, but remained stable among Black men, and increased by 30 percent among Latino men.

During his State of the Union earlier this month, President Trump announced a bold new plan to end HIV in the U.S. over the next decade. HHS has since specified targets of a 75 percent reduction in new HIV infections in five years and at least a 90 percent reduction in ten years. This goal is affordable and feasible but will only succeed with meaningful engagement of people living with HIV and a focus on the underlying factors driving the epidemic.

First, the good news. The plan will focus for the next five years on 48 counties with the highest burden of HIV as well as Washington, D.C., San Juan, Puerto Rico, and 7 rural states that have substantial HIV incidence. We welcome the Administration’s approach, focusing on the epicenter of an epidemic is tested and effective public health strategy. Half of new infections occur in the South, a rate that is not improving. In 2017, HIV diagnoses declined by 17 percent in the Northeast, yet remained stable in the South.

Rates also vary greatly by race. Nationwide, Black people make up 13 percent of the U.S. population but account for 42 percent of new HIV diagnoses annually. Ending the HIV epidemic among Black communities and the South would effectively end the epidemic as we know it.

To achieve this, we must dismantle the forces driving HIV, including racism, homophobia and mass incarceration. These inequities threaten our country’s credibility as a leader in the global HIV response. We must continue to raise awareness, increase access to pre-exposure prophylaxis (PrEP) and increase access to treatment in communities that are most affected in the U.S. — including women and Black and Latino gay and bisexual men.

If the administration is serious about ending the HIV epidemic then they must expand access to the Affordable Care Act, particularly in the southeastern U.S. People living in these states need better and more affordable health coverage options to prevent and treat HIV. Of course, the Administration is unlikely to support expansion of the ACA. This is the Administration that is pursing anti-trans policies in the military, dismantling government LGBTQ health initiatives, normalizing racist rhetoric, and supported cuts to HIV funding.

To accelerate progress at home, we can draw inspiration from global policy. Established under President George W. Bush and reauthorized for the third time this past December, the President’s Emergency Plan for AIDS Relief (PEPFAR) remains one of our country’s greatest bipartisan success stories. Today, the program supports 24 million people with antiretroviral therapy, has provided 15.2 million men with voluntary male circumcisions which have been proven to reduce HIV risk, and drove a 25-40 percent decrease in HIV diagnoses among adolescent women in PEPFAR focus countries.

The International AIDS Conference in 2020, to be held in Oakland and San Francisco offers a platform for U.S. officials to demonstrate global leadership. This gathering will return to the US at an important political moment, ensuring that HIV will be at the top of the policy agenda in 2020. A coalition of HIV and human rights organizations have voiced concern around hosting the conference in the US citing the dangerous rhetoric and policies of this administration. This only further reiterates how critical ensuring human rights are to implementing HIV strategies.

Our call to action for lawmakers is to authorize funding for the new US HIV strategy — and to remove harmful policies that will undermine progress. These include the ban on trans people in the military, criminalizing HIV transmission, harmful rhetoric and racist drug policies. What’s more, they must expand the ACA. That the new Congress is younger and more reflective of the communities hardest hit by HIV than ever before gives us hope that this is possible.

| Return

To end AIDS, we must address the forces driving it

posted on

The following article was originally published by The Hill.

By Raniyah Copeland, President and CEO of the Black AIDS Institute, and Chris Beyrer, Desmond M. Tutu Professor of Public Health and Human Rights at Johns Hopkins University.

Recently, the CDC released data showing that declines in HIV rates have stalled in the U.S., after about five years of substantial declines. The new report — looking at trends from 2010-2016 — reveals what many of us working in the field already know: prevention efforts are not reaching all communities equally.

The overall leveling off in new HIV infections includes declines among some groups and increases among others. Rates dropped by about 17 percent among heterosexuals and about 30 percent among people who inject drugs, but remained stable among gay and bisexual men — who account for about 70 percent of new infections. Further, among gay and bisexual men, new infections decreased by 16 percent among white men, but remained stable among Black men, and increased by 30 percent among Latino men.

During his State of the Union earlier this month, President Trump announced a bold new plan to end HIV in the U.S. over the next decade. HHS has since specified targets of a 75 percent reduction in new HIV infections in five years and at least a 90 percent reduction in ten years. This goal is affordable and feasible but will only succeed with meaningful engagement of people living with HIV and a focus on the underlying factors driving the epidemic.

First, the good news. The plan will focus for the next five years on 48 counties with the highest burden of HIV as well as Washington, D.C., San Juan, Puerto Rico, and 7 rural states that have substantial HIV incidence. We welcome the Administration’s approach, focusing on the epicenter of an epidemic is tested and effective public health strategy. Half of new infections occur in the South, a rate that is not improving. In 2017, HIV diagnoses declined by 17 percent in the Northeast, yet remained stable in the South.

Rates also vary greatly by race. Nationwide, Black people make up 13 percent of the U.S. population but account for 42 percent of new HIV diagnoses annually. Ending the HIV epidemic among Black communities and the South would effectively end the epidemic as we know it.

To achieve this, we must dismantle the forces driving HIV, including racism, homophobia and mass incarceration. These inequities threaten our country’s credibility as a leader in the global HIV response. We must continue to raise awareness, increase access to pre-exposure prophylaxis (PrEP) and increase access to treatment in communities that are most affected in the U.S. — including women and Black and Latino gay and bisexual men.

If the administration is serious about ending the HIV epidemic then they must expand access to the Affordable Care Act, particularly in the southeastern U.S. People living in these states need better and more affordable health coverage options to prevent and treat HIV. Of course, the Administration is unlikely to support expansion of the ACA. This is the Administration that is pursing anti-trans policies in the military, dismantling government LGBTQ health initiatives, normalizing racist rhetoric, and supported cuts to HIV funding.

To accelerate progress at home, we can draw inspiration from global policy. Established under President George W. Bush and reauthorized for the third time this past December, the President’s Emergency Plan for AIDS Relief (PEPFAR) remains one of our country’s greatest bipartisan success stories. Today, the program supports 24 million people with antiretroviral therapy, has provided 15.2 million men with voluntary male circumcisions which have been proven to reduce HIV risk, and drove a 25-40 percent decrease in HIV diagnoses among adolescent women in PEPFAR focus countries.

The International AIDS Conference in 2020, to be held in Oakland and San Francisco offers a platform for U.S. officials to demonstrate global leadership. This gathering will return to the US at an important political moment, ensuring that HIV will be at the top of the policy agenda in 2020. A coalition of HIV and human rights organizations have voiced concern around hosting the conference in the US citing the dangerous rhetoric and policies of this administration. This only further reiterates how critical ensuring human rights are to implementing HIV strategies.

Our call to action for lawmakers is to authorize funding for the new US HIV strategy — and to remove harmful policies that will undermine progress. These include the ban on trans people in the military, criminalizing HIV transmission, harmful rhetoric and racist drug policies. What’s more, they must expand the ACA. That the new Congress is younger and more reflective of the communities hardest hit by HIV than ever before gives us hope that this is possible.

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