The Rainbow Times interviewed AIDS Action Committee Executive Director Carl Sciortino about his thoughts on the recent state budget cuts that will impact HIV/AIDS direct service programs as well as the potential ramifications of a Trump presidency on HIV/AIDS funding locally and nationally.
By: Mike Givens/TRT Assistant Editor—
Just five days after the 28th anniversary of World AIDS Day on December 1, Massachusetts Governor Charlie Baker announced roughly $98 million in budget cuts in anticipation of a revenue shortfall. One million dollars was cut from the HIV/AIDS line item, funds that will have a devastating effect on direct services for those living with the condition.
“AIDS Action will most likely be forced to lay off staff and pull back some of its outreach and prevention services,” said Sciortino.
On World AIDS Day, the Getting to Zero Coalition, which AIDS Action leads, released a comprehensive plan to end HIV/AIDS in Massachusetts by 2020.
“ … eliminating new HIV infections in Massachusetts will require that, by 2020, 90 percent of those living with HIV are aware of their status; 90 percent of those diagnosed with HIV are treated with antiretroviral therapy; and 90 percent of those receiving antiretroviral treatment are virally suppressed,” Sciortino said, noting that the first goal has already been accomplished. “In order to meet the second, an additional 3,334 people living with HIV would need to be receiving quality treatment, and [to meet the third goal] an additional 3,625 people would need to be virally suppressed.”
The budget cuts, commonly referred to as 9C cuts, would “hobble important initiatives” that provide a range of life-saving services and severely impede the second and third goals of the Getting to Zero Coalition, according to Sciortino. Outreach programs to support those living with HIV/AIDS and ensure they adhere to their regimens would be crippled.
Making pre-exposure prophylaxis, also known as PrEP, more widely available, could also be impacted as funding shortages could make it difficult for the prescription medication to be made more widely available. “PrEP is a daily antiretroviral medication that prevents HIV infection, and is an incredibly important tool in the fight against HIV because it is nearly foolproof in preventing HIV transmission when taken as prescribed,” Sciortino said. “The drug is also covered by health insurers, so there’s no excuse for healthcare providers and HIV prevention experts to not be spreading the word about this important prevention tool. It’s like birth control for HIV.”
Massachusetts Administration and Finance Secretary Kristen Lepore released the following statement about the 9C cuts:
“The Baker-Polito Administration was pleased to sign a balanced budget for Fiscal Year 2017 that further increased investments in education, local aid, and efforts to fight the opioid-heroin epidemic, without raising taxes. Today, we are acting to put the budget back in balance for the hardworking people of Massachusetts as provided under 9C authority in response to softening revenues, unavoidable spending deficiencies, and the Legislature’s decision to restore spending above the administration’s signed balanced budget.”
HIV/AIDS Prevention and Treatment Under the Trump Administration
Donald Trump has nominated U.S. Representative Tom Price as his top pick to lead the country’s Health and Human Services Department, a move that has roiled health care advocates and caused a stir in Washington D.C.
Recently, it was reported that Rep. Price sponsored legislation involving several healthcare companies he’d also invested nearly $300,000 in on the stock market, a move that could spark an ethics investigation.
Price has also been a vocal proponent of making heavy alterations to President Obama’s Affordable Care Act (ACA) including eliminating the legislation’s mandatory provision for birth control, reducing Medicare benefits for the elderly, and stripping away insurance seekers’ rights to have pre-existing medical conditions covered by health insurers. Conservative bent notwithstanding, Price has still garnered the high-profile endorsement of the American Medical Association for the head of the Health and Human Services Department.
“Millions of people have been able to get access to quality health care thanks to the ACA, including many people living with HIV,” Sciortino said. “Obamacare makes it illegal to deny health insurance to people living with HIV. The law also makes it illegal to discriminate against LGBTQ people in the provision of health care.
“In the United States, gay and bisexual men and transgender women, particularly those of color and those who are young, are disproportionately impacted by HIV. Repeal of the Affordable Care Act would be a colossal step backward that would ultimately cost us lives and public health care dollars.”
Price’s record on healthcare issues has also been called into question by several sceptics. Price is a member of the Association of American Physicians and Surgeons, an organization that infamously correlated abortions with higher instances of breast cancer, has denied that HIV causes AIDS, and categorically opposes doctors accepting Medicaid or Medicare from patients.
“None of this bodes well for federal funding for HIV prevention in the future,” Sciortino said.
Healthcare in the Commonwealth
Sciortino noted that one of the most effective ways to fight HIV/AIDS in Massachusetts is to provide younger people with the educational resources they need to make informed decisions about sex and their bodies.
“The people most vulnerable to HIV are young people, who simply are not getting accurate information about how HIV is transmitted and how to prevent it,” he said, emphasizing that passage of a law mandating comprehensive, age-appropriate, medically accurate sex education is pivotal to healthy and safe sex lives for young people as they enter adulthood.
“The benefits of a measure like this is that it would also help in [the] prevention of other sexually-transmitted diseases and infections as well as help prevent unintended pregnancies,” he continued. “The promotion of sexual health as a human right is long overdue.”
Currently, a coalition of progressive organizations are advocating for a law mandating that schools that do teach sexual education provide comprehensive curricula for students across the Commonwealth that includes information on abstinence, contraception, and healthy relationships with the goal of preventing unwanted pregnancies and higher incidents of HIV and other sexually transmitted infections.
With the confluence of the 9C cuts coupled with the impending Trump administration, Sciortino said that it’s more important than ever that local organizing and advocacy come to the forefront to continue the work of reducing HIV/AIDS diagnoses to zero.
“We are really going to need to turn to our local communities and state for leadership. Now is not the time to pull back resources from the very people who are likely to come under attack from a Trump administration.”
[This first appeared on the January 5, 2017 issue of TRT]