This article discusses three meetings. First, it reports on the September 27 meeting of the HIV Planning Council (HIV-PC). Second, it discusses the October 5 Enhancing Prevention in Communities (EPIC) Conference. Third, it reports on the October 12 meeting of the South Florida AIDS Network (SFAN).
The Broward HIV Planning Council (HIVPC) oversees the Ryan White Care (RWC) Program of Broward (RWC-Broward). The EPIC Conference focused on developments in bio-medical prevention of HIV. The South Florida AIDS Network (SFAN) advises the RWC program of the Florida Department of Health in Broward (RWC-FL DOH Broward).
The HIV Planning Council Meeting
RWC-Broward contracts with agencies to deliver services to people living with HIV. Twice a year RWC-Broward adjusts the amounts in these contracts. When an agency looks like it will not deliver all its contracted services, the HIV Planning Council will move some of its funds to other agencies. Agencies had requested $2 million in transfers, but only roughly $726,000 was available. At this meeting, the HIV-PC voted to move that $726,000 between agencies.
Unlike previous years, almost all agencies were operating at or above capacity. According to Leonard Jones, RWC-Broward, this results from clients staying in care for longer periods of time. This may result, in part, from the success of the Test and Treat program.
The EPIC Conference
Treatment as Prevention refers to how an undetectable viral load impacts HIV transmission. It eliminates the possibility of the sexual transmission of HIV. At present, no one knows its effect on needle sharing or breast feeding. The phrase “Undetectable Equals Untransmissible” or U=U has begun to replace Treatment as Prevention. In 2017, the CDC, NIH, WHO, and Lancet, all announced their public support for the U=U campaign.
Two people spoke about U=U. Dr. Howard Grossman is the Medical Director for Midland Medical. Diane Jones is on the faculty of San Francisco AIDS Education and Training Center.
Grossman and Jones stressed that this requires a change in how people talk about HIV risk. They also cautioned against an unintended consequence of the U=U campaign. It could stigmatize people with detectable viral loads.
Sonia Boyne, University of Miami’s Comprehensive AIDS program, spoke about stigma. Boyne reported that HIV stigma has more of an impact on who drops out of care than who stays in care. Stigma can result in depression, a disinclination to disclose, and a lower quality of life.
Boyne described three types of stigma. Internalized stigma refers to negative beliefs about the self that a person holds. Perceived stigma refers to actively held beliefs that cause someone to stigmatize someone else. Enacted stigma refers to behaviors based on perceived stigma. Enacted stigma consists of actions such as discrimination, criminalization, or harassment.
Wimsley Cruz, RWC-DOH Broward, reported that about one-third of all ADAP clients in Florida live in Broward. Among all Broward ADAP clients, 694 are eligible for the 90 day supply. Of these 694 people, slightly more than a third have already enrolled. Eligibility requires clients to meet three criteria. First clients would have to have picked up their meds 11 times out of the last 12 scheduled pick-ups. Second, clients would have to have at least one viral load test in the last 24 months. Third, all viral load tests would have to show less than 200 copies of HIV. People can apply for exceptions to these eligibility rules.
Next HIVPC meeting: Thursday October 25, at 9:30 a.m. at Broward Government Center, Room GC430, 115 S. Andrews Ave.
Next SFAN Meeting: Tuesday, November 13, at 6:00 p.m., at Mills Pond Park, 2201 NW 9th Avenue, Fort Lauderdale. SFAN welcomes newcomers.
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