Health Care Access

An HIV vaccine based on the Moderna COVID vaccine is getting promising results

A new HIV vaccine, developed by IAVI and Scripps Research, has shown promising results in its phase I clinical trials. The vaccine was able to stimulate the production of rare immune cells needed to start the process of generating antibodies against HIV. 97% of the 48 participants of the study showed this immune response.

It utilizes a new “vaccine concept” and will incorporate Moderna mRNA technology at its next trial. The concept behind this vaccine is to cause the body to produce broadly neutralizing antibodies (bnAbs) which could target a wide range of HIV variants.

While this is positive news, it is important to remember that the vaccine still has a long way to go. It will undergo another phase I clinical trial, where a small group of volunteers will receive it and scientists will evaluate its safety and measure immune responses. Then it will head to phase II trials, where it will be given to a larger group of people. If the vaccine makes it to phase III, it will be given to thousands of people to test efficacy and safety before being submitted for a rigorous approval and licensing process. Often, vaccines also undergo a phase IV trial which is a formal, ongoing study even after it’s been approved.

Repeal of Trump’s Title X rule

The Biden administration gave notice that it is moving to repeal the changes the Trump administration made to the Title X program, also referred to as the domestic gag rule. Title X is the only federal funding program dedicated to family planning and serves many low-income Black and Latinx people. It provides high-quality, comprehensive family planning services, including abortion, contraception, counseling services and screening for STIs and HIV, at reduced or no cost.

Under the domestic gag rule, providers who discuss abortions or provide abortion with patients, like Planned Parenthood, are be denied critical federal funding – even if they are not using federal funds to deliver abortion services.

Comprehensive sexual and reproductive health care services are essential aspects of health care that can dramatically affect our lives. Women living with HIV and women of trans experience of any HIV status already face persistent HIV-related and gender-based stigma and discrimination from providers.

The current rule only exacerbates barriers to care and is detrimental to patient communication with trusted health care professionals. The rule is pernicious, unjust, and undermines ethical and medical standards for informed consent that require providers to advise patients on comprehensive medical services that are safest and in their best interest. One out of every four Title X providers left the network as a result of this change, which is estimated to have reduced the network’s capacity to provide contraception by 46% and very likely also reduced its capacity to perform STI and HIV testing and treatment, cancer screenings, and other important health care services.

You can submit a comment in support of repealing the domestic gag rule using Planned Parenthood’s comment form. It’s always good to personalize your comment if you can and explain why this change matters to you. The government is required to read and consider each comment, so MAKE YOUR VOICE HEARD!

Ending the HIV Epidemic plans available on the CDC website

Have you had difficulty finding the ending the HIV epidemic (EHE) plan for your area? Or even finding out if one exists? Us too! Thankfully, the CDC has uploaded links to the plans on their website. Check them out here.

The plans included are only those which received EHE funding under a program called PS19-1906: Strategic Partnerships and Planning to Support Ending the HIV Epidemic in the United States – Component B: Accelerating State and Local HIV Planning. Hopefully, more plans will continue to be uploaded as they are developed.

Economic Justice

Funding for HIV in the fiscal year 2022 budget request

Representatives Barbara Lee, Jenniffer Gonzalez-Colon, and Maxine Waters, along with 30 of their colleagues, wrote a letter to President Biden asking that his fiscal year 2022 budget request increases funding for domestic HIV programs and that he reestablishes the Office of National AIDS Policy (ONAP).

They specifically ask that the following three items be included in the budget request:

  • Significant increases in funding for the Ending the HIV Epidemic initiative. Some specific funding requests for include:
    • At least $107 million to the Health Resources and Services Administration’s Ryan White HIV/AIDS Program to expand comprehensive treatment for people living with HIV (+$107 m);
    • An increase of at least 170 million for the Department of Housing and Urban Development’s Housing Opportunities for Persons with AIDS (HOPWA) program;
    • An increase of at least $165.9 million for the Minority AIDS Initiative (MAI);
  • Urging Congress to eliminate the funding restriction for harm reduction programs like syringe service programs (SSPs);
  • Reestablishing the White House Office of National AIDS Policy (ONAP).

Biden released his first budget request in mid-April which included a $267 million increase in federal spending on HIV. While this falls short of the increases requested by advocates and their champions in Congress, it is important and necessary funding. This increase, if approved, will be used to support the Centers for Disease Control and Prevention, the Health Resources and Services Administration, the Indian Health Service, and National Institutes of Health.

Biden’s infrastructure plan

President Biden formally introduced his American Jobs Plan which, if adopted, will invest about $2 trillion over 8 years in improving U.S. infrastructure.

The administration has made it clear that “infrastructure” will not just be viewed in the narrow way of building roads, bridges, and public transit, but instead invests in care infrastructure and well-paid jobs through unions.

It recognizes that we cannot have thriving people, and therefore a thriving economy, without a robust caregiving infrastructure, healthy and safe workplaces and homes, and affordable and equitable education.

Just a few of these key provisions include:

  • Creating training programs that prioritize job creation for training for underserved communities, formerly incarcerated people, people with disabilities, and the long-term unemployed
  • Expanding Medicaid access to home and community-based health services
  • Building or retrofitting 1 million units of affordable housing and eliminating exclusionary zoning (such as those that prohibit multifamily housing and require a minimum lot size to build)
  • $5 billion over eight years to support evidence-based community violence prevention programs in underserved communities.

You can read more about the plan here.

This plan marks an important step forward in the way the nation thinks about infrastructure and the economy. While there is always more that can be done, recognizing care workers, the need for housing, and the impacts of violence (just to name a few) is an incredible step forward. We will be sure to update you with opportunities to engage in advocacy efforts around this proposal.

Sexual and Reproductive Health, Rights and Justice

Illinois expanding Medicaid coverage for a year post-partum

The U.S. Department of Health and Human Services (HHS) announced that it will extend Medicaid coverage for qualifying pregnant and postpartum people in Illinois to a full year after giving birth.

Illinois is the first state in the country to expand health insurance coverage in this way. Continuing to push for this kind of change in other states is critical to addressing the nation’s maternal mortality crisis. Prior to this, people would lose insurance coverage 60 days after giving birth, a critical time where about 1/3 of pregnancy-related deaths occur. HHS quickly followed this approval with the approval of a similar waiver in Georgia that extends coverage for 6 months.

These changes came about through a section 1115 waiver, a program that gives HHS the authority to approve experimental, pilot, or demonstration projects which are likely to assist in promoting the objectives of Medicaid. States can apply for these waivers, and then the Center for Medicaid Services reviews each proposal to see if the program is aligned with Medicaid objectives and what the budget implications will be. These plans tend to be approved for an initial 5-year period which can be extended upon request.

Florida lawmakers are considering filing such a waiver to expand coverage to pregnant people for up to 12 months postpartum. Texas currently has a Section 1115 waiver pending with HHS to extend some Medicaid limited services to people for 12 months postpartum.  

FDA suspends in-person pick-up requirement for medication abortion

Way back in January (seems like ages ago, we know), the Supreme Court issued an order which required that mifepristone, a pill used in medication abortions, must distributed directly by health providers and not by retail or mail-order pharmacies.

The U.S. Food and Drug Administration (FDA) finally notified medical provider groups earlier this month that that it would “exercise enforcement discretion with respect to the in-person dispensing requirement” of mifepristone during the COVID-19 public health emergency.

This is a very confusing was of saying that while the in-person requirement *technically* still exists, the FDA will not be enforcing it while COVID-19 remains a public health emergency. So patients can now pick up the medication at a pharmacy or get it by mail, as is permitted for other equally safe medications.

While the Biden administration could have gone further by doing away with the in-person requirement completely, this change is vital for allowing people who access abortions during the COVID-19 crisis to limit their physical interactions and remain safer during the pandemic.

If you need to access a medication abortion via telehealth during this time, Planned Parenthood offers this service in 21 states. If you have any other questions about accessing abortion care at home during this time you can check out If/When/How’s Repro Legal Helpline.

Ending Criminalization

Modernizing drug policy from coast to coast

In honor of 4/20, New York has legalized marijuana! While that may not be completely factual, it is true that under a new New York law, people 21 years of age and older will be able to grow and use marijuana.

The state’s new, legal marijuana market will use its new tax revenues to fund education, drug treatment and prevention, and other services for communities disproportionately hurt by the war on drugs. The law also automatically expunges people’s criminal records of marijuana offenses that are no longer illegal.

Virginia also legalized marijuana this year and that bill will go into effect on July 1, 2021.

Oregon too is taking steps to modernize its drug policies by decriminalizing “hard drugs,” like heroin, methamphetamine, LSD, and oxycodone, among others. This is the result of a ballot measure that was passed last November and took effect this month. Law enforcement in Oregon can no longer arrest someone for possession of small amounts of these drugs. Instead, people who are found in possession of these substances will face a $100 fine or a health assessment, which could lead to addiction counseling and treatment.

The “war on drugs” and policies that criminalize substance use were instigated and sustained to disrupt, destabilize, and suppress the political power of communities of color. Drug policies in the U.S. have resulted in mass incarceration and the over-policing of Black and Latinx communities. These states are doing great work to shift toward harm reduction-grounded drug policies and ending the racist policies perpetrated by the war on drugs.

Illinois closes in on full repeal of HIV criminalization laws

The Illinois legislature is considering a bill, HB 1063, which would fully decriminalize the transmission of HIV. This bill has passed the state house by an overwhelming margin of 90-9, receiving considerable bipartisan support. Advocates are hopeful that the bill will soon be approved in the Senate and signed into law by the end of May.

HIV criminalization is harmful to the public health goals around HIV, does not account for the latest scientific data around HIV acquisition, increases stigma, and has many other harmful effects for people living with HIV. These laws are also enforced in a discriminatory manner, targeting Black and brown people living with HIV as well as sex workers and people who use drugs.

If you live in Illinois, please contact your state senator and ask for their support in passing HB 1063! You can use the Illinois HIV Action Alliance’s online contact tool.


Ending Violence

New CDC report on IPV and HIV

A report on intimate partner violence (IPV) and people living with HIV was released which used data from the Centers for Disease Control’s Medical Monitoring Project.

The new data shows that one in four adults living with HIV in the United States has experienced intimate partner violence. However, among cisgender women, the rate of prevalence increased to 35.6% and people of trans experience were also more likely to have experienced IPV. Over half of bisexual women experienced IPV and 35.3% of heterosexual women did. The rates of IPV were also higher for people who had experienced homelessness within the past 12 months.

This study also confirmed what other research has shown: people living with HIV who experienced IPV tend to have worse health outcomes. Prior research has shown that exposure to violence can affect the immune system both before and after HIV diagnosis, and that emotional abuse can increase the rate of CD4 decline.

Living with HIV may itself be a risk factor for IPV as partners may use a person’s status, the threat of public disclosure or the threat of prosecution under HIV criminalization laws as tools for coercion, abuse and control.

For people living with HIV who are immigrants, reporting domestic violence to authorities may place them at risk of losing their immigration status, being detained, or even being deported, while also threatening the immigration status of their partners.

It is imperative that more work is done to prevent IPV and to incorporate trauma-informed care into health care settings.