Health Care Access

O’Neill Institute’s New Quick Take on Federal Discretionary HIV Funding

The O’Neill Institute released a helpful fact sheet on federal discretionary HIV funding. Mandatory programs (like Medicaid, Medicare, and social security), which serve broader groups of people and increase when the demand for them increases, were not the focus of the fact sheet. Instead, it aims to highlight discretionary HIV programs specifically tailored to preventing HIV and meeting the needs of people living with HIV. Every year, Congress must decide how much funding to allocate to these discretionary programs through a process called appropriations, meaning their funding levels are not guaranteed to match needs.

This information-packed fact sheet will be a great tool to understand the principal HIV programs that are discretionary, their main functions, and their impacts. It then explains why increasing funding for these programs is so important. First, most of the funding for these programs has not kept pace with inflation. Second, ending the epidemic requires a holistic response addressing economic insecurity, discrimination, and social and structural factors; the actual need for services for people living with HIV is increasing. Federal discretionary funding has never been sufficient to meet the needs of all communities heavily impacted by HIV, especially women living with HIV.

Missouri Will Allow PEP to Be Dispensed Over the Counter

Missouri became the third state, along with Oregon and California, to allow pharmacies to dispense post-exposure prophylaxis (PEP) over the counter without a prescription. This is a time-sensitive, emergency medication that can be taken by a person who believes that they may have recently been exposed to HIV.

Laws like these expand access to the HIV prevention medications and advance the efforts to end the HIV epidemic in these states. This important change was championed by Empower Missouri and the Missouri HIV Justice Coalition.

If you are a person living with HIV in Missouri who is looking to get involved with advocacy, please consider applying to be part of the Missouri HIV Justice Coalition’s PLHIV leadership cohort.

Towards Abolition: Learning and Action Guide

Towards Abolition, launched in May, is an amazing resource for folks in the public health community to find ways they can support abolition of the prison industrial complex in their work.

This Learning and Action Guide frames the importance of abolition for the public health field and supports public health professionals in working toward it. It was created for people involved in the public health field, including students, researchers, practitioners, public health department employees, and others.

The array of resources is immense, with peer-reviewed scholarship, policy change toolkits, videos, podcasts, and articles. The guide contains eleven sections, beginning with “The Prison Industrial Complex: Adverse Implications for Public Health,” and covering a wide range of topics, including “Family Regulation And Reproductive Control” and “Infectious Disease Surveillance And Criminalization,” which highlights the work PWN is doing around molecular HIV surveillance.

The PWN Texas Strike Force Beats Back ADAP Eligibility Changes

The PWN Texas Strike Force worked overtime this spring to prevent devastating changes to the state’s AIDS Drug Assistance Program (ADAP). Due to budgeting issues and a computer glitch, the Texas Department of State Health Services (DSHS) proposed income eligibility changes that would have prevented 2,700 Texans living with HIV from receiving their HIV medications. The Texas Strike Force mobilized to garner public opposition to the proposed changes.

The Strike Force was successful in getting DSHS to reverse its decision to change income eligibility requirements, and all people living with HIV will continue to receive medications. Also, the head of DSHS’s HIV/STD bureau resigned mid-March. The Strike Force will continue to monitor the situation and are currently preparing for multiple meetings where they can raise their concerns with the ADAP program and its management.

If you live in Texas and would like to join the Strike Force or hear what they are up to, be sure to sign up here for more information.

National Hispanic/Latinx Health Leadership Network Releases Updated Recommendations

The National Hispanic/Latinx Health Leadership Network released updated recommendations for the federal government to address health inequities in Latinx communities. There are some really important pieces here, like incorporating language justice in the federal response to HIV and requesting that the National Institutes of Health (NIH) conduct a major research study on the diverse challenges Hispanic/Latinx people face to accessing care (highlighting resilience, challenges, and realities among foreign-born and U.S.-born individuals).

While PWN supports many of these recommendations, the Leadership Network does call for increased funding of all pillars of the Ending the Epidemics (EHE) plan. While HIV programs and services most certainly do need robust funding, the EHE plan is heavily reliant on molecular HIV surveillance (MHS). EHE plans and funding should not go forward without addressing the serious concerns about the use of MHS.

You can download the recommendations in Spanish or English.

HEAL Act Reintroduced

The Health Equity and Access Under the Law (HEAL) for Immigrant Families Act was reintroduced this month in the U.S. Congress (both the House and the Senate). The HEAL Act would expand health care access for immigrants by: (1) allowing immigrants to enroll in Medicaid and CHIP if they are eligible; (2) permitting undocumented immigrants to buy health insurance coverage on the ACA’s health insurance marketplaces; and (3) ensuring that DACA recipients (and anyone with a similar status in the future) can access Medicaid, CHIP, and ACA marketplace coverage.

Currently, the law has a patchwork of restrictions limiting immigrants’ access to health care, like five-year waiting periods to access CHIP and Medicaid and banning undocumented immigrants, including DACA recipients, from purchasing insurance on the ACA’s marketplaces. These cruel, inhumane restrictions disproportionately harm BIPOC immigrants.

PWN endorsed the HEAL Act. If you would like to support the effort as well, the National Asian Pacific American Women’s Forum has created a portal to contact your legislators and let them know you support the HEAL Act!

Sexual and Reproductive Health, Rights and Justice

The Supreme Court Takes Up a 15-Week Abortion Ban Case

The Supreme Court will hear Dobbs v. Jackson Women’s Health Organization, a challenge to a Mississippi law that prohibits nearly all abortions after the fifteenth week of pregnancy. This will be the first abortion case to be heard since Justice Amy Coney Barrett, an outspoken abortion opponent, joined the court and shifted its balance to become decidedly conservative.

As the law stands now, the Supreme Court has said that the Constitution protects the right to have an abortion before a fetus becomes “viable,” which occurs around the 24th week of pregnancy. Now, that doesn’t mean that it has to be easy to get one, but it does mean that accessing an abortion can’t be an “undue burden” on the pregnant person.

In this case, the Court will consider whether all bans on pre-viability abortions are unconstitutional. This would be a big change in reproductive rights in this country. While abortion rights are severely curtailed in many states, until 24 weeks of pregnancy, people who become pregnant may legally access abortion. If blanket bans are permitted earlier than 24 weeks, low-income, BIPOC, rural, and Southern and Midwestern people who become pregnant will be adversely impacted.

This case will not be heard until the fall, and a decision will likely not be released until spring or early summer of 2022. This is a great opportunity to donate to an abortion fund or to join groups trying to protect reproductive rights in your state.

Reintroduction of Women’s Health Protection Act

Members of Congress will reintroduce the Women’s Health Protection Act (WHPA) in the coming weeks to protect the right of pregnant people to access abortion care throughout the country. WHPA is an attempt to undo the burdensome restrictions that some states enact, like mandatory waiting periods, by establishing a statutory right for health care providers to provide, and their patients to receive, abortion care free from medically unnecessary restrictions, limitations, and bans that delay, and at times, completely obstruct, access to abortion.

The EACH Act, also making its way through Congress at the moment, would require abortion care to be covered for people who receive their health care through the federal government.

As the Supreme Court gets closer to ending the constitutional right to an abortion, these bills become even more important. You can learn more and support WHPA before is introduced here and let your members of Congress know what the EACH Act means to you as well.

Ending Criminalization

Illinois and Nevada Pass Bills to Repeal or Modernize HIV Criminalization Laws

Advocates in both Illinois and Nevada scored huge victories in May as they passed bipartisan bills to overhaul HIV criminalization in their states!

Illinois’s HB 1036 completely repeals the state’s HIV criminalization statutes. Once Governor Pritzker signs HB 1036 into law, Illinois will become the second state to completely repeal its HIV criminalization laws. The Illinois HIV Action Alliance, a coalition of many local, state, and national organizations, led the work on the creation and passage of the bill sponsored by Rep. Carol Ammons.

Nevada’s SB 275 is not a full repeal, but is hailed by the advocates who fought for it as a big step in the right direction, repealing a law that made it a felony “to intentionally, knowingly or willfully engage in conduct that is intended or likely to transmit the disease,” according to a Silver State Equality press release. Rather than a felony, a first offense would get a warning, and a second offense would be a misdemeanor.

“While it’s true that the majority of arrests under HIV criminal laws are reduced or dismissed, the outdated laws continued to perpetuate misinformation and antiquated myths, fears and opinions about HIV and how it is spread,” said Connie Shearer, a PWN member who is co-chair of the Nevada HIV Modernization Coalition. “With the passage of SB275, the Nevada legislature chose science over outdated and irrational fear.”

Congratulations to advocates in both states!

Justice in Reentry for People Living with HIV

The Center for American Progress has released a new policy brief, “Justice in Reentry for Formerly Incarcerated LGBTQ People and People Living with HIV,” highlighting the steps that need to be taken to ensure that formerly incarcerated people living with HIV are fully supported by disrupting the “racism, violence, poor health, housing insecurity, and intersectional discrimination they face.”

The brief highlights four areas where the system could improve:

  • State control of formerly incarcerated people after they are released through probation and parole, as well as sex offender registries, which people who are criminalized under HIV exposure statutes are often forced to be included in;
  • Access to safe, culturally competent, and affirming housing options;
  • Exclusion from and discrimination in the legal labor market; the criminalization of sex work and substance use; and bans on accessing support services such as Temporary Assistance for Needy Families (TANF) or the Supplemental Nutrition Assistance Program (SNAP);
  • Accessing culturally competent, destigmatizing health care and fully funding existing federal health centers through the Health and Human Services Administration, like Ryan White programs.

Find the full issue brief here.


LGBTQ Rights, Safety, and Justice

First National HIV Behavioral Surveillance Survey on Transgender Women

The CDC released its first National HIV Behavioral Surveillance (NHBS) report that focuses specifically on HIV among transgender women. This is especially important, as transgender women have historically been ignored in research and grouped with men who have sex with men instead of in their own category. Transgender women, especially transgender women of color, are disproportionately affected by HIV and also face unique challenges and discrimination in accessing care and other supportive services.

This report contains data on HIV prevalence, behavioral risk factors, HIV testing, access to care and other social determinants of health, and the use of HIV prevention services among transgender women.

HUD Withdraws Proposed Rule, Reaffirms Its Commitment to Equal Access to Housing, Shelters, and Other Services Regardless of Gender Identity

The Biden Administration continues to advance the rights of trans people with two new actions in the Department of Housing and Urban Development (HUD) and the Department of Health and Human Services (HHS).

HUD withdrew a rule proposed by the Trump administration that would have weakened the Equal Access Rule. The Equal Access Rule ensures that all people, regardless of gender identity, have equal access to the Department’s Office of Community Planning and Development (CPD) programs. The Housing Opportunities for People with AIDS (HOPWA) program is part of CPD affected by this change, which is incredibly important for transgender people living with HIV who face housing instability and homelessness.

HHS announced that the Office for Civil Rights will interpret and enforce the ACA’s anti-discrimination law and Title IX’s prohibitions on discrimination based on sex to include discrimination on the basis of sexual orientation and/or gender identity.