The Importance of National Transgender HIV Testing Day

April 18 marks the second annual National Transgender HIV Testing Day (NTHTD), a national initiative to increase HIV screening, prevention, and treatment among transgender people. HIV screening is an important step in HIV prevention and the first step in the HIV Care Continuum, the recommended treatment plan for people living with HIV. As simple as getting tested might seem, transgender people still encounter many barriers to screening. NTHTD aims to facilitate screening and prevention among transgender individuals by actively engaging them in their sexual health and wellness and empowering them to take charge over their health and wellness (UCSF, 2018).

Each year, community-based organizations, local health agencies, and social service agencies specializing in gender affirming care focus on strategies to raise HIV status awareness among trans and gender non-binary persons.  By utilizing innovative approaches to reduce HIV and its related health disparities among transgender women the organizations seek to engage the trans community in conversation about culturally tailored HIV screening and treatment in the US.

These efforts have never been more important, as the transgender community is increasing in visibility and new policies threaten the livelihood and well-being of transpeople across the country. The fact remains: HIV continues to be a crisis for transgender Americans.

HIV infection rates are two times higher in transgender people than in sexual gender minorities, including lesbian, gay, and bisexual persons (CDC, 2015; Institute of Medicine, 2011). About 1.4 million or 28 percent of all trans women in the United States are living with HIV (Flores, Herman, Gates, & Brown, 2016). Rates of new HIV infection among Black transgender people is 24.9 percent compared to 0.6 percent in the general United States population (Human Rights Campaign, 2016). Moreover, Black transgender women are more likely to be living with HIV (56 percent) than are White (17 percent) and Hispanic/Latina (16 percent) transgender women (CDC, 2015). Transgender women, especially those of color, are disproportionately affected by HIV infection in the United States (Centers for Disease Control and Prevention [CDC], 2015; White House Office of National AIDS Policy, 2015).

But why are the numbers among transgender people so high? And what can we do about it? First, there is a lack of comprehensive care and approaches to health, a lack of affirming places of care and multi-layered transgender stigma and discrimination that collectively discourage transgender and gender non-binary people from seeking HIV screening and treatment. Second, there is a lack of medical models that support trans-specific care. Third, on a national level, there is a lack of clinicians who are adequately trained to provide transgender health care services.

To increase HIV screening and address the HIV epidemic in transgender and gender non-binary people, we must have safe entries to care, build networks of clinicians and care providers who are representative of the community, and adapt or develop models of inclusive care.

As we commemorate National Transgender HIV Testing Day and mobilize our efforts in working towards advocating for policies that support health equity and parity for this population of men and women may we be reminded of a quote from Sir Williams Dean, former Governor General of Australia, “The ultimate test of our worth as individuals and countries is how we treat the most vulnerable and disadvantaged.”

 

References:

Centers for Disease Control and Prevention. (2015). HIV among transgender people. Retrieved from http://www.cdc.gov/hiv/risk/transgender/

University of California San Francisco, Trans HIV Testing Toolkit Overview: National Transgender HIV Testing Day. Retrieved 4/9/2018 via: http://transhealth.ucsf.edu/pdf/NTHTD/Overview_cd.pdf

Institute of Medicine. (2011). The health of lesbian, gay, bisexual, and transgender people: Building a foundation for better understanding. Retrieved from https://www.nap.edu/read/13128/chapter/1

Flores, A. R., Herman, J.L., Gates, G.J., & Brown, T.N.T. (2016). How many adults identity as transgender in the United States? Retrieved from https://williamsinstitute.law.ucla.edu/research/how-many-adults-identify-as-transgenderin-the-united-states/.

Hines, D. D., Draucker, C. B., & Habermann, B. (2017). HIV Testing and Entry to Care Among Trans Women in Indiana. Journal of the Association of Nurses in AIDS Care28(5), 723-736.

Human Rights Campaign. (2016). Transgender people and HIV: What we know. Retrieved from http://www.hrc.org/resources/transgender-people-and-hiv-what-we-know.

White House Office of National AIDS Policy. (2015). National HIV/AIDS strategy for the United States: Updated to 2020.

 

NMAC Connection Special: An Open Letter to CDC Director Dr. Robert Redfield

An Open Letter to Dr. Robert Redfield
Director, Centers for Disease Control

Dear Dr. Redfield,
Congratulations on your appointment as the new Director of the Centers for Disease Control and Prevention. It was especially heartening that, at your first meeting with CDC staff, you said it’s possible to end the HIV epidemic in America. Your ambitious goal of ending it within the next three to seven years was music to our ears. You are the first CDC director to have this vision and NMAC wants to work with you to make it a reality.

We have a mutual belief that biomedical HIV prevention is key to bending the curve of new HIV infections. Attached is the latest Blueprint from NMAC that shares policy recommendations on ways to expand access to PrEP and U=U/Treatment as Prevention. This document highlights the unique challenges people of color face in HIV prevention, care, and treatment. It gives ways to improve outreach to gay men of color, women of color, and the transgender community.

NMAC would like to formally invite you to attend this year’s National Biomedical HIV Prevention Summit on December 3-4, 2018. The meeting will be an opportunity to dialogue directly with community, share your vision for ending the epidemic, and discuss CDC’s plans to fully implement biomedical HIV prevention.

Ending AIDS must be more than a slogan; it takes planning, collaboration, and funding to make it real. Over the past five years, significant achievements have been made. Despite these successes, our gains have not been realized equally.  Your vision to end the HIV epidemic within our lifetime can only happen when we work together. We may not agree on everything, but NMAC can definitely support, collaborate, and work to end the epidemic with CDC.

Yours in the struggle,


Paul Kawata
Executive Director

NMAC Connection: Scholarship Applications Open

More Federal Funds for Opioid-Related Infections is Good – But More is NeededFive of the nation’s leading organizations focused on ending the HIV, STD, and hepatitis epidemics in the United States – AIDS United, NASTAD, the National Coalition of STD Directors, NMAC, and The AIDS Institute – applaud Congress and the Administration for restoring critical funding for HIV and STDs and bolstering hepatitis programs. The Fiscal Year 2018 Omnibus Appropriations represents a down payment on shoring up the nation’s public health infrastructure, but it also falls short on necessary resources to combat the nation’s opioid crisis and associated infectious diseases.

Read the full statement.

 

April 10 is National Youth HIV & AIDS Awareness Day
From time to time, we will feature voices from NMAC program participants to talk about their communities and their work. This week, in honor of National Youth HIV & AIDS Awareness Day, we’re featuring Joe Gray, a participant in our Youth Initiative.

This is such an overwhelming feeling and such an honor to get to serve my Tribe, the HIV Community. I am a young man from very humble beginnings and this is my truth. I have gone from a hopeless Addict to an HIV Activist. April 10, 2015, National Youth HIV & AIDS Awareness Day, is the day I got clean and moved into a 90 day homeless shelter for persons living with HIV here in Sacramento. I have done a lot of work on self over the years to be where I am and I strive daily to be the person I needed when I was that young kinder-queer and newly diagnosed person living with HIV.
Read the rest of Joe’s story.

Still Time to Apply for NMAC’s Youth Initiative

There’s still time to apply for the eighth cycle of NMAC’s Youth Initiative program to train future leaders in the fight against the HIV epidemic. The seven-month program is open to applicants ages 18-25. Youth living with HIV or on PrEP, LGBTQ, youth of color, and young cis & trans women are particularly encouraged to apply. For more information or to apply, visit the NMAC website.

 

Applications are due by April 10.

NMAC’s Next Community Spotlight Webinar April 24

Join us for our next Community Spotlight webinar on April 24 at 3:00 PM EST. This month’s focus will be on Youth and HIV and will feature voices from NMAC’s Youth Initiative program, which trains future leaders in the fight against the HIV epidemic.

Register now!

We’re Hiring!

NMAC is hiring! If you’d like to come work with us, please check out our latest job opportunities.

Despite Gains in HIV, STD, and Hepatitis Funding, Omnibus Bill Falls Short on Opioid Funding for Infectious Diseases

Despite Gains in HIV, STD, and Hepatitis Funding, Omnibus
Bill Falls Short on Opioid Funding for Infectious Diseases

Washington, D.C. – Five of the nation’s leading organizations focused on ending the HIV, STD, and hepatitis epidemics in the United States – AIDS United, NASTAD, the National Coalition of STD Directors, NMAC, and The AIDS Institute – applaud Congress and the Administration for restoring critical funding for HIV and STDs and bolstering hepatitis programs. The Fiscal Year 2018 Omnibus Appropriations represents a down payment on shoring up the nation’s public health infrastructure, but it also falls short on necessary resources to combat the nation’s opioid crisis and associated infectious diseases.

With STD cases at the highest level ever recorded, Congress restored important funding for STD prevention, reversing a cut of $5 million that was passed last year. Congress also rejected proposed cuts to domestic HIV programs, including to the Secretary’s Minority AIDS Initiative, a crucial source of funding for HIV prevention, care, and treatment for communities of color, as well as the Ryan White Program and CDC HIV Prevention Programming. What’s more, Congress increased funding for the Housing Opportunities for People Living with AIDS (HOPWA) Program. We commend this action, but we also know more must be done to reduce the impact of HIV and STDs on our nation.

Congress also increased CDC hepatitis funding by $5 million, to $39 million, but it is far from the $100 million we believe is needed to institute prevention and education programs, increase testing and linkage to care and treatment, and implement surveillance systems to ensure jurisdictions across the country are adequately equipped to tackle the rapid increases in hepatitis and HIV due to injection drug use.

Moreover, our nation’s opioid epidemic remains virulent. The recent rise in injection-drug use not only accounts for a significant increase in overdoses, but also increases in hepatitis C, HIV, and STDs, particularly among young adults. The number of new hepatitis C cases nationwide nearly tripled between 2010 and 2015, and hepatitis C now kills more Americans than all other 60 notifiable infectious diseases combined. And STD rates show no signs of decline.

We commend Congress and the Administration for restoring crucial HIV and STD funding, and for expanding investment in viral hepatitis prevention — however minimal. Drug treatment and infectious disease prevention efforts can significantly reduce opioid addiction, overdose deaths, and new blood-borne infections. But sustaining the headway made in the struggle against hepatitis C, HIV, and STDs will require more than the bare minimum if we do not want to risk years of progress being undone.

###

AIDS United (AU), NASTAD, the National Coalition of STD Directors (NCSD), NMAC, and The AIDS Institute (TAI) are national non-partisan, non-profit organizations focused on ending HIV in the U.S. They have been working in partnership to identify and share resources to sustain successes and progress we have made in HIV, STD, and hepatitis prevention, care and treatment in the United States.

Constituent Spotlight: Joe Gray

This is such an overwhelming feeling and such an honor to get to serve my Tribe, the HIV Community.  I am a young man from very humble beginnings and this is my truth. I have gone from being a hopeless Addict to an HIV Activist. April 10th 2015, Youth AIDS Day, is the day I got clean and moved into a 90 day homeless shelter for persons living with HIV here in Sacramento. I have done a lot of work on myself over the years so I could be where I am and I strive daily to be the person I needed when I was that young kinder-queer and newly diagnosed person living with HIV. I have gotten the opportunities to do some amazing and beautiful things after getting clean, such as being asked to represent Sacramento as a young gay man living with HIV at AIDSWATCH 2016 in Washington, DC where I advocated for HIV and AIDS funding in our country’s capital. I felt so overwhelmed, and in those moments, I learned about the power of my own story.

I cannot contain nor express in words the gratitude for the NMAC Youth Initiative Program, which has created a space for us young leaders to develop our personal leadership abilities though meaningful discussions and engaging in first-hand training from leaders in the HIV field. I became involved with the NMAC Youth Initiative Program based on a suggestion from a provider here at the clinic in Sacramento where I receive care. While at USCA 2016, I participated in various leadership trainings, dynamic discussions and, because of the training from NMAC, I have gained a confidence I never knew I had within myself. I have learned how to network and connect with other young leaders within the HIV field. I have been able to discover my leadership qualities and personal style. Soon after returning home from the program, I was a guest on POZIAM Radio speaking about my journey from Addict to Activist.

Later In 2017 I was asked to return as a Youth mentor. I made myself openly available to support, uplift, and encourage the youth scholars throughout the duration of our program and with their World AIDS Day projects and assisted with any questions they may have had.  While at USCA 2017, I felt it was important to build interpersonal relationships and deep connections with the other youth. I was able to help create space for them to engage in dynamic discussions about exploring the challenges we face as young leaders and creating networking opportunities, and shared community-based solutions. As we discover and collaborate on new ideas, we uplift and inspire each other’s community based work while redefining youth leadership as we wish to see it. We get to be the change we want to see in the world today.

While attending the Youth Initiative Program, we are given the space to cultivate the skills, abilities, and knowledge to formulate community-based efforts within the HIV community. Currently, I am putting all of what I have learned from Linda Scruggs, her team, and previous years with the Youth Program to work as the Lead on the planning committee for the One Love conference taking place at UC Berkley this year. One Love is a conference designed by young adults for young adults, ages 18-26, all of whom are living with HIV or AIDS. Participants will be engaged in complex discussions and workshop sessions about the unique issues they face with their diagnosis.

It is my hope that my experience will engage other young people living with HIV to know that there is life after diagnosis. We can dream and reach those dreams. We can have goals and achieve those goals. We can love and be loved. Most of all HIV has taught me how to love myself.

Important Happenings in HIV Policy

Important Happenings in
HIV/Health Policy

Week Ending: March 30, 2018
By: Matthew Rose & Sable K. Nelson

 

President Signed the FY18 Budget

On Friday, March 22, 2018, the President signed the bill that set the FY18 funding levels through September 30, 2018.  Flat-funding means maintaining the funding level from the previous fiscal year (FY17). Here’s a summary of what we currently know regarding how it impacts HIV/AIDS funding:

2017 Actual

2018 Estimated

Centers for Disease Control & Prevention (CDC) HIV, Hep, STD, TB line (Total) $1.117 M $1.127 M
Health Resources Services Administration (HRSA) Ryan White HIV/AIDS Program (Total) $2.319 M $2.319 M
Housing and Urban Development  (HUD) Housing Opportunities for People with (HOPWA-Total) $356 M $375 M


BOTTOMLINE:

  • The HIV portfolio of treatment and prevention programs were mostly flat-funded in FY18. We were able to see increases in the STD line to restore it to 2016 funding levels. There was also a 5 million increase in the funding for viral hepatitis. Furthermore there was a build increase of 19 million dollars to the HOPWA program. This is a WIN for the HIV community in this political climate (especially, since the Administration and the House of Representative proposed to cut and/or eliminate federal funding for certain HIV prevention and treatment programs in FY 2018).

 

OMB is reviewing a rule about the public charge

According to a draft of the proposal obtained by The Washington Post, the administration is seeking to further restrict immigration by changing the reach of the rules around “public charge.” It would change what can be used in a determination that would broaden range of factors when considering immigrants or their U.S.-citizen children are using public benefits or may be likely to do so. The proposed rule would force families, including citizen children, to choose between getting the help they need – like the Earned Income Tax Credit, ACA subsidy, CHIP and “WIC” nutrition assistance for babies and moms, medical care, and housing assistance – and reuniting with those they love or even keeping their families together. If adopted, this rule will make families choose between staying together and getting the health care they need, even for the family members who are US citizens.

READ → https://www.washingtonpost.com/world/national-security/trump-proposal-would-penalize-immigrants-who-use-tax-credits-and-other-benefits/2018/03/28/4c6392e0-2924-11e8-bc72-077aa4dab9ef_story.html?utm_term=.cf3dcd1cfc6a

 

 

New Director at the CDC

On Monday, March 26, 2018, Dr. Robert Redfield Jr. began his tenure as the new director of the Centers for Disease Control and
Prevention (CDC) in Atlanta. It is reported that while addressing senior CDC staff, Dr. Redfield stated that the AIDS epidemic could be ended within seven years and he pledged to bring the opioid crisis “to its knees.” Dr.Redfield has a complex history with the HIV community. He rose to prominence in the 1980s as a top researcher into the emerging AIDS epidemic and was most recently a medical school professor at the University of Maryland. However, Dr. Redfield has also been scrutinized for overstating the effectiveness of an experimental AIDS vaccine over two decades ago. NMAC and other organizations are cautiously optimistic to work the new director.

READ → https://www.upi.com/Health_News/2018/03/30/New-CDC-director-aims-to-end-AIDS-epidemic-in-seven-years/2591522426399/ ; https://www.cbsnews.com/news/aids-researcher-robert-r-redford-selected-as-cdc-director/

 

What NMAC is Doing About It

  • NMAC remains vigilant in its advocacy to protect FY19 government funding.
  • NMAC is has been meeting with legislators to work on FY 2019 funding levels
  • NMAC is preparing to for the release of the run around public charge and will be submitting comments
  • NMAC is planning a face-to-face meeting with the CDC Director in the near future

 

What You Can Do

TAKE ACTION: Many of you participated in AIDS Watch 2018 last week. Over 500 people from across the country travelled to Washington, DC to speak truth to power on Capitol Hill and share their personal stories with congressional staffers. It is vitally important to continue those efforts at the state level and speaking to your federal elected officials when they are at home. If we don’t support and advocate for HIV funding and programs, who will?  Our movement cannot afford to stand on the sidelines.  Your U.S. Senators and U.S. Representatives need to hear from you.

 

Also, MAKE SURE THAT YOU ARE REGISTERED TO VOTE in time for the primary and general elections happening this year:

Indiana

4/9/2018

Ohio 4/9/2018
North Carolina 4/13/2018
Pennsylvania 4/16/2018
West Virginia 4/17/2018
Idaho 4/20/2018
Arkansas 4/23/2018
Georgia 4/23/2018
Kentucky 4/23/2018
Oregon 4/24/2018
Nebraska 4/30/2018

For more information, VISIT→ https://www.eac.gov/voters/register-and-vote-in-your-state/

Finally, PARTICIPATE IN THE PRIMARY ELECTION(S) in your state!

NMAC Connection: Important Deadlines for You to Know!

USCA Abstract Submission Deadline is One Week Away!
Want to present at USCA? The deadline for submission of abstracts is now just eight days away on April 6!Whether you’re interested in convening a workshop or presenting a poster, your abstract must be submitted no later than 5:00 PM ESTon Friday, April 6.

Visit the USCA website for full information on the submission process, including a recording of our abstract submission webinar. We can’t wait to see what you send us. While we’re talking about USCA, are you interested in applying for a scholarship to attend? Join us for a webinar on April 11 to explain the process, including application deadlines, scholar responsibilities, and important dates.
Whether you’re interested in an Option A or B scholarship, an HIV 50+ Strong & Health scholarship, or a Social Media Fellowship, this webinar is for you. Register now.

 

Still Time to Apply for NMAC’s Youth Initiative 
There’s still time to apply for the eighth cycle of NMAC’s Youth Initiative program to train future leaders in the fight against the HIV epidemic. The seven-month program is open to applicants ages 18-25. Youth living with HIV or on PrEP, LGBTQ, youth of color, and young cis & trans women are particularly encouraged to apply. For more information or to apply, visit the NMAC website.
Applications are due by April 10.

 

Webinar on Multimorbidity and HIV+ Older Adults
Join us for “Why Are Older Adults with HIV at Increased Risk for Multimorbidity?,” a webinar from our Treatment division, on Friday, April 6, at 3:00 PM with national expert on HIV and aging, Dr. Stephen Karpiak. Register now.

 

2017 Biomedical HIV Prevention Summit Survey Deadline
Did you attend the 2017 Biomedical HIV Prevention Summit? Then we want to hear from you! If you haven’t already, please take a few minutes to fill out our survey on the Summit. We want to hear your feedback to make the 2018 Summit better. The deadline for the survey is April 10.

NMAC Connection: The Latest News From NMAC

Learn About the USCA Scholarship Process in April 11 Webinar

Interested in a scholarship to attend the US Conference on AIDS this year? Join us for a webinar on April 11 to explain the process, including application deadlines, scholar responsibilities, and important dates. Whether you’re interested in an Option A or B scholarship, an HIV 50+ Strong & Health scholarship, or a Social Media Fellowship, this webinar is for you.
Register now
!

Welcome Marissa Miller to the NMAC Family
NMAC is thrilled to welcome Marissa Miller to our family. As a
Program Coordinator, Marissa works in our Leadership Pipeline program, helping to train new leaders in the fight against HIV.  A native of Indiana, Marissa has been an active voice for the transgender community for years in Indiana and Chicago, where she worked at Howard Brown Health.
Marissa shared some of her thoughts about her work here at NMAC.

Join Us for a Webinar on Multimorbidity and HIV+ Older Adults
Join us for “Why Are Older Adults with HIV at Increased Risk for Multimorbidity?,” a webinar from our Treatment division, on Friday, April 6, at 3:00 PM with national expert on HIV and aging, Dr. Stephen Karpiak. As people living with HIV live longer, healthcare providers are spending less time managing HIV-related issues and more time managing age-associated illnesses. This webinar will explore this topic.
Register now!

We’re Hiring!
NMAC is hiring! If you’d like to come work with us, please check out our latest job opportunities.

NMAC’s Newest Voice – How Marissa Miller Makes Change

After a 10-hour drive and saying farewell to my beloved Midwest, I have found myself in Washington, DC. A year ago, this wasn’t my plan, but I have learned to listen to the universe and she told me to step into a new tomorrow. After all, for nearly 28 years I have spoken out as a voice in the Transgender communities, specifically Communities of Color, in Indianapolis, Chicago, and other spaces .

Being HIV-positive, Transgender, and Black has qualified me to have a voice. I believed, whether I understood it or not, from the very beginning that there was a very distinct need for my voice, and I was ready to use it.  A voice is a source of strength that can move others to make change…A VOICE so powerful…A VOICE so transparent…A VOICE so necessary…A VOICE not belonging to just me, but belonging to my people! As an advocate, I have often been mistakenly branded as angry. Yes, it was ANGER that fueled that initial Voice, but today PASSION and LOVE for my community is what now carries this voice.

I am thankful to the universe that my journey from anger to passion and love have positioned me as the first Transgender person on NMAC’s staff.  And not just a Transgender person, but a Transgender Woman of Color. Like with the first of anything, many eyes in both the HIV and transgender community will be paying attention.

Again, my focus at NMAC is not on me, the Transgender Woman of Color living with HIV. I came to NMAC to be a change agent and to work with other leaders as Program Coordinator in the Division of Leadership Pipeline. I am coming to support trailblazing opportunities for our community. I am coming to create additional collaborative partnerships in the fight to end HIV.

And I am coming to help NMAC fulfill its mission.

NMAC Connection: Invitation to CAPS

Would you consider applying to be part of NMAC’s Community Advisory Panels? This is a way too long recruitment letter to talk about our grand experiment. Applications are due March 23.. This newsletter explains NMAC’s vision and strategy to end the HIV epidemic.

NMAC leads with race to end the HIV epidemic in America.

We do it by urgently fighting for health equity and racial justice via our continued commitment to build leaders of color, our focused role within the HIV community on race, and its impact on HIV care and prevention, and by our survival when so many other agencies have closed their doors. In 1987 we started with a commitment to building leaders of color with the skills, connections, and savvy to fight. Today, NMAC continues to build leaders and ask them to focus on race and its impacts on HIV care, treatment, and prevention. NMAC does not do anti-racism work. There are many organizations with more experience and qualifications. To be effective, anti-racism work has to focus on white people. NMAC builds the skills and tells the stories of people of color.

          

In 2014-15, NMAC’s updated strategic plan changed our name, mission, and vision. During this time, America also saw the rise of the Occupy Wall Street, Black Lives Matter, and MeToo movements. Like these causes, NMAC fights for a world that is fair and equitable; however, our fight is focused/limited to ending the HIV epidemic in America. We are not here to end racism. We are here to examine how race impacts HIV care, treatment, and prevention. The majority of Americans living with HIV are people of color, yet 74 percent of the people on PrEP are white. This inequity is why NMAC fights for comprehensive biomedical HIV prevention for all communities highly impacted by HIV.

There are many ways to lead with race. NMAC believes that building the skills of leaders of color, standing up within the HIV movement, and surviving the difficult years is how NMAC leads with race. Will you join our grand experiment?  Online applications are due March 23 to be on NMAC’s new Community Advisory Panels (CAP).

This is a real program that needs real commitments. Your input will influence the workshops, plenaries, and scholarship decisions for both USCA and the Summit.

I’m going to stop before I lose you. An extended version of the letter can be found here.  Thank you for your consideration.

Yours in the struggle,

Paul Kawata
(202)  277-2777
Executive Director