Friday, December 21, 2007

Congress' Status on HIV Prevention goes from + to -

Gay City News is reporting that Congress has gone ahead and cut HIV Prevention dollars from this year's budget. A lot of gay groups and AIDS orgs are justifiably looking at this as a slap in the face of prevention techniques for an ongoing domestic crisis. The new budget plan offers a slight increase to the Ryan White fund and a decrease in money for CDC Prevention Programs.

"Among its provisions are just under $2.2 billion for the Ryan White Comprehensive AIDS Resources Emergency Act, which funds services for people with AIDS provided by states, cities, and private AIDS groups, and $692 million for the CDC's HIV prevention programs, which got $695 million in the 2007 fiscal year."
Although it's good news that there will be more Ryan White dollars it was disheartening to hear the government taking dollars away from prevention programs. That was until I read this quote:
"We know that we're going to be hearing soon about increased HIV incidence rates," said Sean R. Cahill, managing director of public policy, research, and community health at the Gay Men's Health Crisis (GMHC), an AIDS group. "It's unclear if things are getting worse or if they have always been worse, but we do know that things are worse... Given that, we need to be spending more on HIV prevention."
So here's the thought I'm rolling around in my head: (and trust me the last thing I want to do is be complacent about the gov't taking money away from HIV prevention) If things have always been worse or inconsistent or are getting worse than are millions of more dollars going to help?

I believe Safe Sex 101 (wear a condom) is already out there to a tremendous if not commonsense degree and, yes, I'm sure having more money leads to advancements of more effective ways of getting the message across, but this has been going on for over 25 years now, and despite the incredible and well-respected efforts of all prevention programs, something is still being blatantly disregarded.

If the funds were at 800 million and infection rates still increased or stabilized around a high number would we then ask for a billion? And if that didn't work, would we ask for more? I'm afraid millions of dollars isn't the cushion we're relying on it to be.

Money is crucial, there's no doubt. But more crucial than dollars is dialogue. I think it's not only most important, but a huge aid to prevention programs, if the average Joe gay guy begins having the HIV/AIDS conversation again (I'm not saying a lot of you aren't- or ever stopped.) I think at this point it's about internal community dialogue, realistic real-life media portrayal and sex communication regarding the individual and their relationship to sex. The self, self-worth and responsibility must come before the "should I or should I not" passion of sex and the rest will follow. The gay organizations are nothing short of heroes for their time, efforts and passion but we need to stop placing all the responsibility on their shoulders and start looking at ourselves as the solution and dialogue to these rates and statistics. This dialogue will never cost millions of dollars and a budget cut can never be placed on your voice.

UPDATE:
I posted a comment much like the post above over on Bilerico and I got this as a response. It's terrific and schools me about the $$$=resource matter, which I needed to know. The comment is from David Munar of Preventionjustice.org.
"To use an analogue, if HIV were a raging fire you would need more than water guns and pales of sand to put it out. Would you blame the firefighters for being poorly equipped or the municipality for not making sure they have adequate resources to do the job? HIV is our raging fire and our frontline fighters have scarcely any resources to put up a fight, much level figure the right ways to help those at risk.

HIV prevention messages much change and respond to the times, and the strategies you describe are exactly how HIV prevention needs to change. But unfortunately, HIV prevention organizations in the U.S. have LESS FUNDING today than they did TEN YEARS AGO! It's no wonder, then, we are losing the fight to control HIV in the U.S. because we are simply not making it a budgetary or public health priority to do so."

1 comment:

Hawk said...

Eric:

I understand your points and they make sense to me.

However I don't totally agree with David.

On a micro scale I understand his concern. But his myopic view seems narrow-minded and unilaterally focused.

From a cold harsh rational take on disease in the U.S. (I am speaking specifically about the U.S.) it would seem prudent to focus our resources first and foremost on the biggest killers of our population and especially those killers that we do not understand how to avoid.

The top killers in the U.S. are heart disease, diabetes, stroke and cancer; and the total of what the CDC spends on fighting those diseases is still less than what is spent on AIDS/HIV. Furthermore a disease like cancer, let's say breast cancer, is not absolutely avoidable; while through strictly, monogamous, pre-tested relations, one could avoid AIDS/HIV; or at the very least avoid it at an extremely high success rate.

While making the very tough decisions on how to allocate a finite amount of resources to the sensitive topic of national (domestic) disease control, it seems to me to be appropriate that we take into consideration the factors I’ve listed above, as well as the effectiveness of the dollar itself. So while we can scream that we are not properly taking on the challenge of AIDS/HIV, I agree with you that first we must analyze the effect of the funds and then allocate them in a manner that will save the most lives. Taking this approach, AIDS/HIV is too heavily weighted.