Why More is At Stake This Election Than You Think

Unless you have been living under a rock for the past year, you will likely already know that Tuesday, November 8th is Election Day across the United States. To say that this election cycle has been been hard to watch would be an understatement. The news cycle has been primarily focused on the general public’s disdain towards the candidates and the nasty attacks and harmful rhetoric that has been on display for the world to see (and hear). While having to select the next leader of the free world in these conditions may seem to be disheartening for some, we still need to participate in the political process because too much is at stake.

In addition to voting for our next President in the national election, we will also be voting in state and local level elections, which has more of a direct impact on our day-to-day lives. Here are a couple of things to consider if you are wondering what is at stake in this election and if you should even bother heading to the polls:

Protect Progress That We Have Already Made

It may be easy to assume that voting doesn’t matter, but it does, especially for the HIV/AIDS community. We must be sure to protect the hard earned legislative victories that we have already achieved for our community. The AIDS Drug Assistance Program (ADAP) provides HIV-related prescription drugs to low-income individuals with limited or no prescription coverage and reaches over a third of all people with HIV receiving care in the United States.  The state of North Carolina once had the longest ADAP waiting list in the nation. As a result of the North Carolina AIDS Action Network’s advocacy efforts with state legislators, North Carolina’s AIDS Drug Assistance Program ended its waitlist and remains fully funded.

Last year, advocacy efforts with the NC General Assembly led to the expansion of the state’s AIDS Drug Assistance Program to allow the program to use funds to help clients purchase health insurance through premium and cost-sharing assistance. Studies have shown that premium assistance programs lead to better health outcomes and better viral suppression rates for patients. When someone is “virally suppressed,” it means that they have very low levels of HIV in their body, significantly reducing the risk of transmitting HIV to another person. Moving ADAP clients onto health insurance programs will help them access important health services to manage other health needs that are currently out of reach for many. We cannot afford to lose state funding for these vital programs that literally save the lives of the 35,000 people living with HIV/AIDS in North Carolina.

Healthcare Access- Closing the Medicaid Coverage Gap

North Carolina is currently one of the few states that has not expanded Medicaid coverage. The Kaiser Family Foundation estimates that in North Carolina, 244,000 people do not have any option for affordable coverage; however, it is estimated that nearly 500,000 people would be eligible for coverage if the state expanded Medicaid and closed the coverage gap. The Cone Health Foundation released a report analyzing the economic impact of expanding Medicaid in 2016 and found that closing the gap in North Carolina would result in net savings for the state budget, despite any new costs of the program. The report also estimated that if North Carolina expanded coverage in 2016, the state would see $318 million in net state savings from 2016 to 2020. It is clear to most people that not closing the Medicaid coverage gap would prevent lower-income people from getting coverage, but what is often not discussed is that not expanding Medicaid would literally result in death for the most vulnerable people, especially those living with chronic illnesses like HIV/AIDS. In North Carolina, 1,100 people have died as a result of being in the Medicaid coverage gap. Voting for state legislators who sense the urgency of closing the Medicaid coverage gap and will work to expand access to the most vulnerable could literally be the difference between life and death.

PrEP Access in North Carolina

PrEP is an HIV prevention strategy that would allow individuals who are HIV-negative to take anti-HIV medications before ever coming into contact with HIV, which would reduce their risk of becoming infected. The medications’ power works to prevent HIV from establishing infection inside a person’s body. PrEP has been shown to reduce risk of HIV infection through sex for gay and bisexual men, transgender women, and heterosexual men and women, as well as people who inject drugs.

While PrEP does not protect against other sexually transmitted infections (STI) or pregnancy and is not a cure for HIV, its introduction into the world of HIV/AIDS treatment will have a serious impact on substantially reducing the amount of new HIV infections throughout North Carolina, the South and the United States. The Southeastern United States has the highest HIV diagnosis rate of any US region. Specifically in North Carolina, we have two cities on the CDC’s list of the top 25 US cities and metropolitan areas with the highest rates of new HIV infections: Charlotte and Greensboro.Reading statistics like that, it appears that North Carolina is on the verge of a potential HIV epidemic if state and local governments do not immediately take action. This election season, we have the power to elect officials who will work to expand PrEP access to communities vulnerable to HIV in order to prevent a public health crisis in the state.

Preventing Discrimination & Stigma in North Carolina

In March 2016, the NC General Assembly passed House Bill 2, the harmful legislation that significantly stripped discrimination protections for the LGBTQ community in the state of North Carolina. Having a piece of legislation like that on the books has already demonstrated to have a negative economic impact on the state, but it also has the potential to have a negative impact on the HIV/AIDS community by perpetuating stigma and discrimination against the community. Victims of stigma and discrimination are often deterred from seeking life-saving medical services, like HIV testing or treatment. We must stand together and show our determination in fighting against harmful legislation that impacts the lives of LGBTQ North Carolinians and the HIV/AIDS community through voting, calling for the full repeal of HB2 and passing much needed protections.

Voter Suppression in North Carolina

This past July, the Fourth Circuit Court of Appeals invalidated most of North Carolina’s 2013 voting rights law, which imposed strict voter-ID requirements, cut back early-voting hours and eliminated same-day registration, out-of-precinct voting, and pre-registration for those under 18. State legislators claimed that early voting presented more opportunities for “violations,” even though there is virtually no evidence of fraud. In its ruling, the Fourth Circuit said that lawmakers “failed to identify even a single individual who has ever been charged with committing in-person voter fraud in North Carolina.” This archaic type of voter suppression should place everyone on notice that the integrity of American democracy is on the line. We cannot allow for state lawmakers to use their legislative power to disenfranchise (largely minority) voters. What better way to take a stand against voter suppression than to vote?

Looking to the future, there will be many more decisions that will be made that directly impact people living with HIV/AIDS, such as affordable housing and funding for treatment, prevention and supportive services. This election is soo much more than your love or hate for two candidates. The future of our state is on the line. Now more than ever, we must ensure that we continue to advocate for our community through our vote on the federal level, but also on the state and local levels.

Happy Election Day!

-Christina Adeleke, Esq., NCAAN Communications and Development Coordinator

Importance of Your Voice

Since the start of this semester, I have been working for the North Carolina AIDS Action Network. The Elton John AIDS Foundation has graciously financially supported my work with NCAAN.

After accepting my sexuality as a gay man, one of my biggest fears became contracting HIV. I come from a low-income, Latino household, one that used to be undocumented, so there existed many barriers for my family and I to have access to information that would destigmatize HIV and its intersection with queerness in our communities.

I had this idea that because I was gay, I would contract HIV and my family members and loved ones would disown me. The culmination of this fear was that love with another man would be unattainable.

I have been very lucky to befriend people that have helped me destigmatize HIV, both in the community and in myself.  I have reached a level of comfort where I can speak on how I can reduce my risk of contracting HIV, not because being HIV positive would be a lapse in my moral character, but because the working systems of society have made it difficult for people with HIV to live fulfilling lives.

While working at Pride events across the state with NCAAN, I have been able to interact with both HIV positive and negative individuals. These interactions included me working at booths and passing out information, but what has been the most moving for me has been the times when people have shared their status with me, unsolicited.

One of the particular handouts we give at the NCAAN booth includes a small booklet from a pharmaceutical company that has thirty quotes, each for a day of the month, of people with HIV that gives insight into a part of how that individual’s life has changed since they knew their status.

It was one of the pieces of information that moved me the most. It held genuine pieces of people’s stories. It told me about their fight for survival in a society that attempted to disown their humanity and push them further into the shadows, while also letting that person with their newly discovered status know that they would be content and okay.

One of the goals that we have at NCAAN is to increase the accessibility of HIV preventative services to individuals across the state. We also relay information about how to stay “safe,” and we do all as an attempt to decrease the spread of HIV across North Carolina.

While talking to Matt Martin, one of my supervisors, one of the most difficult things that we encounter is a way to amplify preventative information and services, at the same time attempting to discontinue the stigmatization that being HIV positive is a mark of death – stereotypes that have harmed the personal relationships and whole lives of individuals in our LGBTQ communities.

Simultaneously, we tell people to be safe and weary of how to prevent the contracting HIV, while at the same time telling them that it’s okay to be HIV positive, and that a full, healthy life is possible.

The most important voice in the act to destigmatize HIV is the voice of the same people that are being shunned from society. When people with HIV speak of their experiences, they push, implicitly, the taboo of HIV into the light of everyday life. We have all probably met someone with HIV, whether they know it or not, and whether we know it or not. They deserve the same respect and love that we would expect.

In a society that has consistently asked HIV positive individuals to feel wrong and embarrassed about their status, these individuals fight to speak up. Even though the burden is being placed on those that are already burdened, the weight of that voice allows people like me to feel comfortable to reach out and reside in an environment that will allow me to live with health and with love – something that was so far from reach as a closeted child.

-Erick D. Aguilar, Outreach Analyst Intern for the NC AIDS Action Network