One Year Late: Closing the Coverage Gap

By Lee Storrow, Executive Director, NC AIDS Action Network

Tuesday, December 15, 2015, is the final day to apply for health insurance on the exchanges created under the Affordable Care Act (ACA) to guarantee coverage in 2016. 

Approximately 460,000 residents of North Carolina are already enrolled in ACA plans. The ACA was a landmark achievement to increase access to health care for all residents of our country, and will have a profound impact on our ability to fight HIV/AIDS.

In addition to creating competitive health insurance marketplaces, broadening Medicaid eligibility is an important component of the ACA's goal of increasing access to healthcare. Unfortunately, to date, our state's political leaders have failed to move on closing the coverage gap in North Carolina. Expanding Medicaid would provide health insurance to over 500,000 North Carolinians, including thousands of people living with HIV.

Expanding Medicaid wouldn't just improve the health of those living in our state, but it would also improve North Carolina's economic wellbeing. A year ago, the Cone Health Foundation and Kate B. Reynolds Charitable Trust released a report detailing the potential benefits of Medicaid expansion in North Carolina. The one-year anniversary of these findings provides an opportunity to look back on what this study shows we've missed out on in North Carolina in the meantime.

Over the course of this year, our state lost access to $3.3 billion in federal funding. Not only that, but more than 29,000 fewer jobs were created this year because of the state's failure to expand Medicaid. While many of these jobs would have been created in the health care industry, according to the study, "the economic benefits ripple out when health care providers purchase additional goods and services and as health care workers use new income to pay their mortgages, buy groceries, pay taxes and so on," leading to job creation in construction, retail and wholesale sectors, and other industries.

If we are serious about job creation and a healthier state, it's long past time for North Carolina to expand Medicaid.

Giving Back to North Carolina’s HIV Fight

By Jeffery Williams-Knight 

Many of us are drawn to the possibility of being a part of a movement that truly gives back and makes positive change in our communities, our state and beyond.

As a Charlottean, the supervisor of the Mecklenburg County Health Department’s HIV/STD Community Testing and Outreach Program, and as a board chair of the North Carolina AIDS Action Network, I’ve had the unique opportunity to be involved in public education, HIV/STI testing, community-building and HIV/AIDS policy advocacy. As a result of this type of work in my city and across my state, HIV/AIDS-related mortality rates are on the decline, attempts to weaken sex education in the state have thus far failed, and new drug treatments are limiting the impact of HIV.

Nevertheless, our fight is far from over. 

Mecklenburg County remains the epicenter of the HIV/AIDS fight in North Carolina, with the highest number of reported cases in the state. And our hard-fought campaigns continue to help maintain and expand our state’s AIDS Drug Assistance Program, close coverage gaps and expand Medicaid, increase access to comprehensive sex education and life-saving drugs like pre-exposure prophylaxis (PrEP), and fight the HIV stigma we saw so clearly in the days and weeks following Charlie Sheen’s disclosure of his HIV status.

Fortunately, a happy coincidence means help is on the way. 

In this season of giving thanks, I invite you to join me in becoming a part of this movement. I encourage you to be grateful for the HIV/AIDS advocacy that touches so many in this city, this county, this state and across the South. And I ask that you lift up this activism by investing today in the work that could end the blight of HIV/AIDS in our lifetimes.

So, as we commemorate World AIDS Day (Dec. 1) this week—a time to unite behind a global movement to end HIV/AIDS—it’s important to acknowledge that HIV advocacy has never been more important here at home.

Like World AIDS Day, #GivingTuesday falls on December 1st, following shopping holidays like Black Friday and Cyber Monday to unite a global community to look beyond oneself and give back. That’s why this week I’ll be giving back to our state and local HIV advocacy organizations with my commitment, my volunteerism and my wallet. After all, I’ve seen with my own eyes how these often unsung heroes can make a true difference in the fight against HIV/AIDS in my home city of Charlotte, Mecklenburg County, and across North Carolina every single day.  All with a little support from their communities.

We’re told time and time again, “Charlotte’s Got A Lot.”  In addition to our many wonderful people and places, I believe this slogan also references our inexhaustible kindness, our goodwill, and our generosity. 

Now’s the perfect time to show it.

Jeffery Williams-Knight is a board chair of the North Carolina AIDS Action Network where you can donate today at ncaan.org.

#HTGAWM

by Lee Storrow I'm a big fan of trashy tv shows. There’s nothing better on a Thursday night than to sit back and escape your troubles by delving in the drama of #TGIT. Of the Thursday night lineup on ABC informally known as Shondaland (named for producer Shonda Rhimes), How to Get Away with Murder is my clear favorite. How to Get Away With Murder succeeds as a show because of its outlandish plot, compelling characters, and because it depicts the diversity of our daily lives. Viola Davis’ portrayal of Annaliese Keating won her the Emmy Award for Best Actress in a Drama Series this year, making her the first African American to win that award. A primary reasons I love the show is because of it’s portrayal of Connor and Oliver, a mixed-status gay couple. Oliver is the perfect boyfriend. Sweet and geeky, Oliver is the perfect foil to bad boy Connor. They had a rocky start to their relationship in Season One, but just as they were hitting their stride as a couple, Connor found out he is HIV positive.

Connor (Jack Falahee, left) and Oliver (Conrad Ricamora) face new struggles and triumphs in "How to Get Away With Murder" Season 2, including Connor's HIV status and use of PrEP.

While Oliver moped around for the season’s first few episodes after finding out the news, Connor didn’t let that be a barrier to continuing his relationship with the man he loved. He went on PrEP, and, shortly after, the couple moved in together. Connor and Oliver’s relationship should be celebrated for a positive and realistic portrayal of young gay couple finding their way in the modern world. Connor’s decision to go on PrEP and their discussions about it are the frankest I’ve seen on network TV in 2015. At the same time, the couple hasn’t been exclusively defined by Oliver’s HIV status. Recently Oliver has gotten more involved with work at the Keating Law Firm, a the couple experience friction trying to find work-life balance. And while the sex-lives of gay couples are often glossed over in pop culture--a kiss followed by a fade to black--that’s far from the case on How to Get Away With Murder for Connor and Oliver. At the end of last week’s episode, we saw several couples engaged in varying degrees of intimacy, the encounters all intercut with each other. In what might have been the hottest vignette of the four, Connor and Oliver were there in the middle--a picture of destigmatization of sexuality and HIV-status. I’ll be tuning in tonight to watch what happens next in the chronicles of Connor and Oliver on the mid-season winter finale. Our fight to combat stigma and make sure those living with HIV is often a political one that finds us in the halls of government buildings. But it’s a fight that we must fight in other venues as well, including those of pop culture of Hollywood. Visibility matters, and I hope to see more couples like Connor and Oliver on TV in the years to come. They aren’t perfect (who among us is) but their drama, messiness, and commitment challenges stigma and shows us a path forward for more representation in pop culture.

Lee Storrow is Executive Director of the North Carolina AIDS Action Network.

Sheen, Stigma and the South

There will continue to be much commentary over Charlie Sheen’s interview with The Today Show’s Matt Laurer in which Sheen disclosed that he is HIV positive. Others will likely expand upon problematic elements of the interview. 

Charlie Sheen (r.) speaks to The Today Show's Matt Laurer on Nov. 17. 

I was drawn to a positive moment where Lauer named stigma as a barrier toward care for those living with HIV. 

“And when you say shame in that, the stigma that is attached to this diagnosis is one of the worst parts about it. People don't take action, they don't get help because of that stigma.”

You can watch this moment, and Sheen’s response in the first segment of the interview shortly after the seven-minute mark.

Stigma is a very real barrier to accessing medication and care for many HIV-positive North Carolinians. The stigma of both a HIV diagnosis and association with the gay community prevents people from not only getting tested, but also sharing their diagnosis with family and friends. In turn, this thwarts building the support system necessary to best manage the disease and its consequences.

This stigma has an even greater impact in the American South. Recent research from Duke University Law School shows that poverty rates, lack of education, and social stigma in the south have had the compounding effect of increasing death rates of those diagnosed with HIV and AIDS.

Our community know what works to end this epidemic. Comprehensive sex education in public schools, closing the coverage gap to make sure all North Carolinians have access to medical care and continuing to fully fund programs like the AIDS Drug Assistance Program can put our state on a positive path to end transmission of HIV in our lifetime.

In the meantime, we thank Charlie Sheen for sharing his story, as well as Matt Lauer for recognizing the impact stigma had in preventing Sheen and so many others from coming forward sooner.

Lee Storrow is Executive Director of the North Carolina AIDS Action Network.

NC AIDS Action Network will host a timely conversation on the impact of HIV/AIDS stigma in Durham this Thursday, Nov. 19. Email quinton@ncaan.org to RSVP and for more details.

"I Dare Say It"

Triad Health Project's Director of Prevention Services Kevin Varner explains the positive byproducts of HIV status stemming from the support, community, and strength of living with the virus, both inside and out. 

"Coming together and supporting one another...as people with HIV and allies of people with HIV so that we begin how to teach a sense of self-worth...and, I dare say it, how to see HIV as an unexpected gift...that you never wanted, never thought would happen to you...and yet to turn HIV against itself, we must acknowledge its presence, listen to what HIV has to tell us about the importance of staying connected...and the importance of healing beyond the medicine we take every day." 

Come together with us during the 2015 North Carolina HIV/AIDS Advocacy Conference. 

A 15 Year-Old Lesson on What One Person Can Do

On October 17, 2015, the Alliance of AIDS Services – Carolina, Inc., in collaboration with Crape Myrtle Festival, the LGBT Center of Raleigh and the North Carolina AIDS Action Network (NCAAN) will host the 2015 AIDS Walk and 5k Run in Raleigh's Dix Park. This annual fundraising event that raises thousands of dollars to care for people living with HIV/AIDS. To learn more, visit the official registration site. 

In 1999, Dr. Trudier Harris didn't just raise over $17,000 for what was then called AIDSWALK, an annual fundraising event to support those living with HIV/AIDS in North

Carolina. 

Dr. Harris also penned a "how-to" guide to how she did it -- and in doing so captured what one person can do for worthy cause. 

An excerpt: 

"I wrote to family and friends. I placed flyers in the boxes of my colleagues. I put up posters. I left notes at my neighbors' doors. I made phone calls. I made speeches at church. And I took advantage of less conspicuous opportunities. For example, when I went into my dentist's office, I asked if he would contribute. He did so." 

What's most important to remember about Dr. Harris' highly-successful, one-woman fundraising campaign from 15 years ago, is that she was able to raise thousands before the age of vast email and social media networks. And, in doing so, laid the groundwork for today's activists to match and exceed her efforts -- all by leveraging the power of conversations, both on- and offline. 

So what are you waiting for?

One gay couple divorced when we won marriage equality. The reason keep you fighting.

Thursday’s Supreme Court decision allowed millions of US citizens to stay insured, strengthening the fight against the HIV epidemic. Friday’s Supreme Court decision for marriage equality gave many of us a jubilant reason to celebrate.

I woke up Saturday morning, still on a high from the gay marriage decision the day before, to images of Brittany “Bree” Newsome climbing the flagpole in Columbia, South Carolina that displayed the Confederate flag on the grounds of the state capitol. This act of civil disobedience was brave, and a stark image of the forces that continue to oppress black lives in our country.

Our movement still has a lot to do to create a world where all citizens, regardless of race, sexuality, or status, can live with equality and dignity.

On Sunday, I attended a social group for HIV+ men hosted by one of our nonprofit partners. Members of the group shared their reaction to the gay marriage court case. 

While the response was positive and spirited, one couple shared a more nuanced view of gay marriage legalization. Both men were HIV+, and were married out of state several years ago. When gay marriage was legalized in North Carolina in October last year, they at first celebrated, but quickly realized the decision had unintended consequences for them. Both men were enrolled in the AIDS Drug Assistance Program, and as a married couple, their combined income level would make them ineligible for ADAP coverage.

Shortly after marriage equality became legal in North Carolina, the couple legally divorced so they could maintain access to their HIV medication.

I’ve heard many personal stories about the challenges members of our community have faced since joining the team at the North Carolina AIDS Action Network. Theirs is one that will stay with me.

This couple’s story is a stark a reminder that marriage equality and the affirmation of the Affordable Care Act are not enough. We must continue to support our partners in the fight for social justice for all citizens. We must continue to work to make sure ALL citizens have access to comprehensive health insurance, regardless of status or income.

Let’s celebrate our victories from last week. Let’s let them serve as fuel for the fights ahead.

Lee Storrow is Executive Director of the North Carolina AIDS Action Network.

The Women's Empowerment Team of the East takes Raleigh by storm

Guest post by Esther Ross

A phenomenal event took place Wednesday, April 29, 2015 in Raleigh NC for North Carolina HIV Advocacy Day.

The Women's Empowerment Team of the East - aka Girls on Fire, ready for their first meeting with legislators.

The WE Team of the EAST (Women Empowered aka Girls on Fire) advocated on issues that directly impact people living with HIV in North Carolina. They did an outstanding job communicating the importance in achieving viral load suppression, increasing positive health outcomes to improve quality of life is for the state of North Carolina.

The WE Team of the EAST met with two senators who serve our Region 10 area; Senator Don Davis and Senator Louis Pate. We did so well that Senator Don Davis gave up his seat for Miss Juliette Sharpless and agreed to attend our Life Skill Support Group at ECU Physicians in Greenville September 2015 as a pledge of his continued support and commitment of HIV programs in our state.

Miss Juliette Sharpless at Senator Davis's desk for the discussion

Smiles all around: The WE Team of the East after talking with Senator Davis

 In regards to Senator Louis Pate, WE Team of the East did and an excellent job in expounding on the cost effectiveness in promoting programs that increase access to HIV medications to achieve and maintain viral load suppression versus utilizing the emergency room to treat opportunistic infections that occurs as viral load increases.

One of the arguments posed was “Imagine the cost of 1400 clients utilizing the emergency room to treat infections opposed to 1400 clients in which 82% are viral load suppressed in care at ECU Physicians in Greenville, NC." It is important that advocacy efforts continue at all levels in North Carolina to ensure our elected officials recognized the importance of these programs that contribute to the management of HIV in our communities to reducing the spread of HIV and linking those diagnosed with HIV are linked to care.
The recommendations on the agenda were:

1.  ADAP: To fully fund the AIDS Drug Assistance Program and oppose recurring funding cuts to accommodate for future changes in federal appropriations or voluntary corporate rebates especially when Medicaid has not been expanded for this state. 
2.  Youth Access to Healthcare Services: Protect the ability of young people to access mental and sexual healthcare, including HIV prevention, testing and treatment.
3. Harm Reduction: Support House Bill 712, which will authorize the State Bureau of Investigations in collaboration with North Carolina Harm Reduction Coalition, to establish pilot programs to collect and properly dispose of used syringes in two NC counties; and amend the existing Needle-stick Prevention law (HB 850) passed in 2013 so that a person who declares a syringe to a law enforcement officer prior to being searched will not be charged for possession of the syringe or for trace residue inside the syringe.

Felicia Brock talks to Senator Don Davis about HIV policy in Eastern NC

Thank you WE Team of the East for being ‘Women on Fire’ in HIV advocacy: Felicia Osborne; Juliette Sharpless; Mary (Cathy) Taft; and others.

Always ‘On Fire’ - Esther Ross

Esther Ross is the Region 10 Network Coordinator, a Social Work Practitioner and Medical Care Coordinator in the Department of Internal Medicine at the East Carolina University-Brody School of Medicine, and an advocate for those living with HIV in Greenville, NC. 

Truth, power, and the dog in your own backyard: Reflections on North Carolina HIV Advocacy Day

Guest post by Kevin Varner

There was a sense of being "okay" that day in Raleigh.

Underneath what the other advocates and I were doing, there permeated this notion that we were advocating on behalf of those who, for a myriad of reasons, were unable to travel and speak for themselves. Of course that was there. It's "advocacy's" definition.

It was also fantastic and a little intoxicating to speak with representatives from my district who seemed to "get it"--the importance of access to medical care, medicaid, and other basic services for those living with and affected by HIV. The importance of having more powerful allies, regardless of party affiliation, who took time out of the busy day to spend just ten minutes hearing us, and understanding the importance of our place as North Carolinians. It was great. It puffed me up, and my ego was going, "YEAH! This is GREAT! You spoke the TRUTH!"

Kevin in the Legislative Building in Raleigh

Now for the other piece--the piece where the ego meets the awareness--or, the place where the ego meets an obstacle. Not to be a Debbie Downer at all, but just aware...I thought, "That was easy. That was a little too easy." I was preaching to the choir.

In my district, I was lucky to have buy in and face time before I even opened my mouth. I mentioned the agency, Triad Health Project, where I work, and while I was blessed and grateful that the representatives with whom I spoke knew of us and the valuable work we do, and agreed with what we were pitching, I thought--"I wonder how this would go down if I had to fight harder? How would I deal with closed ears, polite nods, and rejection?"

What about those people in our state government who don't feel they have a dog in the fight for HIV funding, stigma reduction, HIV decriminalization, Harm Reduction Bills, and the advocacy the North Carolina AIDS Action Network and the North Carolina Harm Reduction Coalition do? I want to say to those state legislators the following:

Okay, sure. You may not think you have a dog in this fight. You may think "No way--not my issue, and definitely NOT in my backyard."

But, you DO have a dog, and I bet that dog can fight. And you DO have a backyard, and I bet it's just a matter of time before HIV and Harm Reduction issues show up in it. So, rather than becoming reactionary, and making a party line decision based on what your party is doing, or making a decision based on fear, on stigma, on belief, even...why not dig a little deeper for facts, statistics, and have conversations with those of us in the state who are living with HIV, with addiction, and with those who are working so hard to insure access to services that provide medicine, dignity, support, and empowerment to those with HIV and addictions...don't you think that by doing so, you'd strengthen your own "dog" and also make your own backyard a safer, better place to be?

That's what I didn't get to say at North Carolina HIV Advocacy Day. And that's what I think ought to be said, and heard in our state.

Kevin Varner is a North Carolina AIDS Action Network Speaking Positively Advocate and Director of Prevention Services at Triad Health Project in Greensboro, N.C. He blogs at LifeWithAPlusSign.wordpress.com.

Press Release: New report shows inequalities in North Carolina HIV rates

PRESS RELEASE: March 4, 2015

CONTACT: Lee Storrow

lee@ncaan.org

(919) 914-0311

HIV and AIDS have a serious and unequal impact on certain communities in North Carolina, according to a report released today by the state Department of Health and Human Services.

Approximately 36,300 people were living with HIV in the state in 2013, the most recent year for which data are available. North Carolina ranks eighth in the nation for new HIV diagnoses.

Communities of color and gay and bisexual communities are hardest hit. More than 65 percent of North Carolinians living with HIV are African American. Gay and bisexual men make up roughly 60 percent of newly diagnosed cases.

Young men between the ages of 13 and 24 made up one in five people diagnosed with HIV in 2013. Most of these are young men of color.

“Like many public health issues, HIV tends to affect communities without access to comprehensive healthcare, economic security, housing, and other basic human needs,” says Lee Storrow, executive director at the North Carolina AIDS Action Network.

 “Segregated social networks and pervasive stigma exacerbate the issue,” Storrow says. “The good news is, we know what North Carolina needs to do to address this epidemic.”

The state’s report highlights the success of North Carolina’s AIDS Drug Assistance Program, which serves roughly twenty percent of people living with HIV in the state.

Three-fourths of the clients enrolled in the program qualify as virally suppressed, meaning they are at least 96 percent less likely to transmit the virus to a partner and the levels of the virus in their blood are so low as to be undetectable.

The rate of new diagnosis is also holding relatively steady from past years.

With treatment, people diagnosed with HIV can expect to live long and active lives.

Yet more than one quarter of individuals living with HIV in North Carolina did not see a doctor in the last year. Only 36 percent of the overall population living with HIV in the state is virally suppressed.

 “Everyone living with HIV or any other chronic illness should be able to see a doctor when they need to. Our elected leaders must expand Medicaid. That one simple step will extend health insurance to thousands of people living with and at high risk for HIV,” Storrow said.

“Most importantly, this new report is a call to all of us to work for the interests of the communities most affected by this epidemic, to raise HIV as a critical issue in our state, and to stand up for the dignity and rights of North Carolinians living with HIV and AIDS.”

The full report is available online at http://bit.ly/1Cscs11.

###

The North Carolina AIDS Action Network improves the lives of people living with HIV/AIDS and affected communities through outreach and public education, policy advocacy, and community-building to increase visibility and mutual support of people living with HIV/AIDS throughout our state. Read more at www.ncaan.org.

Thank you, Matt Bomer

On Sunday night, the Hollywood Foreign Press Association passed out their 2014 awards for the best in film and television. The Golden Globes are one of the most watched award shows on TV, and Sunday's broadcast was recognized by many for its culturally progressive message, from acceptance speeches that recognized single mothers and the diversity of roles for women this year to Jeffrey Tambor receiving an award for playing a transgender individual on the TV show Transparent.

A highlight of the evening was Matt Bomer’s acceptance speech for Best Supporting Actor for his role in the TV film The Normal Heart. Bomer played a  New York Times reporter who died of AIDS during the 1980’s. (Bomer's speech starts at 2:00.)

During Bomer’s acceptance speech, he thanked his husband and three children for their support during the filming, offering that he knew he was really grumpy at times due to his weight loss needed to depict the character. He recognized his fellow actors and the team that brought The Normal Heart to the screen. And he closed with these words, “To the generation that we lost, and the people we continue to lose to this disease, I just want to say, we love you. And we remember you.”

Too often we fall in a trap of assuming that death from HIV/AIDS is a thing of the past, that the epidemic is something we can put behind us. While we are so lucky to have made the advancements we have, there are still too many people dying from this disease. HIV rates are increasing among gay and bisexual men, and young men and men of color are seeing disproportionate increases.

Thank you, Matt Bomer, for recognizing the people we continue to lose from this disease. We need more leaders, from pop culture to politics, to do the same thing.

Lee Storrow is Executive Director of the North Carolina AIDS Action Network.