What the Experts Are Saying About Moving Beyond HIV Stigma

In our roundtable discussion, experts urge a better understanding of the epidemic among African-Americans.

BY Andrew Harmon

April 30 2012 4:03 PM ET

2. While not a panacea, health care reform would prove instrumental for improving access to HIV care among minority populations.

If it survives a U.S. Supreme Court decision, there are several reasons in the realm of HIV/AIDS why the negative connotations of “Obamacare” will be forgotten, as the president’s reelection campaign currently is so zealously attempting to remind us.

Among the primary goals in the Affordable Care Act for combating HIV/AIDS, as outlined by the administration in the National HIV/AIDS Strategy, are the end of insurance discrimination based on preexisting conditions and a significant expansion of Medicaid for low-income individuals (those at 133% of the federal poverty level, or $14,483 per individual, would qualify for Medicaid). Both are extremely relevant for many African-Americans living with HIV. Currently, as a result of the law passed by Congress, insurers can’t place lifetime limits on care, nor can they deny coverage to children living with HIV.

Baker: But having universal health care alone won’t take away marginalization of LGBT people in health care. It won’t take away substandard care around HIV alone. If that would do it, Europe wouldn’t have an HIV epidemic — and especially around gay men, which is what their epidemic primarily is, gay men and minorities. So we have to consider: What is transformative in the health care system, beyond just financing it? What can transform the quality of care? And how do we put those incentives and mandates in place?

3. The White House and Congress need to hear from LGBT Americans that HIV/AIDS remains a priority.

There are many “asks” of this administration and leaders in Congress from the LGBT community: Stop defending DOMA in court. Pass employment nondiscrimination protections. Say “I do” to marriage equality. Often, HIV/AIDS concerns are pushed lower on our list of demands. While HHS has done increasingly good work on the issue, experts want more — and they want gay Americans to step up and speak out.

Moodie-Mills: I think that this White House absolutely gets it. What I’m seeing from HHS and from the Office of National AIDS Policy is that they understand the complexities of the issues at hand. It’s not simply, “Let’s add a little more to the Ryan White fund.” It’s actually, “How do we get rid of this disease, and what are the behavioral, structural, and other systemic conditions that perpetuate this?” But from the outside, we need to push them to move a little quicker. In my conversations with the administration, they always say to me, “We need to feel the external pressure.” The challenge that I see is that we’re not always doing that successfully.

Baker: This is a quantifiable issue that we know causes premature death in our community. And our tax dollars, which we do pay, do not benefit us. We have study after study showing us that the most underfunded population are gay men. So why are we passive when research and prevention dollars are not going to our community? Would we allow anything else to be killing us and be so silent about whether the federal government should be responding in kind?

Sharon J. Lettman-Hicks, executive director and CEO, National Black Justice Coalition: There is a tremendous amount of progress being made, and it’s not just with HIV/AIDS. [The Department of Health and Human Services] has done an amazing job in reaching out to the full LGBT equality agenda in recognizing that there are major health issues and service issues around our community. But we can do more to be out front. The LGBT community as a whole needs to regain a priority in the conversation about HIV/AIDS, because I do believe it’s been relegated to HIV/AIDS-specific organizations.

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