BESHAR AND JASPERS: An AIDS-free world

On Dec. 1, World AIDS Day calls upon us to consider the HIV/AIDS pandemic — its human cost, global impact and unresolved future. Events on campus, online and around the world will promote education, advocate solidarity with those who are HIV-positive, and honor the 30 million lives lost over the past three decades. AIDS is not a distant problem, nor is it isolated in underdeveloped countries. AIDS matters to you because it affects people in Connecticut, in New Haven and at Yale.

Consider these statistics: Connecticut has the eighth highest per capita incidence rate of HIV/AIDS among the 50 states. From 1981 to 2010, over 20,000 cases of HIV/AIDS have been reported to Connecticut’s Department of Health. In New Haven alone, 3,000 people live with HIV. The pandemic affects every age group and ethnicity. Infected males widely outnumber females at a ratio of 65-to-35.

In past years, HIV infection rates have broadly outpaced the government’s response. Since 2002, the prevalence of HIV cases has increased in Connecticut, despite national decreases in diagnoses.

However, recent changes in the American health care system, implemented by the Affordable Care Act (ACA), may better equip Connecticut to care for people living with HIV. Passed in 2010, the ACA aims to expand access to affordable health coverage, reducing the number of uninsured Americans. Acknowledging the particular impact of the ACA for people with HIV, the White House concurrently published the United State’s first comprehensive national HIV/AIDS strategy: a three-pronged approach that aims to reduce the number of new HIV infections, increase access to primary and HIV-specific care and reduce HIV-related health disparities.

In the past, the majority of HIV-infected Americans relied on Medicaid to cover their health care costs. Over 24 percent of those infected are uninsured, depending instead on the Ryan White HIV/AIDS Program, which funds health care and supportive services for a low-income demographic. Although these programs are significant for many HIV/AIDS patients, the Ryan White Program is not designed as an insurance system and is burdened by long waiting lists.

In light of the parameters of the Ryan White Program, the ACA expands Medicaid advantages for HIV/AIDS patients. Those infected no longer have to fulfill stringent financial or categorical requirements to become eligible — such as being pregnant, having children or suffering from an additional disability. The ACA also provides a 50 percent discount on brand-name drugs, thereby closing the prescription drug benefit “donut hole” that previously made many treatment options unaffordable. And because many HIV specialists also serve as their patients’ primary care physician, the ACA has also increased Medicaid payments for primary care services.

In Connecticut, the Department of Public Health has been awarded more than $23.8 million in prevention fund grants from the ACA. A portion of these funds has been allocated to HIV/AIDS prevention campaigns, which seek to identify high-risk populations, increase testing opportunities and offer HIV-infected patients the medical services they need. Connecticut has also recently enacted the Personal Responsibility Education Program, teaching youth about contraception and the prevention of HIV infection.

Last year, Secretary of State Hillary Clinton offered her vision for the near future: an AIDS-free generation. In that future, every child is born free of HIV and faces a lower risk of contracting the illness as they grow up. This lofty goal is not abstract. With the induction of the ACA, as well as the continuation of other important programs and agencies, this goal is achievable.

But more can always be done. The ACA has been controversial, with many states choosing to opt out of some of its policies. National and state governments must continue to seek out opportunities and programs that serve people living with HIV. Communities, like ours here at Yale, must dedicate time and energy to education campaigns, prevention efforts and advocacy events.

The U.S. has set the bar high to achieve an AIDS-free generation, and with these efforts, Connecticut can reach this goal, too. We know how to get there. The question is not “Can we end AIDS?” It is “Will we?” Does the U.S. have the political willpower to implement the substantial means to achieve a great end?

On AIDS Day, we invite you to support, engage and learn more about local initiatives here in New Haven. Seek out peers and faculty interested in HIV/AIDS research and lend a hand. Call upon your representatives, take initiative and get involved. By making democracy work for you, the answer is yours to decide.

 

Isabel Beshar is a junior in Saybrook College and Austin Jaspers is a sophomore in Trumbull College. Contact them at isabel.beshar@yale.edu and austin.jaspers@yale.edu .

This column is part of the News’ Friday Forum on World AIDS Day. Click here to continue.

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