Back to Basics: ACT UP New Yorks Plan for Expanded Prevention and Education
in the i!ht A!ainst A"#$
Eighteen years after the advent of HAART there are multiple means of HIV prevention, and they involve both people who are living with HIV and people who are HIV-negative. Treatment as revention !Tas" involves treating those with HIV so they are healthy and so they have an undete#table viral load that is e$tremely unli%ely to transmit HIV. The &ood ' (rug Administration !&(A" has approved Truvada as re-E$posure rophyla$is !rE", a pharma#euti#al HIV prevention for people at ris%. Antiretrovirals as ost- E$posure rophyla$is !E" #an stave off a potential infe#tion after transmission. The tools of Tas, E, and rE must be utili)ed to lower the *+,+++ new HIV infe#tions that ta%e pla#e nationally every year for the past ten years. The huge amounts of data gathered from thirty years of HIV-related resear#h must be translated ,ui#%ly and pragmati#ally into poli#ies and programs that will help relieve our #ommunities of the #rippling physi#al, mental, and so#ial effe#ts of this disease. Toward this end, A-T . /0 has spent the past year influen#ing HIV poli#y on the #ity, state and federal levels to begin to reali)e these goals. 1or% in dire#t a#tion, advo#a#y, #ommunity organi)ing, #ommunity edu#ation, and strategi# #ommuni#ations have produ#ed signifi#ant results and A-T . /0 see%s to e$pand its impa#t in these areas. 2ast summer A-T . members met with offi#ials from /ew 0or% -ity3s (epartment of Health to demand a more responsive implementation of rE and E. A-T . members testified before the #ity3s HIV advisory panels and helped shape an information #ampaign targeting the use of rE in #ommunities at highest ris%. This #ampaign was laun#hed on year later, 4ust in time for 5+67 8ay ride 1ee%end. 2ast summer A-T . #alled upon /ew 0or% 9tate to update its guidelines for E, and the state responded by issuing revised guidelines. This past winter A-T . #alled upon /ew 0or% 9tate to issue final guidelines for rE, and the state responded by issuing them. :ffi#ials from /ew 0or% 9tate3s AI(9 Institute met with A-T . members in /ew 0or% -ity to initiate an ongoing dialogue on prevention poli#ies and information materials. ;embers of A-T . have been deeply involved in the effort to #onvin#e 8overnor -uomo to endorse a #ommunity-initiated pro4e#t to End the AI(9 Epidemi# in /ew 0or% 9tate by 5+5+. :n 5+67 8ay ride (ay, the 8overnor announ#ed his support of a three-pronged plan to support e$panded testing, in#reased a##ess to ARV3s for people living with HIV, and greater a##ess to rE. This spring A-T . #alled upon the federal -enters for (isease -ontrol to issue final federal guidelines for rE. -(- responded by issuing the guidelines and pro#eeded to invite members of A-T . to Atlanta to meet with the agen#y3s HIV offi#ials. A-T . members dis#ussed their demands for e$panded pharma#ologi#al prevention and pragmati# use of the Affordable -are A#t for HIV prevention and ongoing health #are for HIV- negative people at ris%. A-T . also demanded spe#ifi# in#iden#e data for trans women and men. In #ommuni#ating with #ommunity AI(9 servi#e organi)ations that #ondu#t trials for rE, A-T . has found that interest in rE is high, but the high #ost of Truvada and bias on the part of medi#al providers are obsta#les to its implementation on levels that will signifi#antly affe#t the number of new infe#tions. In 5+67, A-T . plans to push the -(- for in#reased seminars and wor%shops that train medi#al providers about E and rE guidelines and the implementation of these approa#hes. Through dire#t a#tion and advo#a#y, A-T . also plans to #ontinue pressuring Truvada manufa#turer 8ilead to lower the pri#e of the HIV drug, as well as the pri#e of its drug 9ovaldi, whi#h #ures the fre,uent #o-infe#tion of Hepatitis -. A-T . will also a#t as wat#hdog to ma%e sure 8overnor -uomo ma%es good on his promise to see that /ew 0or% is first to <End the AI(9 Epidemi# in /ew 0or% 9tate by 5+5+.= 1hile the national number of new HIV infe#tions has dropped in some #ommunities at ris%, the number has flared among subpopulations su#h as transgender women and young men who have se$ with men !;9;", parti#ularly men of #olor. -(-3s in#iden#e estimates #urrently group transgender women with ;9;, #onfounding efforts to ,uantify the epidemi# for trans women. Resear#h suggests that dire#ting effe#tive prevention interventions toward se$ual networ%s would be an effe#tive prevention strategy> but one that will re,uire more pre#ise data on different subpopulations than -(- now provides. A-T . will pressure -(- to disaggregate HIV in#iden#e data for transgender women from data it #olle#ts for gay and bise$ual men so it #an ma%e separate in#iden#e estimates. A-T . will #all on -(- to #olle#t data spe#ifi# enough for tailoring prevention to the se$ual networ%s of a full range of gay and bise$ual men. A-T . will also #ontinue to send members to those #onferen#es that enable effe#tive meetings with health#are providers and #ommunity a#tivists and organi)ers. 1ith the laun#h of a new 0outh -au#us in ?uly, A-T . plans to impa#t the la#% of youth edu#ation around HIV prevention, ,ueer and straight se$, and HIV stigma. Through advo#a#y, dire#t a#tion, and #ommunity edu#ation, A-T . will pressure #ity, state, and federal authorities to issue and implement basi# se$ual edu#ation guidelines, free of stigmati)ing language, that normali)e se$ as part of a healthy life. If ne#essary, A-T . will help design a survey that effe#tively inventories students3 needs in terms of se$ual edu#ation. In the va#uum that is Ameri#an publi# edu#ation around HIV@AI(9, young gay men and others have been taught to fear HIV but have not been given the %nowledge and the tools that will help them to be#ome fully fun#tioning, se$ual beings while maintaining good health. Through #ommunity organi)ing, #ommunity edu#ation, and strategi# #ommuni#ations, A-T . plans to help #hange the way HIV-negative and HIV-positive gay men navigate se$, HIV prevention, HIV stigma, and HIV #riminali)ation. A-T . is in the pro#ess of revamping its web presen#e by re#asting its #entral site and aggregating it with an older ar#hival site that is replete with hundreds of histori# do#uments, designs, and footage. A-T .3s #onstant stream of a#tivities and information updates ma%e it ne#essary to establish a site with a #ontent management system that is easily updated by multiple volunteer members. 1ith a modest investment, A-T . /03s web presen#e #an serve as vibrant media hub, #ommunity forum, and invaluable a#tivist ar#hive. A stronger site will also enhan#e A-T .3s development efforts.