Federal funding not enough to tackle soaring HIV infections in the South

The South is hard hit with HIV infection, but Ryan White funding hasn’t kept up with the shift

Ryan-White

PREVENTION | AIDS Healthcare Foundation is releasing educational posters they hope will get people to test regularly for HIV.

STEVE RAMOS  |  Senior Editor

Editor’s note: This is the first of a two-part series on Ryan White funding.

When Antonio Rivera moved to Sherman from Los Angeles five years ago, he thought he had escaped a life he described as “harrowing.” He’s been HIV-positive for over a decade, but he says limited accessibility to HIV specialists, counseling and nutritional programs is forcing him to return to California.

“I’ll be moving to Oxnard where my two sisters live,” he said. “I don’t want to go back, but I don’t have a car, and it’s not easy for me to get to the places I need to go. A lot of times, I miss doctor appointments because I can’t get there. That’s not good.”

According to Tim Boyd, director of domestic policy with AIDS Healthcare Foundation, California has 411 physicians who are HIV specialists. Compare that to 243 physicians who specialize in HIV in nine Southern states combined, including Texas.

“There are 275 physicians in New York state who are HIV specialists,” Boyd said. “You can see where Texas and the other Southern states are having a problem.”

Rivera’s access to physicians in California won’t be as restricted as what he’s experienced in Sherman, but it isn’t a move he wants to make.

“I’m poor,” he said. “I was raised in Los Angeles, and I lived in a really bad part of the city. Gang violence was high. It won’t be so bad this time in Oxnard, but I hate it that I have to go back there just because Texas doesn’t have the doctors California has.”

The shortage of HIV specialist physicians in the South is further burdened by a hefty rise in HIV infections. According to the Center for Disease Control and Prevention, both the number of people diagnosed with AIDS and the rate of AIDS diagnoses (number of diagnoses per 100,00 people) is highest in the South (15,855 diagnoses or 13.7 per 100,000 people). These are the figures for 2011, the latest statistic the CDC lists.

“HIV infections have shifted to the South,” Boyd said. “Earlier prevention efforts were focused in urban and gay communities, but HIV is stepping outside those areas. HIV is now hitting a population that didn’t get prevention messages before.”

So, has federal funding of agencies who provide HIV services followed that shift?

“No,” Boyd said, “Right now, the South doesn’t receive an equitable share of Ryan White funds. As an average, New York gets $800 person, but Dallas and Houston get less than $600.”

The Ryan White CARE Act was enacted in 1990 and is the largest federally funded program in the U.S. for people living with HIV/AIDS. The act sought funding to improve availability of care for low-income, uninsured and under-insured victims of AIDS and their families. Those funds, $2.3 billion, contribute significantly to many of the agencies who provide services to people living with HIV, but the federal government hasn’t adjusted the allocation of Ryan White funds to address the increase of HIV infections in the South.

“New York gets a lot because the way Ryan White funding is allocated is based on HIV cases in a metropolitan area,” Boyd said. “It’s tried to move away from that, but it hasn’t caught up with how HIV is shifting.”

AHF is nudging the federal government to address the disparity in how Ryan White funds are doled out. In March, the agency announced the introduction of the Ryan White Patient Equity and Choice Act, a bill to make needed improvements to how the funds are allocated. Rep. Eddie Bernice Johnson, D-Dallas, is one of the co-sponsors for the bill.

“This bill will help begin to ensure funding follows the HIV epidemic where it is growing and that Ryan White is better focused on ensuring more people get the care they need to stay healthy and become noninfectious to others.”

In a press release that addressed the bill, Boyd said, “Providers such as Medicaid and private insurance do not cover services like HIV care retention services, HIV medical case management and treatment adherence services — things that are essential to saving lives and stopping the spread of HIV. Moreover, these providers do not have the HIV expertise of the CARE act.”

Rivera agrees.

“The South is in the dark ages when it comes to HIV,” he said. “I think that’s part of why it’s become the center for new HIV infections in the country. I know this is the Bible Belt, and there’s a prejudice against gays, which is one of the groups so affected by HIV.”

Half of all new infections in the United States are in the South, although the region has only a little more than a third of the country’s population, accord to the CDC. The South also has the highest rate due to HIV.

Dallas is No. 1 in HIV infection per capita in the state, Boyd said, and there are many factors that contribute to that, including drug abuse, homelessness and using sex for survival.

“But we’re eliminating barriers and making HIV testing more accessible,” Boyd said.

If the federal government would shift more of the Ryan White funding to the hard-hit South, Boyd and others say they would be able to provide more services.

“Oh, my God,” said AIDS Services of Dallas CEO Don Maison. We’d be able to pay for food. We’d be able to pay for transportation for medical services. We’d be able to pay for medical case management.”

About 48 percent of Resource Center’s budget comes from Ryan White funding, according to CEO Cece Cox. If the South were to receive a more equitable share of the funds, she also would be in a position to offer more services to their clients.

Patients in the South, like Rivera, often live far from physicians who specialize in HIV. They can’t afford a vehicle and have trouble getting to their appointments, which might be up to 100 miles away. Once infected, poor people face hurdles that keep them from getting adequate care.

They often have no health insurance and little money for medication and tests. Blacks have been hit the hardest. They account for half of the men and nearly three-quarters of women in the South with newly diagnosed HIV infections, according to the CDC.

“A lot of gay black men in Dallas live on the ‘down low,’” Rodney Thompson said. “They live so-called ‘straight lives’ with their girlfriends and wives, but they’re having sex with men. In our community, a lot of people see being gay as immoral. It’s too bad because that’s one of the reasons the HIV infection rate is so high in Dallas.”

Thompson said he gets tested at least twice a year, but his family doesn’t want to know about it. As an out black man, he said he battles the prejudice against gays in his community.

“It’s about religion, I guess,” he said. “They’re just stuck on that. In the meantime, people are getting sick.”

With increased Ryan White funding, Boyd said AHF and other agencies can reach more people and offer more services.

“We’ve got to resolve this disparity in how the funds are allocated,” he said. “With increased funding, Texas and Dallas and Fort Worth can better meet the need of people with HIV. It’s hard enough for an area like Tarrant County to meet the existing needs of people with HIV with the funds they do have.”

Right now, though, Rivera thinks it’s too late for him.

“Not so,” said a Dallas AIDS activist. “While increased Ryan White funding would provide additional services, there are already many services available to him in North Texas, including free medical care, clinics and transportation that he needs to access. Even with their current budgets that don’t get the share of Ryan White funds we should receive, Dallas area agencies are doing a great job serving people with HIV.”

This article appeared in the Dallas Voice print edition April 4, 2014.

—  Steve Ramos

GEAR presents scholarships, awards

GEAR, the Resource Center’s transgender program, presented awards and scholarships on Saturday at the 2014 GEAR Awards Reception to some of its members. San Francisco Human Rights Commission Executive Director Theresa Sparks spoke to the attendees, who numbered about 100.

Wendy Marsden won the Katherine Walton Award for service.

“I had a rough time of it, and I wanted to pay it forward,” Marsden said as she accepted her award.

Katie Sprinkle began a legal clinic to help trans people navigate through the legal issues they will deal with. GEAR coordinator Blair High said the only other city with something comparable is New York. Sprinkle was also given and award for service to the community.

The next GEAR legal clinic is Wednesday, April 2. Anyone who would like an appointment should call 214-540-4498 to reserve time for a free 20-minute session with Sprinkle, who is an attorney.

Ann Marie, who started a job clinic for GEAR members, was also given a service award. The unemployment rate is exceptionally high in the trans community, and many members lose their jobs as they begin to transition.

Ally awards were given to American Specialty Pharmacy and Dr. Patrick Daly. The pharmacy set up a scholarship program to cover the cost of hormone therapy for two GEAR members. Daly runs a monthly clinic for GEAR and works with trans patients in his practice.

Despite some gloomy statistics, Sparks gave an optimistic talk about being your authentic self. Although trans people face high unemployment rates, face family rejection, are harassed in public accommodation and by the police and 41 percent have attempted or contemplated suicide, “Things are getting better,” Sparks said.

She cited a recent legal case that was decided and rules that trans people can’t be discriminated against in federal jobs. The Affordable Care Act made health insurance available to many trans people for the first time. The Department of Justice published nationwide training curricula for police on trans issues. In California, a new law allows trans students to use the bathroom, join a fraternity or sorority or a sports team for the gender they identify.

After Sparks told her story of going from CEO of an international corporation with thousands of people working for her to taxi driver after she transitioned and then back to another CEO position before heading the Human Rights Commission, she gave some advice.

“You can be who you are,” she said. “We need to come out to ourselves and love ourselves. Embrace it. You’re a very special person,” she said.

—  David Taffet

Pegasus Square Dance Club is back after decade dance break

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Members of Pegasus Square Dance Club dance during an organizing meeting in February. Weekly lessons at Resource Center begin March 9 at 2 p.m. and are open to the public. (David Taffet/Dallas Voice)

After a 12-year hiatus, LGBT square dancing is back.

Alan Josephson said several people from Dallas connected last summer at the International Association of Gay Square Dance Clubs Convention.

“It took a few months to identify a caller and locate a place to meet,” he said.

He explained that in square dancing, there’s a boy’s part and a girl’s part, but in gay square dancing, everyone gets to choose which part they want to dance. He encouraged people who aren’t usually great dancers to participate because square dancing doesn’t require much foot work.

“It’s fun and social,” Josephson said, “with lots of gay flourishes.”

A 10-week series of dance lessons begins at Resource Center on March 9 at 2 p.m. The first two afternoons are open dances. The full series of lessons are $90, but no one will be turned away because of ability to pay.

Josephson said square dancing is great exercise and is good for partners or singles, and the trans community participates in big numbers.

“There are more trans people in square dancing than I’ve seen anywhere in community activities,” Josephson said.

So does Josephson usually dance the boy part or the girl part?

“I’m bidancial,” he said.

More information at Pegasus-Squares.com.

—  David Taffet

Dallas City Council approves resolution

Photos by Steve Ramos

—  Steve Ramos

Resource Center and Fairness Fort Worth ask reps to protect LGBT elderly

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Cece Cox

Resource Center and Fairness Fort Worth reached out to Rep. Marc Veasey and Rep. Eddie Bernice Johnson to add LGBT-specific protections to Medicaid’s Home and Community-Based Services programs for seniors. Veasey represents U.S. District House 33, and Johnson represents U.S. District House 30.

The National Senior Citizens Law Center issued a report in 2011 that found LGBT seniors often went back into the closet to protect themselves in healthcare facilities. Many endured verbal and phyical abuse by other residents and staff.

RC’s CEO Cece Cox and FFW’s President David Mack Henderson asked Veasey and Johnson to encourage HHS to amend its rules to protect LGBT seniors.

Their letter is below:

RC FFW

 

—  David Taffet

Insurance navigators will be at Resource Center on Saturday

GetCoveredResource Center teams with Planned Parenthood and Get Covered America to provide healthcare insurance assistance on Saturday at the Resource Center.

Navigators will help anyone needing help find a policy that is complaint with the Affordable Care Act.

Andrew Greenberg, coordinating the event for Get Covered America, said the navigators will help find insurance through the marketplace or direct people to Medicare or Medicaid, if they qualify.

Those covered at work who do not qualify for federal subsidies for their insurance, but have a partner taking advantage of DP benefits may qualify for a subsidy and receive comparable benefits at a lower out-of-pocket price.

Bring the following information:

If you desire to speak with a navigator, please bring the following:

• Birth certificate or U.S. passport

• Photo ID (driver’s license, state ID card, military ID card, school ID card)

• Social Security card

• Proof of income (paystub, income tax return, letters from Social Security)

• Employer insurance information (if applicable)

The event takes place at Resource Center, 2701 Reagan St. on Feb. 15, 10 a.m.–5 p.m. Anyone who can’t attend or has additional questions about the event may contact Andrew Greenberg at 972-345-4591 or by email.

—  David Taffet

Lone Star Ride Fighting AIDS distributing assets this Saturday

Lone Star Ride 2010Need a tent? Water? Want a Lone Star Ride Fighting AIDS keepsake like a T-shirt or jersey? All of those items, and more, will be distributed free.

Lone Star Ride Board President Jacque Borel sent this message to all former Lone Star Ride participants — riders and crew.

The Lone Star Ride Fighting AIDS has reached the end of the road, but there are a number of items stored in the LSRFA storage facility which may be of value to previous riders and crew.

The storage unit, at 4641 Production St., Unit No. 25, will be unlocked from 10 a.m. until noon this Saturday, Feb. 8, so that former participants can pick up whatever supplies and equipment they wish.

The storage unit must be emptied by the end of February, so all materials which remain after this Saturday will be either donated or otherwise disposed of. If there are questions, please contact Jacque Borel, board chair.

Production Street is off Lucas Avenue between Maple Avenue and Harry Hines Boulevard in Oak Lawn.

The beneficiaries have already been to the storage locker and gotten whatever they can use. Items include camping equipment, bottled water, rakes, brooms, bike racks, ice chests, jerseys, shirts and a variety of other memorabilia.

Borel assures us that the tents do not come equipped with the rocks that always seemed to be strategically placed under each and every tent during the ride.

A number of items of historical importance will be donated to the LGBT archives at University of North Texas.

—  David Taffet

Resource Center receives grant from Elton John foundation

Elton John

Elton John

The Elton John AIDS Foundation awarded Resource Center a $38,000 grant for its Latino HIV/AIDS outreach and prevention program, Valor Latino.

The grant will support existing services including a monthly social support group for Latino gay and bisexual men, Spanish language prevention materials and advertising.

Resource Center CEO Cece Cox said she was grateful to the EJAF for its support.

“HIV/AIDS disproportionately impacts the Dallas-area Hispanic community and Valor Latino is actively leading efforts to reduce HIV infections,” she said.

In 1996, the Center established the first HIV prevention program to target Latino gay men in Dallas. Valor Latino is a comprehensive HIV prevention program offering bilingual and culturally appropriate education, outreach, counseling, testing and referral services with a focus on Latino gay and bisexual men in North Texas.

In 2012 and 2013, Valor Latino tested 1,627 Latino gay and bisexual men. Just over 4 percent of them tested positive. More than nine out of 10 of those diagnosed with HIV now receive medical care and services.

According to the Centers for Disease Control, Latinos are the racial/ethnic group most likely to receive late diagnoses.

Since 1992, the Elton John AIDS Foundation has raised and distributed more than $300 million for projects across the globe focusing on HIV prevention, harm reduction, community health and human rights empowerment campaigns, stigma eradication, and compassionate public policy development.

In 2013, EJAF granted $7.3 million.

According to its website, the 21 new and 35 renewal grants support organizations working to address some of the most critical challenges presented by the HIV/AIDS epidemic in the United States and the Caribbean.

Resource Center has received this grant for Valor Latino each year since 2011. Other Texas organizations received funds from EJAF including Out Youth and Migrant Clinicians Network in Austin, International AIDS Empowerment of El Paso and Houston’s St. Hope Foundation and AIDS Foundation Houston.

—  David Taffet

Resource Center, other agencies announce limited holiday hours

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The Resource Center food pantry received a large donation from the Dallas Museum of Art

Resource Center’s food pantry will be open Dec. 18-Dec. 20  from 9 a.m.–2 p.m. and will be close Dec. 23–Jan. 1.

“All clients are currently shopping for two weeks because of the holiday,” Resource Center spokesman Rafael McDonnell said. “If people wish to donate to the pantry, our biggest area of need is canned protein with pop-top lids — tuna, chicken, chili, Spam, etc.”

The Resource Center itself will be closed Dec. 24-Jan. 1. The last lunch served by the hot meals program will be on Dec. 23.

Legacy Counseling

Legacy Counseling Center will be closed Christmas Eve and Christmas Day as well as New Year’s Eve and New Year’s Day. However, Executive Director Melissa Grove said in case of emergencies, call the hotline number, 214-207-3953. Through the holiday period, the Walk-in Clinic will operate, but Grove asked anyone using it to call ahead.

AIDS Arms

Trinity Clinic will close at 3 p.m. on Dec. 24 and will be closed Christmas Day. The clinic will close at 3 p.m. on Dec. 30 and will be closed Dec. 31 and Jan. 1.

AIDS Interfaith Network

AIDS Interfaith Network will be closed Dec. 25–27 and Jan. 1.

The Daire Center will close on Dec. 24 and because of the agency move will not re-open until the end of January. The exact re-opening date will be announced later.

—  David Taffet

Harold Simmons Foundation donates $600K to Resource Center capital campaign

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An early artist’s rendering of the new center on Cedar Springs and Inwood roads.

The Harold Simmons Foundation donated $600,000 to the Resource Center’s capital campaign, center officials announced Tuesday.

Serena Simmons Connelly, director of philanthropy for the Harold Simmons Foundation, said that this is the only large gift ever made by the Harold Simmons Foundation to an LGBT cause beyond supporting HIV/AIDS.

She added this gift “takes it to a different realm of basic human rights of our gay and lesbian fellow citizens. I feel hopeful about Resource Center being a place for families and the issues of youth and seniors – a place where people move into a healthy life.”

Resource Center CEO Cece Cox said in a statement that “the generous investment from the Harold Simmons Foundation moves us closer to ensuring that LGBT youth have a space free from bullying, that families and seniors are supported, and that persons living with HIV are cared for.”

Resource Center demolished a strip mall on the corner of Cedar Springs and Inwood roads last April for the new building.

The original cost of the building was $12 million, but decreasing the size of the new facility lowered the cost. Cox said $5 million of the $8.7 million goal has been raised and groundbreaking is planned for January 2015.

For more information on the capital campaign, contact Chief Development Officer Cameron Hernholm at 214-540-4421 or chernholm@myresourcecenter.org.

—  Anna Waugh