Thursday, April 04, 2019

Trump's Ass Backwards Approach to Stopping the HIV Epidemic


In addition to the scandal of allowing Gilead raking in billions of dollars and imposing astronomical prices for PrEP, a totally government and charity developed drug, the Trump/Pence regime is moving to slash funding to family planning clinics that provide free HIV testing to the poor, including poor women who increasingly make up those being diagnosed with the virus.  The Trump/Pence motivation is simple: attack family planning clinics to please the anti-abortion Christofascists who remain the regime's most loyal base of support.  Never mind that abortion services/referrals are offered by only a small percentage of such clinics which often provide the only means of medical treatment for the poor - a group that Trump despises, especially those who are non-white. Such ass backward actions reveal the disingenuous nature of Trump's claim he wants to end the HIV epidemic by 2030.  A piece in Politico looks at the damage the Trump/Pence approach will do to stopping the rate of HIV infections (which is the worse in the South/Bible Belt).  Here are excerpts:
Last month, the Centers for Disease Control and Prevention released a report detailing the state of the HIV epidemic in the United States. One finding stood out: Nearly 40 percent of new HIV transmissions come from a relatively small group of people who don’t know they have the virus.
In his State of the Union address, President Donald Trump announced an initiative to end the HIV epidemic in our country by 2030. . . . . There’s just one problem: The Trump administration is also cutting funding to many of the safety net medical clinics that do a significant number of these tests.
One reason that some Americans don’t know they have HIV is that they lack access to routine health care. While millions of people have gained access to health care through Obamacare or the expansion of Medicaid that accompanied it, there remains a significant coverage gap in states that decided not to expand Medicaid, and it’s those states, many of them in the South, which have the highest rates of HIV infection.
For the more than 2.5 million poor, uninsured Americans who cannot get Medicaid or any financial support to purchase Obamacare, one of the only remaining places they can get health care, including low-cost or free HIV testing, is at so-called Title X clinics.

The Title X Family Planning Program was enacted by Congress in 1970 and it is the only federal grant program dedicated solely to providing all individuals, regardless of their ability to pay, with family planning and related preventive health services including HIV testing. In establishing Title X, Congress made clear that its major goal was to “decrease adverse health and financial effects on children, women, and their families of inadequately spaced childbearing” by providing information, access to birth control and preventative health services. For nearly 50 years, this government-funded program has greatly improved access to vital medical care for millions of low-income, uninsured people.
Currently, there are nearly 4,000 Title X-funded family planning clinics across the U.S., and they serve approximately 4 million people each year. In addition to providing family planning services like low-cost or free birth control, Title X clinics also provide low-income men and women with services such as free testing for HIV, other sexually transmitted infections, and breast and cervical cancer screening.
[N]early half a million men also receive care in these clinics each year, mostly driven by their need for testing services. In 2017 alone, Title X clinics performed 1,192,119 confidential HIV tests, resulting in 2,195 new HIV diagnoses.
Another key component of Trump’s plan is to focus on geographic HIV hotspots. The Southern U.S. is the current epicenter of the national HIV epidemic; Southern states account for over half of new HIV diagnoses despite having only 37 percent of the population. This is particularly true for women; of all U.S. women recently diagnosed with HIV, 56 percent were living in the South. In fact, my home state of Georgia has the highest rate of new HIV diagnoses in the country.
In states like Georgia that did not expand Medicaid, Title X clinics serve as the sole source of heath care for the majority of their female clients.
Sadly though, the administration announced in February changes to Title X that will result in cutting funding to a sizable portion of family planning clinics. The motivation for these cuts is purely political, with the singular goal of removing Planned Parenthood and other medical clinics that provide abortions or refer patients for abortions out of the Title X network within the coming months. As it happens, only 13 percent of all Title X clinics are operated by Planned Parenthood, and an additional 26 percent are nonprofit, community-based family planning clinics, many of which may be in jeopardy of losing funding as well.
Title X funds have never been allowed to pay for abortions, but the new rule will cut funding to family planning clinics solely because they provide or refer patients elsewhere for abortions. Due to the loss of federal funds, some of these vital safety net clinics may close, others will have to lay off staff and reduce hours, and many may have to reduce services—like HIV testing—in order to offset costs.
Rather than dismantling Title X clinics, the Trump administration should leverage and expand on the important role that this network of family planning clinics has always played in providing HIV testing to the 4 million people they serve each year.
I]t’s time to increase funding to family planning clinics to expand HIV testing, not decrease access to HIV testing through politically motivated efforts that may result in the closing of vital safety net clinics.

As always, actions speak louder than words and Trump's actions send a message to the poorest Americans: just get sick and die.

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