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PrEPing for the End Of The HIV/AIDS Epidemic

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By Phill Wilson, NNPA Columnist –

(NNPA) Now 30 years after the first AIDS case was diagnosed in America, evidence is quickly mounting that we are turning the corner and the tools that could end the HIV pandemic lay in our hands.

Recently the Centers for Disease Control and Prevention (CDC) announced the results of two clinical trials involving heterosexual men and women that demonstrated for the very first time that antiretroviral (ARV) medications taken daily can dramatically reduce their risk of becoming infected with HIV. This strategy of providing daily ARVs to uninfected people to reduce their chances of infection is called pre-exposure prophylaxis (PrEP).

The two trials, conducted in three African nations, provide evidence that ARVs, originally developed to save lives, also offer a powerful strategy for preventing new HIV infections acquired through heterosexual contact—the epidemic’s primary method of transmission across the world and a disproportionate factor in Black America.

The smaller of the two studies, known as TDF2, involved just over 1,200 sexually active, HIV-negative young adults, ages 18-39. Researchers found that participants who took a daily pill of Truvada—a mix of tenofovir and emtricitabine—reduced their risk of becoming infected with HIV by 63 percent. This study was conducted in Botswana and managed by the CDC and the Botswana Ministry of Health.

The second study, known as Partners PrEP, was conducted in Kenya and Uganda by researchers from the University of Washington and funded by the Bill and Melinda Gates Foundation. The study recruited 4,758 sero-discordant couples—that is, couples in which one partner has HIV and the other does not. The uninfected partners were randomly assigned to take Truvada, Viread—an ARV containing only tenofovir—or a placebo. Those taking Truvada saw their infection risk drop by 73 percent. The HIV-negative partners taking Viread had an average of 62 percent lower chance of becoming infected.

The Partners PrEP findings were so definitive that it was stopped early because it would be unethical to continue providing participants placebos.

These study results come on the heels of promising clinical-trial findings showing that vaginal microbicides can prevent HIV-infection in women and that PrEP can prevent infection among gay and bisexual men. And only two months ago, breakthrough research showed that when participants started taking ARVs almost immediately after being diagnosed with HIV rather than waiting until the disease had progressed, they were much less likely to infect others, a strategy known as "treatment as prevention."

We have reached a deciding moment. HIV is 100 percent preventable, including among some of our most at-risk populations: women, gay and bisexual men and young adults. HIV is also 100 percent diagnosable and in many cases treatable. Our prevention toolbox is now exploding with options. We now have the all of the tools needed to end the AIDS epidemic!

The promising new PrEP results arrive at a critical time. Wednesday marked the one-year anniversary of the launch of the historic National HIV/AIDS Strategy, the nation’s first comprehensive roadmap for fighting the epidemic, and one that places the wellbeing of Black people front and center. We also have health-insurance reform to provide care to the least among us.

But the anniversary and this remarkable string of study results come during an economic downturn that has seen many people lose jobs and others slip through the proverbial “safety net”—losing health insurance, unemployment, and other benefits. It also comes at the same time many states are cutting funding for HIV/AIDS-prevention programs and the AIDS Drug Assistance Program (ADAP).

So while we have the toolkit to end the epidemic, the question remains whether we have the political will to invest in using the tools strategically, effectively and compassionately.

It’s time to call on Congress, the Obama Administration, and federal and state agencies to do three things:

1. Invest in expanded access to testing and linkages to care. People need to know their HIV status, and those who are HIV positive need to be linked to appropriate care immediately.

2. Increase access to care for vulnerable communities including the ADAP waiting lists. Nationally over 8500 people remain on ADAP waiting lists. Fourteen states have reduced the number and types of drugs they will pay for. A number of states have stiffened financial eligibility requirements, capped enrollment or removed some people who were already enrolled. Other states are considering doing the same.

This approach is outrageous. Not only are such cuts immoral and financially shortsighted, as these recent data prove, starving ADAP programs creates a public health threat.

3. Raise HIV science and treatment literacy in vulnerable communities. HIV health disparities are growing in the U.S., and Black people are disproportionately impacted. Black Americans become infected at a younger age and at higher rates, are diagnosed at a later point in their disease and die faster than any other racial ethnic group. Our lack of scientific understanding about how the virus behaves in the body and what options exist to treat it is one of the biggest barriers to efforts to confront HIV in our communities.

Lacking this knowledge too many of us in the Black community become distracted by myths and misinformation. When we don’t understand the science of HIV/AIDS, we are unable to protect ourselves, we put off getting tested, delay starting treatment, fail to adhere to the treatment regimens and are reluctant to own the disease and/or our responsibility for ending it.

If we don’t raise HIV-related science literacy, capacity and infrastructure in Black communities, Black people will continue to be left behind, and we won’t succeed in ending the disparities, despite the biomedical advances we’re making.

PrEP offers tremendous promise, but it is not a magic bullet. We still need to use condoms, offer comprehensive sexual education, provide prevention counseling, and choose fewer partners and know our status and our partner’s stratus. Policy makers need to step up and leaders need to lead. But PrEP has the potential to become a powerful weapon in the war against HIV/AIDS.

It's time to get serious about PrEPing to end this epidemic.

Phill Wilson is the President and CEO of the Black AIDS Institute, the only National HIV/AIDS think tank in the United States focused exclusively on Black people. He can be reached at PhillWilson@BlackAIDS.org

Is Race an Issue for Black Suburb with White Mayor?

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By Wendell Hutson, Special to the NNPA from The Chicago Crusader –

Allegations of misuse of a city credit card by Dwight Welch, long-time mayor of Country Club Hills, has evolved into a racial bomb being lobbed by public officials, along with accusations of misfeasance. Welch, a white former policeman has been mayor of the city for the past 24 years and his unsuccessful opponents in the last election—two Black aldermen – Steve Burris and Vincent Lockett-recently accused the mayor of abuse and misuse of a city credit card. Welch countered the allegations are racially motivated.

According to the U.S. Census Bureau south suburban Country Club Hills has a population of 16,169. Nearly 92 percent are Black. About 4.5 percent of the city’s residents are white. Welch maintained that the issues surrounding how he has used his city-furnished credit card are racially motivated. “These two individuals ran against me and lost. So is it any surprise that they are now trying to drum up false allegations against me?” Welch told the Crusader. “I am a white man whose constituents are majority Black. And the only reason why I have been mayor this long is because the voters want me here.”

Kendrick Walker, who is Black, has lived in Country Club Hills for the last two years and does not consider race when voting. “What difference does it make what color a candidate is? As long as that candidate is doing a good job then that is all that matters to me,” Walker, 37, said. “The only issue I have with Mayor Welch is the property taxes, which are too high.” According to Walker, her property taxes have gone from $336 to over $1,000 in two years. She has no problem with Welch as mayor, and said she has no problem with voting for a white mayor, city services are good and that economic development seems to be booming.

The city’s police chief, treasurer and eight of its 10 aldermen are Black. But race had nothing to do with allegations leveled against Welch for allegedly misusing a village issued American Express card, said Aldermen Steven Burris and Vincent Lockett. “Race did not play a part at all,” Lockett said. “The mayor misused his credit card. He created this mess himself and now he wants to use the race card.” Welch said contrary to published reports his American Express card was not revoked. “I voluntarily turned in the card to avoid any further allegations of misuse,” explained Welch. Every charge on my credit card was legitimate. And I do not have any other village issued credit cards despite what some council members are saying.”

Burris doubts if Welch’s only credit card was issued by American Express. “We are still digging through the rubble of paperwork he has created to hide inappropriate charges,” Burris said. Burris added that questionable charges for Welch include a stay at a water park and dining at fancy restaurants. And a review of Welch’s expenditures showed he spent $435 at the Apple Store, $376 at Hooters, $585 at Nordstrom, and $1,400 for charges at Build-A-Bear, Nike Town, the Disney Store, and on Broadway play tickets. His credit card expenditures included charges from the Chatham Pancake House in Country Club Hills. One charge showed $173 while another one was for $216.

Welch countered that aldermen are allotted an annual expense account of $9,000 and many of them including Burris and Lockett, have ‘questionable charges’ as well. “They’re a fine one to talk about credit card charges when you have aldermen using their expense accounts to provide college scholarships,” added Welch, who is allotted a $36,000 annual expense account and is paid an annual salary of $144,000. The fiscal year 2012 budget for CCH is $35 million, according to Welch who added that he used his credit card mostly to cover expenses as the village’s lobbyist.

“The mayor of most cities serve as its lobbyist rather than pay someone. So, when I travel, eat out or entertain prospective developers and businesses it is to benefit Country Club Hills,” added Welch. But all Country Club Hills residents don’t support Welch. “He tries to rule this town like a king. He thinks no one should question him and he does not take kind to those who oppose his views,” said Jack McAdams, 73. “This is a man who is arrogant and cares about no one but himself.”

Lockett and Burris have both questioned why the Cook County State’s Attorney office has not indicted Welch or at the very least investigate him. “We know a Black man would never be mayor of a white suburb like Schaumburg or Highland Park and walk around free if these types of allegations were swirling over his head,” Lockett said. Tandra Simonton, a spokeswoman for the Cook County State’s Attorney office, said, “we don't confirm or deny if we conducted criminal investigations.”

Zimbabwean Writer Honored with Annual Caine Award

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By Fungai Maboreke –

Zimbabwean writer Elizabeth Zandile Tshele, better known as NoViolet Bulawayo, is the recipient of this year’s Caine Prize for African Writing, considered Africa’s leading literary award.

She won the award for her story “Hitting Budapest” about six hungry children from a slum who steal guavas from an upscale suburb.

Speaking to the BBC, NoViolet said: “I try to write stories that don’t normally get told.” Ms Bulawayo explained that she was "marrying the personal with the imaginary."

“Some of these incidents in Hitting Budapest are taken from my own life - the stealing of guavas to begin with, growing up less privileged and having these dreams," she said.

Among the other writers on the shortlist were: Beatrice Lamwaka, of Uganda, for her story Butterfly Dreams; Tim Keegan, of South Africa, for What Molly Knew; Lauri Kubuitsile, of Botswana, for In the Spirit of McPhineas; and Lata and David Medalie, of South Africa, for The Mistress’s Dog.

Award-winning author and Chair of Judges, Hisham Matar said, “The language of Hitting Budapest crackles. Here we encounter Darling, Bastard, Chipo, Godknows, Stina and Sbho, a gang reminiscent of Clockwork Orange. But these are children, poor and violated and hungry. This is a story with moral power and weight; it has the artistry to refrain from moral commentary. NoViolet Bulawayo is a writer who takes delight in language.”

Bulawayo is a Truman Capote Fellow and Lecturer of English at Cornell University in New York State.

Law Requiring Mandatory Drug Testing for Poor Met with Criticism

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By Nisa Islam Muhammad, Special to the NNPA from The Final Call –

(FinalCall.com) - Republican Florida Governor Rick Scott recently signed into law a bill requiring adults applying for temporary cash assistance to undergo drug screening. His rationale is to increase personal accountability and prevent Florida's tax dollars from subsidizing drug addiction, while still providing for needy children. Parents failing the required drug test may designate another individual to receive the benefits on behalf of the children.

“While there are certainly legitimate needs for public assistance, it is unfair for Florida taxpayers to subsidize drug addiction,” Governor Scott said. “This new law will encourage personal accountability and will help to prevent the misuse of tax dollars.”

However, this new bill flies in the face of research and evidence that proves such bills are ineffective and wasteful.

“Given the high cost of treatment programs and the waiting lists for services in many areas, mandatory drug testing of all applicants or recipients of TANF benefits is a poor use of resources. In a time of tight state budgets, it is perverse to spend limited funds in pursuit of the small number of substance abusers who are not identified through screening processes, rather than on providing actual services,” wrote Matt Lewis and Elizabeth Kenefick of the Center for Law and Social Policy (CLASP) in their February report, Random Drug Testing of TANF Recipients is Costly, Ineffective and Hurts Families.

“Despite the persistence of proposals to impose drug testing at the state and federal levels, these proposals have consistently been rejected because the data do not support the money-saving claims.”

According to the National Conference of State Legislatures many states have proposed drug testing for welfare recipients since the passage of welfare reform in 1996. Drug testing is expressly permitted in the federal rules governing the TANF block grant. Michigan was the first state to implement mandatory drug testing, but the law was found unconstitutional in 2003 by a Michigan Court of Appeals. The Florida legislation is the first to be passed by a state legislature since the Michigan case.

The bill seems to be based more on stereotypes than the facts of life for poor people.

“A lot of stereotypes exist about poor people and why they're poor. People want to attribute their poverty to poor choices and not to our economy even though we're coming out of one of the worst economic recessions,” said Elizabeth Lower-Basch, CLASP Senior Policy Analyst.

The bill requires all applicants for TANF to be tested for controlled substance use and the applicant must pay for the drug test. If they test negative the applicant will be reimbursed for the cost by adding the amount to their benefit check.

If an applicant tests positive, the applicant is ineligible for benefits for one year, but can reapply in six months if he/she completes an approved substance abuse treatment program.

A parent's positive test result does not affect the child's eligibility for benefits; however, any benefits received must be disbursed through a protective payee, who must also pass a drug test.

The Florida chapter of the American Civil Liberties Union warned that the bill may be challenged in court and is headed in the same direction as its Michigan predecessor.

“The wasteful program created by this law subjects Floridians who are impacted by the economic downturn, as well as their families, to a humiliating search of their urine and body fluids without cause or even suspicion of drug abuse,” Howard Simon, the chapter's executive director told reporters

Is Redistricting in California a Step Backwards for Blacks?

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When the law was passed mandating that redistricting was to be done by the voters instead of the legislators, it seemed like a great thing, but now ...

By Yussuf J. Simmonds, Special to the NNPA from the Los Angeles Sentinel –

Not long ago, in an attempt to educate the community about redistricting, there was a column in this the Los Angeles Sentinel newspaper describing the process in simple terms. In addition since the redistricting process has been underway, several community groups have been formed to act as watchdogs over the process: to monitor the town hall styled meetings; to keep the community informed; to write letters to the commission; and to engage the commissioners. One such organization is the African American Redistricting Collaborative (AARC).

The commissioners' mandate was to have released a preliminary draft of the maps by June 10, which they did and to have the final maps delivered to the California secretary of state by August 15. Apparently the preliminary maps, if allowed to become final, would irreparably devastate the African American community politically. According to a nine-page letter sent to the California Citizens Redistricting Commission (CCRC) by AARC, "Our main source of concern is the guidance supplied by your counsel, which has apparently led to some very disturbing map visualizations at the June 30th and July 2nd meetings. From what we gather, these visualizations ignore the hard work by AARC, CAPAFR and MALDEF to harmonize their interests into mutually agreeable configurations..."

It is also important to note that the commission may have already received the results of a study on Racially Polarized Voting in Los Angeles County, which seemed to coincide with the 'disturbing map visualizations' as referenced by AARC in its letter relative to the African American community.

(Another disturbing trend is while the process to redraw California's State and Congressional lines has received national attention, the County of Los Angeles' redistricting effort has proceeded without much fanfare (tantamount to magic: keep the focus on one thing while the real trick is being performed elsewhere). It has been reported that during the past year and a half, 19 plans have been submitted by the public to alter representation for the County's 10 million residents and some have recommended adjustments to the Second Supervisorial District [represented by Mark Ridley-Thomas], which has the highest concentration of African Americans. This has been done outside the purview of African Americans and without a spotlight as with the CCRC's mandate).

Historically, African Americans have fought, bled and died in the fight for civil rights FOR ALL AMERICANS. Every group, ethnicity, race and religion have benefited from the burdens that African Americans have borne so that this nation can live up to its creed that "all men (women and children) are created equal." So it appears paradoxical that the rights that African Americans have fought for are now being eroded and shifted to others.

Specifically, two out of the three African American congresswomen in South Los Angeles are being threatened to lose their districts, if the present maps become permanent. However, a careful analysis of the proposed district boundaries, suggest that it has to be a win-lose outcome. But that is not the case. An alternate boundary map does show just the opposite: a win-win situation for all concerned.

A new map shows that African Americans can maintain their political base and Latinos can have their just due also. It has been proposed, and it is incumbent upon the commission and other communities of interest to fairly and objectively review the proposed map that will result in a solution mutually acceptable for all concerned.

There is still time to correct the above stated imperfections in the mapping process. Marqueece Harris-Dawson, president of Community Coalition, who has been active in the South Los Angeles community for more than 20 years, recently spoke on redistricting and its economic and political impact on South Los Angeles as part of the Brotherhood Crusade's workshop series, of which Charisse Bremond-Weaver said, "Our latest workshop series, The Economic Impact of Institutional and Structural Racism, is a prime example of how we help the entire community establish positive habits and attitudes about money that ultimately lead to an understanding of its power."

The time is at hand and as AARC's letter also stated, "...We can no longer remain silent in the face of so many instances of mis-statements about important elements of voting rights law. Time is too short and the stakes are far too high for our community..."

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