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GAY PEOPle's ChroNICLE OCTOBER 11, 1996

COMMUNITY GROUPS

For the next president: An agenda for ending the epidemic

In the second decade of the AIDS epidemic, there is no question that the President of the United States must be the nation's commanderin-chief in the fight against a disease that has already claimed over 300,000 American lives and threatens many, many more.

AIDS discriminates against no one. There is neither a community that has been unaffected by, nor a family that has been immune to, the ravages of this insidious disease. Fueled by poverty, AIDS is spreading fastest in the communities that have least access to health care and education, particularly communities of color.

We cannot end the AIDS epidemic without making a commitment to end the crises that keep it growing. Nor can we ignore the specific epidemic without making a commitment. The

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The AIDS Action Council calls on the next president to adopt the following five-point AIDS agenda:

Prevention

Despite promising advances in the treatment of AIDS, there is not yet a cure for, or a preventative vaccine against, HIV disease. And, preventing new HIV infections is much less costly than the costs associated with treating newly infected individuals.

Therefore, the next president must ensure that all Americans have access to effective, skills-based HIV education and prevention

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programs targeted to the wide variety of communities affected by the epidemic. These programs should be open, honest and sensitive to the needs of communities at risk for HIV, including adolescents, communities of color, women, and men having sex with men. The president must also fight attempts at any level to restrict the content of HIV prevention programs or educational materials.

As the incidence of AIDS continues to spiral among substance abusers, the next president must commit to adequate funding for substance abuse prevention and treatment with particular attention to the treatment needs of women, intravenous drug users, and HIV infected individuals.

Additionally, the president must lift the prohibition on federal funding for needle exchange programs and thus ensure that all injection drug users have access to free needle exchange programs or have the option to purchase clean needles.

Research

Biomedical research is critical to the discovery of new and effective AIDS drugs and therapies. Behavioral research is critical to developing effective education and prevention programs that are grounded in science. In dealing with research issues, the next president must work from the premise that the interrelatedness of all biomedical and behavioral research requires increased funding for AIDS research at the National Institutes of Health (NIH).

The NIH's Office of AIDS Research (OAR) and its consolidated budget authority over AIDS research funds must be maintained so that the OAR is able to target research dollars in a way that assures the most effective and strategic use of scarce federal resources.

The president must use his leadership to hasten the pace and productivity of research, and to ensure the expedient development of promising new drugs. The next president must also take steps to assure that newly approved (and currently marketed) therapies are affordable and accessible to all people living with HIV and AIDS. The rapid review and approval of promising HIV related therapies is critical to expanding access to drugs for all people with HIV infection. These steps, however, must not in any way, jeopardize the Food and Drug Administration's public health mission in determining the safety and efficacy of all drugs and medical devices.

Care

Too many Americans living with HIV and AIDS lack access to vital care they need to stay alive and healthy. Many cannot afford private health insurance, and others confront inadequate or makeshift health insurance coverage. The majority of Americans cannot afford the high cost of prescription drugs, much less the promise of new AIDS treatments to extend and enhance the quality of their lives. And, lacking community based care, many Americans living with HIV and AIDS must rely on public emergency rooms for their care.

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All people living with HIV disease must have access to health care and social services at tall stages of the disease. This must include, at a minimum, full access to counseling, diagnostic testing, early intervention therapies, in and out patient comprehensive services, community based care, and drug therapies treating HIV disease and its complications, including opportunistic infections. And, these services must be provided by health care professionals who are properly trained in HIV and AIDS care and treatment.

Absent universal health care, the next president must commit to strengthening federal support for vital health care and social services such as the Ryan White CARE Act and Medicaid. AIDS care services authorized under the Ryan White CARE Act, including the AIDS Drug Assistance Program, should be fully funded or granted significant funding increases. The Medicaid entitlement must be maintained, as must the guarantee to basic health care that this safety-net program represents to half of all Americans living with HIV and AIDS.

Housing

For people living with HIV and AIDS, housing can make the difference between life and death. Adequate housing is critical to preventing the onset of illness and to maintaining the quality of life for HIV infected individuals and their families. For example, without housing, HIV infected Americans cannot access potentially life enhancing or life prolonging drug therapies.

As the epidemic grows among low income communities and the already homeless, the need for housing is also growing. The president must demonstrate a strong commitment to the reauthorization of the Housing Opportunities for People With AIDS (HOPWA)program and other federal housing programs. This commitment must include support for an increase in funding for the HOPWA program, which, despite a steady increase in need, and in the number of cities and states qualifying for grants, has been subject to level funding for three years.

Civil rights

Hundreds of thousands of Americans living with HIV and AIDS must battle not only the disease itself, but also fear, stigma and discrimination. Many Americans remain at risk of losing their jobs (including military careers), their homes, even the companionship and support of their families, simply because they are HIV infected.

The next president must show that mandatory testing and other HIV related discrimination are un-American and unacceptable. The president must ensure that the moral and legal authority of the federal government is used to fight discrimination against people living with, at risk for, or perceived to be at risk for, HIV infection. The president must fully implement the Americans with Disabilities Act and fight against policies that bar people living with HIV and AIDS from insurance coverage, employment, housing and entrance into the country.

The next president must ensure that HIV antibody testing is not used as a means of social control, or as a tool for discrimination. HIV antibody testing should only be offered as a diagnostic tool used to inform medical decision making.

A profile of the epidemic

●AIDS is the leading cause of death among Americans ages 25 to 44.

More Americans have died of AIDS related complications than have died in the Gulf, Vietnam, and Korean wars combined.

513,486 Americans have now been diagnosed with AIDS, and more than 319,849 have died. The Centers for Disease Control estimates that more than one million Americans are infected with HIV.

52.5 percent of Americans living with HIV and AIDS are people of color; 34% African-American, 17.5% Latino, .7% Asian/Pacific Islander, and .3% American Indians.

1 14% of Americans living with HIV and AIDS are women. Three out of four of these women are women of color.

From AIDS Action Update, the newslet ter of the AIDS Action Council, an association of local AIDS groups with offices in Washington, D.C.