Reblogged from blog.aids.gov

This month, the Centers for Disease Control and Prevention (CDC) launchedREASONS/RAZONES – the newest HIV testing campaign under the CDC Act Against AIDS initiative. The bilingual campaign is the agency’s first national effort to encourage HIV testing among Latino gay and bisexual men, who are among those hardest hit by HIV in the United States.

The campaign asks gay and bisexual Latinos“What’s your reason?/¿Cuál es tu razón?” for getting an HIV test through a series of campaign materials that feature men sharing their reasons for getting tested for HIV. REASONS/RAZONES uses images of family, friends, and partners to emphasize a strong sense of self, family, and community. The campaign also includes information about accessing fast, free, and confidential HIV testing.

The campaign’s bold images and messages will appear in mobile and online advertising, national and local print and outdoor/transit advertising and will be the focus of a media relations effort to generate print and broadcast news stories.

Latinos are the largest and fastest-growing ethnic minority in the United States and also one of the groups most heavily affected by HIV. Latinos account for 16 percent of the population, but 21 percent of all new HIV infections. Latino gay and bisexual men account for nearly almost 1 in 4 new infections among gay and bisexual men of all races.

Yet, too many Latino gay and bisexual men with HIV do not know they are infected. A recent study among gay and bisexual men in 21 American cities found that more than a third (37 percent) of Latinos living with HIV were unaware of their infection. The need for greater testing is particularly urgent among young men. CDC data show that 70 percent of HIV positive Latino gay and bisexual men between the ages of 18 and 24 do not know their status.

REASONS/RAZONES initially launched in Los Angeles on June 6 and will launch in Miami on June 26, two cities with high HIV and AIDS prevalence among Latinos. The Los Angeles community engagement launch event is timed to coincide with Gay Pride, while the event in Miami coincides with National HIV Testing Day. REASONS/RAZONES also had a presence in Washington, D.C. at Capital Pride events on June 7 – June 9. Roll-outs in other cities will follow throughout the summer months.

Please visit http://hivtest.cdc.gov/reasons/ to download all campaign materials, view and share the campaign videos, find a HIV testing center near you and share your reasons for getting an HIV test.

REASONS/RAZONES is a part of Act Against AIDS, the 5-year, multi-faceted national CDC communication initiative designed to refocus attention on HIV and AIDS in the United States. Act Against AIDS focuses on raising HIV awareness among all Americans and reducing the risk of infection among the hardest-hit populations. The multiple campaign phases use mass media (radio, TV, newspapers, magazines, the Internet and other communication channels) to deliver important HIV testing and prevention messages. To learn more about Act Against AIDS, visithttp://www.cdc.gov/actagainstaids/.

Muchos cambios están ocurriendo en el ámbito del trabajo en prevención del VIH en los Estados Unidos. Con el lanzamiento de la Estrategia Nacional para combatir el VIH y el SIDA, en Julio del 2010, se han establecido metas muy ambiciosas. Asimismo, reciente hallazgos científicos han traído al armamentario de prevención nuevas herramientas para prevenir la infección del VIH en poblaciones a  mayor riesgo.

A pesar de todos estos descubrimientos, las poblaciones hispano-parlantes en los Estados Unidos, o de origen Latino (Hispano), tienen que entender completamente estas estrategias y herramientas, y adoptarlas como propias, con el fin de que la población en pleno se beneficie de estos desarrollos.

Este blog intentará traer toda esta información nueva y ponerla al alcance de los trabajadores de salud (personal médico y no-médico);  que atienden a estas poblaciones,  que conocen y entienden sus necesidades de educación (en cuanto a prevención y  de tratamientos del VIH),  aconsejamiento/asesoramiento, apoyo psicológico y emocional y de cómo navegar el sistema médico en los Estados Unidos.

Una de las características más importantes del trabajo en VIH y SIDA es que es una actividad laboral que la persona elige de manera autónoma. Esto es, que el individuo tiene un compromiso genuino de ayudar a las personas afectadas por la infección del VIH. Por ello es importante contar con un intercambio de ideas y experiencias que, idealmente este blog va a recopilar y al mismo tiempo, brindará la oportunidad de compartir información técnica validada por investigación con el fin de estandarizar el conocimiento de las nuevas estrategias que conforman lo que se denomina como Prevención 2.0. Este nuevo abordaje  es la combinación de todas esas intervenciones que sabemos son efectivas para prevenir la infección del VIH y que son accesibles para la población que tiene mayor riesgo.

En los Estados Unidos cada año ocurren 50, 000 nuevas infecciones de VIH y se estima que aproximadamente un millón doscientos mil personas viven con el VIH y esta cifra crece cada año en decenas de miles, amplificando el riesgo de infección para otras personas. Asimismo, una serie de factores sociales, económicos y demográficos tienen un efecto directo en el tamaño de la probabilidad de infectarse para algunos individuos, por ejemplo: el estigma asociado a la enfermedad, la discriminación, el nivel de ingreso económico, grado de escolaridad y la zona geográfica donde se vive. Por todo esto es necesario intensificar los esfuerzos de prevención apoyándose en el modelo de trabajo que establece que el tratamiento de la enfermedad del VIH es una medida de prevención.

De la misma manera la Prevención de Alto Impacto (HIP, por sus siglas en inglés) ha sido diseñada para maximizar los esfuerzos de prevención para todos los individuos que están a mayor riesgo de la infección del VIH, incluyendo hombres homosexuales y bisexuales, minorías de color, mujeres, usuarios de drogas, hombres y mujeres transgénero y población juvenil.  Las estrategias de este nuevo abordaje tienen un alto margen de costo-beneficio y que son reproducibles en amplia escala, teniendo como población blanco a una población específica y atinada la cual vive en un área geográfica bien delimitada.

Después de 3 décadas de arduo trabajo en el campo de prevención del VIH contamos con nuevas herramientas que han demostrado su efectividad. De hecho, la inversión realizada en prevención ha contribuido a la reducción del número anual de casos nuevos  desde que se dio el pico máximo de la epidemia a la mitad de los 80s. La estabilización del número de casos es un signo de progreso  así como la disminución de la transmisión materno-infantil y la reducción de casos entre usuarios de drogas. Todo esto ha generado ahorro en el gasto de atención. Por ejemplo, se ha estimado que por cada caso de infección de VIH  prevenido se ahorra al país $360,000 dólares que es lo que costaría proporcionar atención médica y tratamiento de por vida a esa persona. Es bien importante tomar en cuenta toda esta experiencia y las destrezas que el personal de salud en general ha desarrollado a través de años de esfuerzos, ya que estas experiencias y habilidades nos ayudaran con los cambios que se avecinan.

El éxito de este blog va a depender del grado de participación de la audiencia usuaria. Es bien sabido que la población de habla hispana y de origen Latino/Hispano es muy diversa. Sin embargo, todas esas poblaciones comparten características que nos podrían ayudar a identificar estrategias de trabajo que podrían beneficiar a la totalidad de la comunidad Latina. Es importante reconocer que la experiencia laboral, día tras día, enriquece las experiencias de los trabajadores de salud y esto ayuda a identificar modelos de trabajo que han demostrado ser efectivos y prácticos; desafortunadamente en el quehacer cotidiano, esas experiencias no son diseminadas o estructuradas, dado que en este ámbito laboral no se acostumbra la publicación o diseminación.

Las estrategias que han probado ser efectivas y que reducen substancialmente el riesgo de infección  son presentadas a continuación, siempre y cuando sean diseñadas considerando los factores sociales, financieros y estructurales que se sabe ponen a ciertos grupos a mayor riesgo de la infección y estas son:

-          Practica de la prueba del VIH y enlace inmediato a cuidado médico.

-          Terapia Antirretroviral

-          Acceso a condones y jeringas estériles

-          Programas de prevención para personas que viven con VIH y sus parejas

-          Programas de prevención para personas a riesgo alto de infección

-          Tratamiento de la adicción a drogas y estupefacientes

-          Tamizaje y tratamiento de enfermedades de transmisión sexual

En el futuro revisaremos con detenimiento cada una de estas estrategias y espero que podamos discutirlas a profundidad e identificar los factores que tenemos considerar para alcanzar a la población hispano-parlante de manera efectiva.

Esperamos que esta breve introducción abra el dialogo y que compartan con nosotros sus preocupaciones, ideas y experiencias en el proceso de la implementación de la prevención del VIH de alto impacto. Como comentamos al principio esta blog, el éxito de esta ventanilla de información va  a depender del grado de participación de nuestra audiencia.  Gracias por  estar con nosotros….. OV

 

¿Cómo está su agencia incorporando estos nuevos cambios? ¿Qué tipo de asistencia técnica necesita su agencia para adoptar estos cambios? ¿Su agencia ha incorporado exitosamente estos cambios? Cuéntenos!

-Octavio Vallejo

 

 

 

PrEP or (Pre-Exposure Prophylaxis) is a common buzz word in the HIV prevention field lately as it is a biomedical HIV prevention strategy that is in line with the National HIV/AIDS Strategy and CDC’s High Impact HIV Prevention guidelines.  While conducting our capacity building work, we have noticed an increase in inquires around PrEP.  Below is a list of resources for understanding more about PrEP that we at Shared Action have come across in the last year.

First, we at Shared Action have created a short informational fact sheet on PrEP, which can be accessed here:  https://docs.google.com/file/d/0Bw5vIjccZK_QSUVuZW13WUpXcjA/edit?pli=1

Another resource is PrEPfacts.org.  This interactive website is the product of collaboration from San Francisco AIDS Foundation, San Francisco Department of Public Health, Project Inform, Be The Generation, other health agencies, and community-based providers.  The website has multiple webpages with more detail regarding PrEP including:

• An Overview of PrEP
• Previous Research
• Facts
• Common Questions
• And More!

When looking for information, we always recommend going directly to the source.  Gilead, the pharmaceutical who makes Truvada for PrEP has their own webpage.  This site has all of the technical information on the drug and PrEP including research, safety information, and facts.   http://www.truvadapreprems.com/pre-exposure-prophylaxis

Last but not least, the CDC’s website contains its own information page on PrEP.  It includes fact sheets, press releases, and current research on PrEP.  http://www.cdc.gov/hiv/prevention/research/prep/

Do you have a resource you prefer to use when seeking information on PrEP?  Please share it in the comments!

-Andi Zaverl

Combining the expertise of the Center of Excellence for Transgender Health and the World Professional Association for Transgender Health, the National Transgender Health Summit will provide an exceptional educational forum for disseminating cutting edge research and increasing clinical skills among health care professionals of all backgrounds.

We invite health care providers, health and human service professionals, mental health professionals, health administrators, researchers, students and advocates to attend this groundbreaking Summit. Programming will include plenary sessions by world-renowned experts in the field of transgender health care, training tracks for medical and mental health care providers interested in building their skills for working with transgender patients and clients, a research track for the dissemination of cutting edge developments in the field of transgender health, and a transgender health policy institute.

 

In the past three months two of my friends passed away. Both of them were trans women of color. Both of them had lung related conditions. Neither one of them had regular medical care to manage their conditions nor reliable health support systems. It is evident that transgender people experience health disparities due to various reasons including lack of access to quality health care and fear of accessing care due to previous negative experiences. The 2013 National Transgender Health Summit provides exceptional learning opportunities for clinicians and health care professionals to better address transgender health care issues among others. The summit will be held on May 17-18, 2013 in Oakland, CA. Please visit (http://transhealth.ucsf.edu/trans?page=ev-summit2-program) to register and learn more about the summit.

-Jordan Blaza

 

Reblogged from blog.aids.gov

 

 

As part of our continuing efforts to pursue the National HIV/AIDS Strategy’s (NHAS) call for a more coordinated response to the epidemic in the United States, Federal agencies recently completed a review and update to the HIV/AIDS information available onBenefits.gov.

The mission of Benefits.gov is to reduce the expense and difficulty of interacting with the government while increasing citizen access to government benefit information. The site’s core function is the eligibility prescreening questionnaire or “Benefit Finder.” Answers to the questionnaire are used to evaluate a visitor’s situation and compare it with the eligibility criteria for more than 1,000 federally-funded benefit and assistance programs. Each program description provides citizens with the next steps to apply for benefit programs of interest. Benefits.gov is a collaborative effort of 17 Federal agencies, and is managed by the Department of Labor. The site has been visited more than 50 million times and more than 11.2 million citizens have been referred to agency benefit programs. Users include the general public, persons seeking benefits for themselves, health care providers, case managers, state and local health departments, Federal government policymakers, program developers, and advocacy groups, among others.

After a review last summer of the HIV-related programs featured on Benefits.gov, we conferred with the site’s administrators and identified several enhancements that could be made to better serve users seeking information about HIV-related services and benefits. We then worked with the NHAS Federal Leads Work Group—composed of representatives from the Departments of Health and Human Services, Housing and Urban Development, Justice, Labor, and Veterans Affairs as well as the Social Security Administration—to compile information about seven additional programs to be added to the site. Short narratives highlighting the nine benefit programs, including six from HUD and three from DOL, are now part of the Benefits.gov database.

In addition, Benefits.gov created an HIV/AIDS benefits page to list these and other relevant benefits available to people living with, at risk for, and/or affected by HIV/AIDS. This information is available in English and Spanish.

Benefits.gov also now includes several HIV-specific questions in the online pre-screening tool to assess individual eligibility and more effectively direct users to locate appropriate programs. Finally, Benefits.gov also has added the AIDS.gov HIV Testing and Care Services locatorwidget to several pages, which will also help visitors identify nearby services.

“By ensuring that Benefits.gov features the full range of Federal benefits and services for people living with HIV/AIDS, we hope to facilitate improved access to this information and the available benefits and services to a broader population,” said Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases. Dr. Valdiserri also noted that these efforts will be bolstered by the outreach Benefits.gov concentrates on several key populations including low income individuals and families, caseworkers serving at-risk populations, Veterans, and students and educators.

Editor’s note: Dr. Kosub was on detail to OHAIDP when this work was conducted.

Reposted from the Office of National AIDS Policy

 

On Monday, March 4, 2013, at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta, Dr. Deborah Persaud of the Johns Hopkins University presented an intriguing case study of a child who by all measures seems to be cured of HIV infection. This single case has sparked significant conversation, debate, and optimism. There are important questions that have naturally arisen from this case and we hope to examine some of the aspects of the research agenda that now need to be pursued. While this is an exciting case, we want to stress that it remains very important for people living with HIV/AIDS to continue their medications and to see their healthcare providers on a regular basis.

Certain of the facts are clear. An infant was born at a hospital in Mississippi to a woman unaware she was infected with HIV until she was already in labor. Having been born somewhat prematurely, the child was transferred to the University of Mississippi Medical Center, where the baby came under the experienced and skilled care of pediatrician Dr. Hannah Gay. Knowing that the mother was not previously treated for HIV infection (which put the infant at a high risk of becoming infected), Dr. Gay proceeded under the assumption that the infant had become infected. She started the infant on a three-drug cocktail of antiretroviral medications for HIV treatment, as opposed to the standard two-drug regimen for prophylaxis (prevention) of infection. Blood samples from the infant were repeatedly drawn, and lab results confirmed that the baby indeed had a detectable level of virus. Over the course of several weeks of treatment with antiretroviral drugs, the amount of virus in the child’s blood declined to undetectable levels. The child was discharged from the hospital on antiretroviral therapy that continued for up to 18 months, at which point the mother and child interrupted their medical care. Fast forward several months: the child reappeared in care after a significant lapse in antiretroviral therapy. Surprisingly, the child had no detectable circulating virus, no detectable anti-HIV antibodies, and was clinically healthy. Dr. Gay then reached out to Dr. Persaud and Dr. Katherine Luzuriaga of the University of Massachusetts to perform laboratory studies to help understand what had happened with this toddler.

Several aspects of how this case was dealt with stand out. First, the potential importance of this case was recognized immediately and some of the best laboratories in the world were brought in to help validate the laboratory data. Investigators with long-standing working relationships, some established a decade or more ago, collaborated on state-of-the-art analyses of specimens. The results from all the laboratory studies confirmed that there was no ongoing HIV replication in this child; all that apparently remained was miniscule snippets of viral material.

This case study has touched off vigorous discussions, with both agreements and disagreements about key questions — a healthy and important part of the scientific process. For example, questions have arisen whether the child was ever truly infected in the first place, or was the virus detected in the blood stream of the infant soon after birth actually virus that was passed from the mother during pregnancy or during birth? Was the observed result due to the early treatment within 30 hours of birth, or was there something important about the intensity of the antiretroviral treatment or even some characteristic of the infant’s immature immune system?

It is essential that critically important questions are raised and ultimately addressed. This is a report of a single case, and as scientists, our goal is to confirm or refute research findings, and through this process, we also seek to fill in the missing details. There are several immediately obvious lines of research that will be pursued. First, we will work to better understand the relationship and/or difference between the virus passed to an infant from the mother and the virus produced by an infant’s infected cells during the early hours and days following exposure. Second, assuming that the immediate treatment of infants at high risk for infection could result in a possible “cure” of a truly infected infant, the risk-to-benefit ratio of starting very early 3-drug treatment (rather than 2-drug prophylaxis) for babies born under such conditions is now altered and must be discussed and possibly reconsidered. In addition, studies need to be designed and implemented to investigate the questions of timing and duration of pediatric antiretroviral treatment. In this regard, we need to examine existing cohorts of children who years ago were truly infected (or were assumed to be infected) and were treated not within hours of detection of virus but within weeks to months to determine if such cases had similar outcomes to the Mississippi child and can shed light on the timing and intensity of starting therapy. To this end, the team led by Drs. Persaud and Luzuriaga presented information at CROI on five additional children who had been perinatally infected and started antiretroviral therapy at a median of 2 months after birth. Encouragingly, in these children long-term control of HIV replication following early antiretroviral treatment has resulted in extremely low levels of virus and diminished anti-HIV immune responses.

Of course, as part of the National HIV/AIDS Strategy, as we move forward with our research agenda we must engage in serious discussions on the criteria, risks and ethics involved in all our studies, including the idea of stopping antiretroviral therapy in individuals who may be “cured. As physicians and scientists, we must first do no harm as we seek ways to improve the health of the nation and world through biomedical research.

Anthony S. Fauci, M.D. is the Director, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health.

Carl W. Dieffenbach, Ph.D., is the Director of the Division of AIDS, National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH).

 

Cross-posted from NIH/NIAIAD News Release

 

Discovery Provides Clues for Potentially Eliminating HIV Infection in Other Children

 

A two-year-old child born with HIV infection and treated with antiretroviral drugs beginning in the first days of life no longer has detectable levels of virus using conventional testing despite not taking HIV medication for 10 months, according to findings presented today at the Conference on Retroviruses and Opportunistic Infections (CROI) in Atlanta.

This is the first well-documented case of an HIV-infected child who appears to have been functionally cured of HIV infection—that is, without detectable levels of virus and no signs of disease in the absence of antiretroviral therapy.

Further research is needed to understand whether the experience of the child can be replicated in clinical trials involving other HIV-exposed children, according to the investigators.

The case study was presented at the CROI meeting by Deborah Persaud, M.D., associate professor of infectious diseases at the Johns Hopkins Children’s Center in Baltimore, and Katherine Luzuriaga, M.D., professor of pediatrics and molecular medicine at the University of Massachusetts Medical School in Worcester. These two pediatric HIV experts led the analysis of the case. The National Institute of Allergy and Infectious Diseases (NIAID) and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), both components of the National Institutes of Health, provided funding that supported the work of Drs. Persaud and Luzuriaga and other investigators involved in the analysis of the case.

“Despite the fact that research has given us the tools to prevent mother-to-child transmission of HIV, many infants are unfortunately still born infected. With this case, it appears we may have not only a positive outcome for the particular child, but also a promising lead for additional research toward curing other children,” said NIAID Director Anthony S. Fauci, M.D.

In July 2010, the child was born prematurely in Mississippi at 35 weeks, to an HIV-infected mother who had received neither antiretroviral medication nor prenatal care.

Because of the high risk of exposure to HIV, the infant was started at 30 hours of age on liquid antiretroviral treatment consisting of a combination of three anti-HIV drugs: zidovudine, lamivudine, and nevirapine. The newborn’s HIV infection was confirmed through two blood samples obtained on the second day of life and analyzed through highly sensitive polymerase chain reaction (PCR) testing. PCR tests conducted on separate occasions that indicate the presence of HIV in an exposed infant are considered to have confirmed the diagnosis of infection.

The baby was discharged from the hospital at 1 week of age and placed on liquid antiretroviral therapy consisting of combination zidovudine, lamivudine and co-formulated lopinavir-ritonavir. This drug combination is a standard regimen for treating HIV-infected infants in the United States.

Additional plasma viral load tests performed on blood from the baby over the first three weeks of life again indicated HIV infection. However, by Day 29, the infant’s viral load had fallen to less than 50 copies of HIV per milliliter of blood (copies/mL).

The baby remained on the prescribed antiretroviral treatment regimen until 18 months of age (January 2012), when treatment was discontinued for reasons that are unclear. However, when the child was again seen by medical professionals in the fall of 2012, blood samples revealed undetectable HIV levels (less than 20 copies/mL) and no HIV-specific antibodies. Using ultrasensitive viral RNA and DNA tests, the researchers found extremely low viral levels.

Today, the child continues to thrive without antiretroviral therapy and has no identifiable levels of HIV in the body using standard assays.  The child is under the medical care of Hannah Gay, M.D., a pediatric HIV specialist at the University of Mississippi Medical Center in Jackson. Researchers will continue to follow the case.

“This case suggests that providing antiretroviral therapy within the very first few days of life to infants infected with HIV through their mothers via pregnancy or delivery may prevent HIV from establishing a reservoir, or hiding place, in their bodies and, therefore, achieve a cure for those children,” said Dr. Persaud.

NIAID and NICHD provided funding that supported the collaborating investigators involved in the analysis of the HIV-infected child through the International Maternal Pediatric Adolescent AIDS Clinical Trials Network’s (IMPAACT) cooperative agreement grant AI066832. Analysis was also performed by Tae-Wook Chun, Ph.D., a lead investigator in NIAID’s Laboratory of Immunoregulation in Bethesda, Md. The Foundation for AIDS Research (amfAR) also contributed funding.

For more information about NIAID’s HIV/AIDS cure research, see the NIAID HIV/AIDS Web portal.

AIDS.gov posted an entry on a 1-day conference that is being held on March 22nd, 2013 on how digitial technology will influence clinical care in the coming years.

You can read the blog entry here.

Today we received word that the National Association of People with AIDS will shut down. Here are some words from Paul Kawata, the executive director of NAPWA:

 

Remembering NAPWA
Ending the Epidemic by Paul Kawata

In the early days, death from HIV was quick and very ugly. It seems unbelievable, but there was a time when funeral directors would not cremate our dead, hospital staff would not bring food into the room, even some of our friends would turn their backs on us because they feared infection. It is a testament and the legacy of the LGBT community that we rolled up our sleeves and developed whole new infrastructures to respond to the epidemic. The continuum of care model was developed by us to take care of our friends.

There were heroes, amazing men, women and children who stood up to discrimination and fought back against the stigma and lies surrounding this disease. The HIV community owes a great debt to our straight allies and the lesbian community who stood with us when so many others looked the away. This epidemic was and is the test of a generation. Would you stand up and be counted or run away and hide?

The National Association of People with AIDS (NAPWA), the first national organization representing people living with AIDS has closed. We can point fingers or cast blame, but right now I want to remember the visionaries who started and built this important organization at such a critical time for our community. NAPWA’s first executive director was Stephen Beck, followed by Mike Meridian, Bill Freeman, Terri Anderson, Cornelius Baker and Frank Oldham. Ordinary Americans who stood up to be counted. I was lucky to be taken under the wings of so many early heroes. I learned to fight from Michael Hirsch, compassion from Bobby Campbell, running an organization from Richard Dunne, and to dream from my friend Paul. Many who survived this period have their own Michaels. That friend who gave them courage to do things they could never have imagined.

This is my story about Michael Hirsch. When I first came to Washington, I had no idea which way was up. Michael was the first person to take me under his wing. He was the quintessential New York Jewish gay activist who was the first executive director of the New York PWA Coalition and The Body Positive. Michael could drive me crazy, make me angrier than I thought possible, and laugh until I cried.

He would infuse during meetings. He wanted to remind the world that HIV was about real people with real problems. Because of Michael I was accepted into the PWA community. He insisted I attend early organizing meetings that would later become the National Association of People with AIDS.

Michael wrote long diatribes about life, the movement, his frustrations and joy. They were intimate letters between someone who was dying and someone who would remember. He closed each letter with “Yours in the struggle”.

When I got the call — if you did AIDS work in the 80s or early 90s, you know which call I mean — to come to the hospital for Michael while I was in Washington. I hopped on the shuttle to New York as quickly as I could and prayed to make it on time. The taxi ride from LaGuardia to Saint Vincent’s seemed to last forever. When I rushed into the hospital, Michael’s mother and sister were sobbing. My heart sank, was I too late? Just then Rona Affoumado, former executive director of the Callen-Lorde Health Center, found me and said, “Oh God, you made it. The family just decided to pull the plug.” …I wasn”t too late

Rona escorted me into Michael’s room. It was all pumps and whistles from the many machines keeping him alive. It had that unique smell, the smell of death. Michael was unconscious. The morphine stopped the pain so he could sleep. When they turned off the machines, there was an eerie silence. I held Michael’s hand and told him how much I loved him. Just then his eyes opened and a single tear rolled down his cheek and he was gone.

The nurse later said it was a reflex, to me it was a sign. It was Michael saying goodbye and to always remember. I close all of my emails with “Yours in the struggle” to honor his life and the lives of so many we’ve lost.

Michael’s story is the story of our movement. With NAPWA’s closing, we’ve lost a national voice for PLWHA just as we’ve found a pathway to end the epidemic. The dream of an AIDS-free generation cannot happen without leadership from people living with HIV or AIDS. All of us fighting to end this epidemic must work to carry on and fulfill NAPWA’s vision and ensure that people living with HIV or AIDS are front and center in the fight to end this epidemic. We must never lose sight of the fact that our fight is more than a battle against some abstract disease, but a struggle for our friends and lovers.

Goodbye NAPWA. I will remember your history, legacy and the leaders who made it possible.

Yours in the struggle,

Paul Kawata
Executive Director
National Minority AIDS Council

Cross posted from HealthCare blog.

 

Countdown to Affordable Health Insurance

 

By Kathleen Sebelius, Secretary of Health and Human Services

Posted January 16, 2013