A Victory for LGBT Health in the Americas

Shared from huffingtonpost.com


Early in October, global health leaders in the Americas Region made a major step forward to improve access to and quality of health care for lesbian, gay, bisexual, and transgender (LGBT) persons.

At the annual meeting of the Pan American Health Organization, delegates from governments throughout the region unanimously passed a resolution entitled Addressing the Causes of Disparities in Health Service Access and Utilization for Lesbian, Gay, Bisexual and Trans (LGBT) Persons. By passing this resolution, health authorities in the Americas have pledged to promote equal access to health services for those in the LGBT community, taking into account the widespread stigma, discrimination, and persecution experienced by many in the population. This is a huge victory, as approval of the resolution marks the first time any United Nations body taken steps to address discrimination in the health sector against LGBT persons.

Unequal treatment against LGBT people exists both in and outside of the health sector in the Americas region. In some countries it is government sanctioned, where laws or policies exist criminalizing same-sex conduct. However, even where there are no explicit laws, stigma and outright discrimination often prevent LGBT persons from accessing needed services. However, the discussions my colleagues and I had at PAHO before the vote took place were not about areas of disagreement, but instead focused on what it would take to reach the public health goal of achieving universal access to care. When I introduced the nondiscrimination agenda item on behalf of the United States I cautioned, “If we exclude the LGBT population from our work, a portion of universal health care will become an illusion.”

This resolution will improve norms and standards in the Americas to promote equal access to health services for all people. Director-General of the World Health Organization Dr. Margaret Chan has called universal coverage, “the single most powerful concept that public health has to offer. It is the best way to cement the health gains made during the previous decade. It is a powerful social equalizer and the ultimate expression of fairness.” This resolution also creates an important precedent for other World Health Organization (WHO) regional bodies as well as for WHO itself. The U.S. government stands firm in our resolve to capitalize on this significant step forward for LGBT health. We will continue our work at WHO to raise these issues and we look forward to the report PAHO will produce on “the health situation and access to care of LGBT persons, the barriers they can face in accessing health care services, and the impact of reduced access for this population.”

While discussions about LGBT health are sensitive in every country, what I said at PAHO remains true: “Ensuring access to nondiscriminatory care is a goal that all countries can and should support. Despite religious or cultural differences, we all recognize the fundamental principles of making sure that every person can see a health provider when they are injured, get medicine when they are sick, and have access to the basic preventive care necessary to live a healthy and active life.”

I am proud of the leadership role the United States continues to play to advance LGBT nondiscrimination, and we will continue to push ahead to provide equal and quality health outcomes for all citizens of the world.

Statement from Deborah von Zinkernagel, Acting U.S. Global AIDS Coordinator, On Passage of the PEPFAR Stewardship and Oversight Act of 2013


Shared from pepfar.gov

We commend the U.S. Congress for passing the PEPFAR Stewardship and Oversight Act of 2013, reaffirming its strong commitment to this historic global health program. The Act, a bi-partisan and bi-cameral effort, extends critical authorities and strengthens oversight of the landmark 2003 legislation establishing the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).

A mere decade ago, AIDS was a death sentence in Africa. It threatened the very foundation of societies – creating millions of orphans, stalling economic development, and leaving countries stuck in poverty. Today, the picture has changed dramatically, with millions of lives being saved and people with HIV being empowered to lead long and productive lives.

Moreover, landmark scientific advances coupled with success in implementing effective programs have put an AIDS-free generation in sight. We are also maximizing our impact through unprecedented coordination with the Global Fund to Fight AIDS, Tuberculosis and Malaria, partner countries, the private sector, faith-based organizations, and civil society to invest our respective resources in the most complementary and synergistic manner possible.

The passage of the PEPFAR Stewardship and Oversight Act demonstrates the United States’ sustained commitment to fighting this deadly disease, but the U.S. cannot do it alone. Achieving an AIDS-free generation is a shared responsibility. We are profoundly grateful to Congress for its leadership in ensuring our path and our purpose in the global fight remains strong.

The 2013 POZ 100: Celebrating Unsung Heroes

Shared from The Huffington Post

I’m a big fan of the singing competition The Voice on NBC. It got in my veins after season 2 semifinalist Jamar Rogers disclosed his HIV-positive status on the show. Apart from the talent of the contestants and the witty banter among the judges, what got me hooked were the blind auditions. The idea of vocal talent alone being the first barrier to the show feels right to me. Until the judges turn around to see who’s singing, most of the performers are unsung heroes of a sort. Some get to tell their stories of struggling to make their dreams come true. For others, just auditioning is a triumph.

In many ways, this year’s POZ 100 list has much in common with The Voice. The HIV/AIDS community has many heroes. Our best-known heroes range from celebrities and activists to politicians and researchers. As a gay Latino who has lived with the virus for more than 20 years, I’m grateful for all they’ve done over the past three decades. I may not have survived this far without their efforts.

Although they might not be as well-known, I believe that the overwhelming majority of our heroes are in our midst. They are the people on the front lines of the fight against HIV/AIDS. To honor their service to our community, POZ magazine has recognized these unsung heroes in our fourth annual list.

In past lists we’ve praised both people living with the virus and HIV-negative people. This year we asked individuals and organizations to focus their nominations on HIV-positive people who haven’t gotten widespread recognition. People living with the virus often have a unique understanding of what needs to be done and how best to do it. They know what it’s like to be newly diagnosed and how it feels to deal with HIV-related stigma and discrimination. They understand the challenges of accessing care, treatment and support. They realize that by sharing their stories, they are not only inspiring others living with the virus but empowering themselves and the HIV/AIDS community.

The people on this year’s list may not consider themselves heroes, but we do. Each person, in his or her own way, is taking a brave stand against the virus. They are fighting back. They do so not because they’re seeking glory or accolades but because fighting back is a means to their survival.

The list includes people of all ages, ethnicities, genders and sexual orientations from across the United States and Puerto Rico, at organizations large and small. It comprises a variety of careers, from bloggers and advocates to doctors and educators, and spans across many diverse populations affected by the virus.

Although their contributions certainly merit the attention, we by no means present these 100 people as the only ones deserving recognition. They are stand-ins for the countless unsung heroes in our HIV/AIDS community. Celebrating the honorees on this year’s POZ 100 should be an exercise in applauding all unsung heroes.

Since 1994, POZ has entertained and educated our readers and our community. This year’s POZ 100 has turned that around, allowing our readers and our community to entertain and educate us. We strive to provide hope in every issue of the magazine, but putting together this year’s list gave us hope.

The people we spotlight on this year’s POZ 100 have the power and the passion to effect change in the world. We hope their stories inspire you as much as they’ve inspired us. Go to poz.com/100 to read more. Also, stay tuned for a HuffPost POZ 100 slideshow on World AIDS Day, commemorated every year on Dec. 1.

FACT SHEET: New Administration Proposal To Help Consumers Facing Cancellations

Shared from whitehouse.gov

“I’ve assigned my team to see what can we do to close some of the holes and gaps in the law, because my intention is to lift up and make sure the insurance that people buy is effective, that it’s actually going to deliver what they think they’re purchasing.  Because what we know is, before the law was passed, a lot of these plans people thought they had insurance coverage and then they’d find out that they had huge out-of-pocket expenses or women were being charged more than men.  If you had preexisting conditions, you just couldn’t get it at all.

“And we are proud of the consumer protections we’ve put into place.  On the other hand, we also want to make sure that nobody is put in a position where their plans have been canceled, they can’t afford a better plan even though they’d like to have a better plan.  And so we’re going to have to work hard to make sure that those folks are taken care of.” – President Barack Obama, November 7, 2013

Today, the majority of Americans have employer-based health insurance that is already providing them quality health care coverage. The Affordable Care Act strengthens employer coverage while creating new protections for people in the individual market – preventing them from being charged more because of a pre-existing condition or getting fewer benefits like mental health services or prescription drugs.

The new Health Insurance Marketplace will help millions of hard-working Americans find affordable health insurance.  Premiums are, on average, 16 percent below what was originally projected.  Nearly one in four insurers offering health plans through the Marketplace are selling to individuals for the first time.  And a recent study found that an estimated 17 million Americans can get discounts on their premiums through the Marketplace, through tax credits.

The law aimed to make Marketplace coverage optional for the less than 5 percent of Americans who have individual market coverage that they want to keep.  Health plans that consumers had when the law was passed in 2010 are “grandfathered” in and do not have to adopt most of the new consumer protections. But, in order to provide consumers with better protections and coverage, health insurers in the individual and small group markets have to adopt consumer protections for any new plans purchased after 2010. In some instances, they are adopting those protections by canceling current policies and replacing them with new and sometimes more costly plans.

Many consumers receiving these cancellation letters will be able to find a better deal with financial assistance or better coverage through the Health Insurance Marketplace, but we know a small slice of these consumers may not be eligible for a plan at a more affordable price. Last week President Obama directed his team to explore administrative actions that could be taken to help these consumers who are receiving cancellation letters.

To meet that commitment, today, HHS is using its administrative authority to:

  • Allow insurers to renew their current policies for current enrollees without adopting the 2014 market rule changes.  This will give consumers in the individual and small group markets the choice of staying in their plan or joining a new Marketplace plan next year.  HHS will consider the impact of this transitional policy in assessing whether to extend it beyond 2014.
  • Require insurers offering such renewals to ensure consumers are informed about their options.  Specifically, insurers offering these renewals must inform all consumers who either already have or will receive cancellation letters about the protections their renewed plan will not include and how they can learn about the new options available to them through the Marketplaces which will offer better protections and possible financial assistance.
  • To protect against the potential impacts this change will have on premiums, HHS will adjust the temporary risk corridor program which is designed to stabilize premiums as changes are implemented.

Whether an individual can keep their current plan will also depend on their insurance company and State insurance commissioner – but today’s action means that it will no longer be implementation of the law that is forcing them to buy a new plan.  Turnover is high in the individual market, with 50 to 67 percent of enrollees staying for a year or less.  This means that the number of people in these bare-bones policies will decrease over time.  As such, this action provides a smoother transition in a market that’s generally used as a bridge by most consumers.  And, this action will not allow these older plans to be sold to new customers in 2014, which would undermine the Marketplace and drive up premiums for millions of hard-working Americans.  In short, this administration solution will give consumers more information and choices, including keeping their old plans. As he has said since he signed the bill into law, the President is willing to work with members of Congress in either party on good-faith, constructive solutions that strengthen the law by pursuing the same goals as this Administrative action and do not seek to undermine or repeal the law as a whole.

Updated Pediatric HIV/AIDS Guidelines

Shared from blog.aids.gov


The National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), the HIV Medicine Association (HIVMA) of the Infectious Diseases Society of America (IDSA), the Pediatric Infectious Disease Society (PIDS), and the American Academy of Pediatrics (AAP) announce the release of the updated Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Exposed and HIV-Infected Children. The guidelines were simultaneously published in the Pediatric Infectious Disease Journal (PIDJ).

These guidelines are intended for use by clinicians and health care workers providing medical care for HIV-exposed and HIV-infected children in the United States. The guidelines are developed by a panel of specialists in pediatric HIV infection and infectious diseases from the U.S. government and academic institutions, under the auspices of the NIH Office of AIDS Research (OAR).

GLPortal160x160The guidelines can be found in Web-friendly and PDF formats on the AIDSinfo clinical guidelines portal. To view or download the guidelines, visit the Pediatric OI Prevention and Treatment Guidelines section of AIDSinfo.

These guidelines were last published in 2009. Selected key updates to the guidelines include the following:

  • Greater emphasis on the importance of antiretroviral therapy (ART) for prevention and treatment of opportunistic infections (OIs), especially those OIs for which no specific therapy exists;
  • Increased information about the diagnosis and management of immune reconstitution inflammatory syndrome (IRIS);
  • Information about managing ART in children with OIs, including potential drug-drug interactions;
  • Updated immunization recommendations for HIV-exposed and HIV-infected children, including pneumococcal, human papillomavirus, meningococcal, and rotavirus vaccines;
  • Addition of sections on influenza, giardiasis, and isosporiasis;
  • Elimination of sections on aspergillosis, bartonellosis, and human herpesvirus 6 (HHV-6) and HHV-7 infections; and
  • Updated recommendations on discontinuation of OI prophylaxis after immune reconstitution in children.

In addition to information on the diagnosis, prevention, and treatment of each OI, the guidelines include a summary of the most important recommendations for each OI at the beginning of each section and a table of dosing recommendations at the end of each section. Summary tables are included at the end of the document that list dosing recommendations for preventing and treating OIs in children, drug preparation and toxicity information for children, and major drug-drug interactions.

Additional HIV/AIDS-Related Medical Practice Guidelines Available from AIDSinfo

AIDSinfo is the U.S. government source for HIV/AIDS medical practice guidelines on the management of HIV/AIDS and OIs of HIV/AIDS. Visit our clinical guidelines portal to view and download the most up-to-date, federally approved medical practice guidelines in both Web-friendly and PDF formats.

The guidelines are also available in a mobile-optimized format, which allows you to view the guidelines in an easy-to-read format on your phone or tablet on the AIDSinfo mobile site.

If you have questions or comments about the updated Pediatric HIV/AIDS OI Prevention and Treatment Guidelines, any other HIV/AIDS medical practice guidelines, or any AIDSinfo features, please send an e-mail to ContactUs@aidsinfo.nih.gov.

– See more at: http://blog.aids.gov/2013/11/updated-pediatric-hivaids-opportunistic-infection-prevention-and-treatment-guidelines-released.html#sthash.LgNCXsBV.dpuf

HHS awards Affordable Care Act funds to expand access to care

Shared from hhs.gov


Funding supports new primary care sites in 236 communities to serve more than 1.25 million additional patients

The U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius today announced $150 million in awards under the Affordable Care Act to support 236 new health center sites across the country. These investments will help care for approximately 1.25 million additional patients.

Community health centers work to improve access to comprehensive, culturally competent, quality primary health care services.  Community health centers play an especially important role in delivering health care services in communities with historically high uninsurance rates.  Community health centers are also on the front line of helping uninsured residents enroll in new health insurance options available in the Health Insurance Marketplaces under the Affordable Care Act, through expanded access to Medicaid in many states, and new private health insurance options and tax credits.

“We are committed to providing more people across the country with the quality patient-centered care they deserve,” said Secretary Sebelius. “Health centers are key partners in the improving access to quality, affordable health care services for those who need it most. With new, affordable health insurance options available under the Affordable Care Act, community health centers are also key partners in helping uninsured residents sign up for health coverage – many of whom have been locked out of the health insurance market for years.”

New Access Point Awards map

As community-based and patient-directed organizations, health centers are well positioned to be responsive to the specific health care needs of their community.  Through the Affordable Care Act’s commitment to expanding access to high quality health care for all Americans, these grants will support the establishment of new full-time service delivery sites.

Health centers also link individuals to care through outreach and enrollment, assuring that individuals in their communities have the information and assistance they need to enroll in care through the Health Insurance Marketplace.  Today, approximately 1,200 health centers operate more than 9,000 service delivery sites that provide care to over 21 million patients in every State, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin.  Since the beginning of 2009, health centers have added 4 million patients and more than 35,000 new full-time positions.

“We are thrilled to be able to provide additional Affordable Care Act resources to health centers to establish new sites,” said the U.S. Department of Health and Human Services’ Health Resources and Services Administration (HRSA) Administrator Mary K. Wakefield, Ph.D., R.N.  “With these new funds, health centers will provide more individuals and families across the country with access to high quality affordable health care.”

Health Center New Access Point grants, listed by organization and state, are available at


To learn more about the Affordable Care Act, visit www.HealthCare.gov.  To learn more about HRSA’s Health Center Program, visit http://bphc.hrsa.gov/about/index.html.

Continuing Our March to an AIDS-Free Generation and Improved Global Health

Shared from Dipnote.


It is with a degree of sadness but also an enormous debt of gratitude that I post my final blog as U.S. Global AIDS Coordinator and head of the Office of Global Health Diplomacy.

I am deeply grateful to President Obama who gave me this extraordinary chance to serve and to Secretaries Clinton and Kerry for their exceptional leadership in this historic endeavor — and for the faith they put in me with these two positions.  These past four and a half years have been among the most fulfilling of my 30-year career in HIV/AIDS.

I want to express my sincere appreciation to former President Bush, whose bold vision launched U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) and brought the full weight of American power and capability to the global effort to combat this epidemic, and to the United States Congress for its leadership, from both sides of the aisle, which has consistently and courageously stood behind this country’s global AIDS efforts.

I also want to also send my heartfelt thanks to my staff and to all the incredible men and women with whom I have served — Americans of all backgrounds, as well as colleagues around the world.  These committed and courageous people are living proof that through determination, dedication, and unfailing effort all things are truly possible.

And, above all, I want to thank my family, who stood by my side and gave me the strength to carry on not only in recent years, but for the past three decades of my involvement in the fight against HIV/AIDS.

I am extremely proud of all that we have accomplished together.  Since 2008, we have more than tripled the number of individuals receiving lifesaving anti-retroviral therapy through support from PEPFAR.  We have surpassed one million babies being born without HIV due to PEPFAR-supported programs.  And perhaps most importantly, we have arrived at a moment in which creating an AIDS-free generation is truly within our reach.

Through our collective efforts, we have also all been a part of transforming the way that development is done.  While continuing to rapidly expand access to lifesaving HIV services, we have moved PEPFAR from an emergency state to a more sustainable footing.  We have helped establish a robust health care delivery capability — often where little to none previously existed — that is being used not only to address HIV, but also a broader range of health issues.  We have helped elevate issues of health and development into the upper echelons of diplomatic dialogue.  And we have evolved our relationship with host countries to a true and enduring partnership — one that positions them to assume greater ownership of their national HIV response.

All of this has only been possible because thousands of committed and compassionate individuals wake up each day and go to bed each night thinking about how we can all do more and do it better.  The global AIDS community is truly unlike any other that I have known.  I am honored and humbled to have played my small role in this unprecedented worldwide movement.

One day in a future we can now clearly see, we will achieve the dream of an AIDS-free generation.  When we do, it will mark the completion of an incredible and improbable journey from those terrifying early days of the epidemic in San Francisco.

This epidemic has wrought untold harm on our world, stolen millions of lives, destroyed families and entire communities, and very nearly entire nations.  But it also brought out the best in people — in the United States and around the planet.

We can find no better way to honor those we have lost than to keep pushing forward, and to complete the task that we began more than thirty years ago.  We must also ensure the lessons of this fight are truly learned and applied to many of the other challenges our world faces.  In this way, we can build a future that is not only healthier, but also more peaceful, more just, and more secure for generations to come.

About the Author: Eric Goosby serves as the U.S. Global AIDS Coordinator, leading all U.S. government international HIV/AIDS efforts, and director of the Office of Global Health Diplomacy at the U.S. Department of State.

– See more at: http://blogs.state.gov/stories/2013/11/01/continuing-our-march-aids-free-generation-and-improved-global-health#sthash.Sp45stXo.dpuf

Clearing up the Facts (Healthcare)

Shared from HHS.gov


There has been a lot of confusion about some recent notices to consumers from insurance companies that sell coverage in the individual insurance market, and I’d like to clear up the facts.

Today, more than 3 out of every 4 Americans get insurance from an employer, Medicare, Medicaid, or the Veterans Benefits Administration.  Americans who purchase insurance on their own, however, generally buy coverage in the individual insurance market.

Before the Affordable Care Act, coverage in the individual market often was unaffordable, had high co-pays or deductibles, or lacked basic benefits like maternity care, mental health services, and prescription drug coverage.  These plans also had high turnover rates, and often were not renewed at the end of a plan year.  One study showed that more than half of enrollees in the individual market left their plan within a year.

The health care law is creating new protections for people in the individual market, as well as strengthening employer-based coverage.  In the Health Insurance Marketplace, consumers will no longer be charged more because of gender or a pre-existing condition, recommended preventive services will be covered with no additional out of pocket cost, there will be caps on out of pocket costs, and plans will have to offer a basic package of 10 categories of essential health benefits.

Some insurance companies that sell products in the individual market are making changes to their plans.  Plans that were in place before the Affordable Care Act passed, and that essentially have not changed – that is benefits have not been cut or additional costs imposed on consumers – are exempt or “grandfathered” out of these basic requirements that ensure quality coverage.  Those grandfathered plans can stay the same.  Nothing has changed this fact, and that coverage can continue into 2014, so long as both the insurance company and the consumer agree that it will continue.

Some of less than 5 percent of Americans who currently get insurance on the individual insurance market have recently received notices from their insurance companies suggesting their plans may no longer exist.  These Americans have a choice – they can choose a plan being offered by their insurer, or they can shop for coverage in the Marketplace.  As insurers have made clear – they aren’t dropping consumers; they’re improving their coverage options, often offering plans that are more affordable.

Today, consumers have a choice of an average of 53 qualified health plans in the states where the federal government runs the Marketplace, including those in which it does so in partnership with states.  Nearly all consumers live in states with average premiums below earlier estimates.  Moreover, half of the people in the individual market today qualify for lower costs on monthly premiums when signing up for coverage through the Marketplace.

While the product is good, there is no denying the online experience on HealthCare.gov must be improved.   We will not stop improving the site until every American that wants it has access to quality, affordable coverage.

Importantly, while the team is improving the site, we have opened up new pathways for consumers to apply for coverage through the Marketplace.  There are four basic ways to apply for coverage.  Sign up by December 15 for coverage that starts January 1, 2014.  Enrollment stays open until March 31.

Updates on Healthcare.gov II

Shared from HHS.gov


Kathleen Sebelius, Secretary of Health and Human Services
Wednesday, October 23, 2013

Over the last few days, we’ve shared updates with you on our tech surge and the steps we’re taking to ensure that HealthCare.gov gets better.  Starting tomorrow and moving forward, we will also provide updates through regular blogs and CMS press telebriefings.  We know how critical affordable health coverage is, and as I’ve committed, we won’t stop improving the site until every American who wants it gains access to these new options for care.

Today, we wanted to share an infographic that provides a snapshot of where we are—including technical issues we’re addressing and solutions that our team is putting into place to improve the consumer experience on HealthCare.gov.  Please take a moment to look and feel free to share the graphic with anyone you know that may have questions about the site in your own social networks.

We are committed to continuing to update you on our progress as we improve the site. As always, your feedback is critical to this process. Please feel free to submit comments about your experience, either complimentary or critical, athttps://www.healthcare.gov/connect/.


Updates on Healthcare.gov

Shared from HHS.gov

Kathleen Sebelius, Secretary of Health and Human Services
Tuesday, October 22, 2013

Today, we are announcing key steps the Department is taking as part of a tech surge to continue to improve the consumer experience on HealthCare.gov.

First, I am very pleased to announce we are bringing management expert and former CEO and Chairman of two publicly traded companies Jeff Zients on board to work in close cooperation with our HHS team to provide management advice and counsel to the project.  Jeff has led some of the country’s top management firms, providing private sector companies around the world with best practices in management, strategy and operations.  He has a proven track record as Acting Director at the Office of Management and Budget and as the nation’s first Chief Performance Officer.  Working alongside our team and using his rich expertise and management acumen, Jeff will provide short-term advice, assessments and recommendations.

We’ve also brought in additional experts and specialists drawn from within government, our contractors, and industry, including veterans of top Silicon Valley companies.  These reinforcements include a handful of Presidential Innovation Fellows.  This new infusion of talent will bring a powerful array of subject matter expertise and skills, including extensive experience scaling major IT systems.  This effort is being marshaled as part of a cross-functional team that is working aggressively to diagnose parts of HealthCare.gov that are experiencing problems, learn from successful states, prioritize issues, and fix them.

In addition to our efforts to ramp up capacity and expertise with the country’s leading innovators and problem solvers, we have secured additional staff and commitments from our contractors, including CGI, the lead firm responsible for the federally facilitated marketplace technology.  They are providing and directing the additional resources needed for this project within the provisions of their existing contract.

We will continue to keep you updated on our progress on improving HealthCare.gov.  As we work to fix the site, we encourage Americans to continue to sign up for quality affordable coverage in four ways: by phone, online, by-mail and in person.  Millions of Americans are already benefitting from the law, through increased benefits like preventative care at no additional costs and drug discounts for seniors.  We believe the product of the law – affordable health insurance – is good, but we won’t stop until every American who wants it gains access to these new options for care.