Talking Back to Stigma

Talking Back to Stigma 

When Words Work Against Us: The Language of HIV Stigma

By Candace Y.A. MontagueFrom TheBody.com

February 15, 2015

When a person has HIV, there's a virus within his or her body. That diagnosis doesn't mean that the person is now defined by the virus he or she carries. But for many years, the language of HIV/AIDS has -- intentionally or unintentionally -- marginalized groups of people living with HIV, as well as those in communities with high rates of HIV infection. The time has come to reframe the lingo around HIV/AIDS in order to empower rather than alienate, and to educate the general public.

The U.S. Centers for Disease Control and Prevention defines HIV as "a virus spread through body fluids that affects specific cells of the immune system, called CD4 cells, or T cells. Over time, HIV can destroy so many of these cells that the body can't fight off infections and disease." It continues on to say that an HIV infection can lead to AIDS. Often, however, HIV and AIDS morph in people's minds into a single condition in which people who contract HIV are perceived as having received an automatic death sentence.

Terminology can also foster stigma by misidentification. Vickie Lynn, M.S.W., M.P.H., instructor and doctoral student in the Department of Public Health at the University of South Florida, says that when people refer to men and women with HIV, it is imperative to make those labels secondary. "Many people use language incorrectly, so I think it confuses the general public. They put the disease before the person and not the other way around. So rather than use labels to define a person, we need to use terms that are more appropriate. Instead of saying 'HIV-infected people' we should be saying 'people living with HIV,'" she explained in a recent webinar sponsored by the Positive Women's Network-USA (PWN-USA).

In the webinar, Lynn and her colleague Valerie Wojciechowicz, a motivational speaker and creator of4HIVhelp.com, presented ways that people can reroute their language use. They highlighted how language shapes our world and how to choose empowering language over stigmatizing words. "Look up the term 'full-blown AIDS.' There's no such thing as full-blown AIDS because there's no half-blown AIDS. There are some people who still use that term. I was horrified that reputable journals use this type of terminology," stated Lynn. She adds that when people discuss HIV/AIDS, they should refrain from stigmatizing words such as victim, sufferer and contaminated. She also advises that people replace terms like "risky sex" and "promiscuous" with more accurate terms such as "condomless sex with or without PrEP" and "having multiple sex partners."

Mixed Messages

The media can have a big effect on changing the tide on stigmatizing language, they explained. Although most ads and campaigns are well intentioned, inaccurate wording can unwittingly work against the desired goals. Phrases that suggest that one partner gives AIDS to another or that women should insist on a man getting a condom can counter empowerment. AIDS is not communicable; only the virus that causes it is. Protection can come from the male or female in a relationship. Staying healthy is everyone's responsibility. Projecting misinformation is yet another way of perpetuating stigma.

Additionally, mixed messages can reinforce discrimination. HIV has been described as a chronic disease, which reduces the alarm. However, creating a more relaxed atmosphere around this condition -- which remains highly stigmatized and requires ongoing monitoring and care -- can also be a way to deny or restrict important services needed by people living with HIV, such as health care and housing.

And if HIV is a manageable, chronic disease that doesn't warrant extra attention, then why is HIV status used as a means of criminalizing people in certain states? People living with HIV are literally beingprosecuted for their saliva, which does not transmit the virus.

Who Is Responsible for Changing the Language?

The media, medical professionals and community health advocates all play a role in changing the language. But change can also be propelled by the people who live with HIV. Making self-denigrating statements like "I'm sick" or "I have that bug" can fuel fear that living with HIV is a forlorn predicament.

Waheedah Shabazz-El, regional organizing coordinator for PWN-USA and goodwill ambassador for Philadelphia FIGHT, has been living with HIV for 12 years. She says that people with HIV have the ability to stop the cycle of language misuse from continuing.

"People living with HIV are best suited to create this manifesto. We are in a better position to tell the public what stays and what doesn't stay. I was always told that it's not what you're called but what you answer to. It's an inside job. And then it becomes an outside job," she told TheBody.com.

People living with HIV can advocate for more effective, accurate use of language by making changes from within organizations. Shabazz-El says that people can start by not accepting terms that portray people living with HIV in a negative light. "We need to be involved in the decision making. I've heard people use the word 'consumers' to describe us. But it's not used the way we see it in the dictionary. It's used to say that we just consume AIDS services. We don't give back. I have approached organizations and asked them to change the word 'consumers' in their mission statements. I'm a person living with HIV, not a consumer."

Misinformation can be the enemy of hope when people are trying to make change, whether in their individual lives or at the broader public level. Using imprecise language to describe people living with HIV is an assured way of fostering fear and discrimination. Advocates stress that it will take a conscientious effort by people living with and without HIV to create change -- but it can be done.

Candace Y.A. Montague is a native of Washington, D.C., and covers HIV news all around the District. She has covered fundraisers, motorcycle rides, town hall meetings, house balls, Capitol Hill press conferences, election campaigns, protests and an International AIDS Conference for The D.C. Examiner.com, emPower News Magazine, the Black AIDS Institute and TheBody.com. One of her two master's degrees is in community health promotion and education. She is also an educator and a mother of two.

Copyright © 2015 Remedy Health Media, LLC. All rights reserved.

Read More Stories like this here: http://www.thebody.com/

Imagine a World Without HIV

February 19, 2015

Steve Chase Humanitarian Awards Imagine a World Without HIV

The 21st Steve Chase Humanitarian Awards were presented in a ceremony on February 7 in Palm Springs, California. The annual fundraiser honors individuals for their contributions in the fight against HIV/AIDS and supports the work of the Desert AIDS Project (DAP). This year’s event raised an estimated $1.3 million. The awards are named for renowned interior designer Steve Chase, a DAP donor, volunteer and board member who died of AIDS-related complications in 1994.

Founded in 1984, DAP serves people living with, affected by or at risk for HIV in the Coachella Valley. In addition to its HIV health center, DAP also provides case management, mental health and substance abuse counseling, housing assistance, and many other comprehensive services to its clients. The organization also provides HIV testing as part of Get Tested Coachella Valley—a region-wide public health program that encourages everyone to get tested.

“Imagine” was the theme for this year’s awards, which was hosted by comedian Mario Cantone. The audience was asked to imagine a world without HIV, to imagine an AIDS-free generation and to imagine themselves helping to create that world. 

Tony-award winner Shoshana Bean performed at the event along with the So You Think You Can Dance All Star Cast, who told the story of a serodiscordant gay couple and how HIV affected their relationship. The original performances were choreographed by Mandy Moore.

Dr. Michael Gottlieb, who diagnosed the first AIDS cases in 1981 and was a founding chair of amfAR, the American Foundation for AIDS Research, was presented with the Science and Medicine Award by Dr. Steven Scheibel. Philanthropist Helene Galen was presented with the 100 Women Award by U.S. Senator Barbara Boxer for her generous contributions over the years. The Partners for Life Award was presented to David Morgan, owner of Reaction Marketing and Promotions, by actor Leslie Jordan. And legendary fashion designer Bob Mackie honored Joan Rivers with a special tribute for her legacy of AIDS-related work. 

Timothy Ray Brown, the first—and so far only—person successfully cured of HIV, also spoke at the awards gala and was a testament to the idea that if we can imagine a life with HIV, it can actually come true.

Click here to learn more about the Desert AIDS Project.

Event co-chairs Barbara Keller and Jim Casey

Host Mario Cantone

U.S. Senator Barbra Boxer

100 Women Award recipient Helene Gale

Partner for Life Award recipient David Morgan and actor Leslie Jordan

Fashion designer Bob Mackie

Dr. Michael Gottlieb and Timothy Ray Brown

Tony-award winner Shoshana Bean

So You Think You Can Dance All Stars

Photos by Gregg Felsen

Search: Steve Chase Humanitarian Awards, Desert AIDS Project, Coachella Valley, Mario Cantone, Dr. Michael Gottlieb, Helene Gayle, David Morgan, Joan Rivers

Read More Articles Here: http://www.poz.com/

PrEP

February 24, 2015

PrEP Reduces Group of Gay Men’s Risk of HIV By 86% in UK Study

A group of British men who have sex with men (MSM) and transgender women given Truvada (tenofovir/emtricitabine) as pre-exposure prophylaxis (PrEP) had an overall 86 percent lower risk of HIV as a consequence. This is the highest population-level effectiveness of PrEP seen in a randomized study to date, and it should give ammunition to supporters of this HIV prevention method as they face any detractors who claim that prescribing Truvada to HIV-negative MSM will prove ineffective or lead to significant collateral damage.

Begun in 2012, the PROUD study included 545 very high-risk HIV-negative MSM and transgender women at 13 sexual health clinics in the United Kingdom.  A total of 276 of them were randomized to receive PrEP immediately upon entry into the study, while the remainder of the participants were set to receive PrEP a year later so that the researchers could observe them as a control group in the meantime. Researchers presented their findings of the study at the 2015 Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle.

In October 2014, the study’s independent data monitoring committeerecommended that the group that was supposed to receive PrEP on a deferred basis should instead receive Truvada immediately, based on an interim analysis of the study that showed high effectiveness for PrEP among the study population.

There were three new cases of HIV among the group that received PrEP immediately, for an incidence of 1.3 per 100 person-years, compared with 19 new cases in the deferred group, for an incidence of 8.9 per 100 person-years. Consequently, the researchers concluded that PrEP reduced the risk of HIV infection by 86 percent on what is known as an intent-to-treat basis. This means that giving PrEP to the population as a whole reduced the men’s overall risk of the virus by 86 percent, when compared with the overall risk of HIV among the group that received PrEP later on. If the researchers were to examine individuals’ HIV risk based on their personal adherence to Truvada, those who took the drug daily would likely have an individual rate of protection higher than 86 percent. Previous studies of MSM and transgender women have used mathematical modeling to estimate that PrEP is 99 percent or even 100 percent effective if taken every day.

That said, the men in the PROUD study appeared to have adhered to the Truvada regimen quite well. MSM in the iPrEx and iPrEx open-label extension studies did not adhere well, accounting for those studies’ lower intent-to-treat effectiveness rates of 44 percent and about 50 percent, respectively.

In a press release, Sheena McCormack, a professor of clinical epidemiology at the Medical Research Council Clinical Trials Unit at University College London, and chief investigator of the PROUD study, said that the results of her study “are extremely exciting and show PrEP is highly effective at preventing HIV infection in the real world. Concerns that PrEP would not work so well in the real world were unfounded. These results show there is a need for PrEP, and offer hope of reversing the epidemic among men who have sex with men in this country. The findings we’ve presented today are going to be invaluable in informing discussions about making PrEP available through the [U.K. National Health Service].”

PrEP is not currently approved in the United Kingdom. In fact, the United States is the only country to have approved Truvada as an HIV prevention method.

A major concern about PrEP has been that it will lead those taking Truvada to use condoms less frequently, or to take other greater risks sexually, such as by having more sexual partners. Even if Truvada could effectively neutralize these risks, or ensure that on balance individuals have less risk of HIV than they did before they started PrEP, there is still the risk of sexually transmitted infections (STIs) to consider. (A risk that may be mitigated by the twice-yearly STI screening required in the United States.)

Evidence in the PROUD study suggested that the men in the PrEP group were not using condoms less since starting on Truvada. They also did not have a greater rate of STIs, nor did they report a higher median number of partners when compared with the deferred group.

A major benefit of this study is that it showed PrEP is feasible and effective in a real-world setting. The health clinics administering the study were relatively easily able to integrate PrEP into their HIV prevention methods.

Referring to findings of multiple studies of PrEP presented at CROI, Mitchell Warren, executive director of the global HIV advocacy group AVAC, said in a press release, “Today’s results add to a powerful body of evidence that ARV-based prevention works when it is used correctly and consistently. But they’re also a reminder that with nearly every prevention option available today, from condoms to PrEP to HIV treatment, correct and consistent use is both critically important and a real challenge.”

Search: PrEP, pre-exposure prophylaxis, Truvada, tenofovir, emtricitabine,PROUD, UK, England, men who have sex with men, MSM, gay men, iPrEX, OLE,Sheena McCormack, Mitchell Warren

Read More Articles Here: http://www.poz.com/index.shtml

Up in Smoke?

Up in Smoke?

by Rita Rubin

The future of medical marijuana for HIV/AIDS looks hazy.

Click here to read a digital edition of this article.

Jay Lassiter started smoking pot at age 19, right around the time he learned he was HIV positive. “It was a coincidence,” he says. “Sort of like sex, drugs, and rock ‘n’ roll. It was part of the package.”

When Lassiter was 24 he moved to California, which in 1996 became the first state to legalize medical marijuana. But if he wanted to buy it, Lassiter had to get a letter from a doctor. He could no longer put off making an appointment.

Nearly 20 years later, the now-42-year-old Lassiter credits marijuana with saving his life. “I wanted pot because I liked to smoke pot,” says Lassiter, a political consultant and outspoken advocate of legalized marijuana for all adults, not just those who need it for health reasons.

“I knew that my entry into the world of having access to legalized marijuana was predicated on my HIV status,” he says. “At that point, having access to a drug that I liked to do recreationally provided the incentive for me to face up to this disease and ultimately manage it for a very long time.”
Lassiter, who now lives in New Jersey, says he smokes pot daily, but he really only uses it to help manage HIV symptoms a couple times a month. “I still like smoking marijuana,” he explains, noting that pot does help him sleep and eat better.

When asked if he smokes only legally obtained medical marijuana, Lassiter told this reporter to write that he “smiled sheepishly and had no comment.”

In Maine, Maryland and New Jersey, smoking medical pot is allowed for conditions that might affect people with HIV/AIDS, such as wasting syndrome, pain and nausea, but HIV/AIDS is not specifically cited.

In 19 states and the District of Columbia, smoking medical marijuana is allowed for several conditions, including HIV/AIDS. In New York state, only edible—not smoked—medical pot is allowed for any condition, including HIV/AIDS.

Although Alaska, Colorado, Oregon, Washington state and DC also have legalized recreational marijuana, the federal government still deems pot illegal for any use. As a result, some doctors are reluctant to recommend it, and few scientists have studied its safety and effectiveness in treating people with HIV/AIDS and other conditions.

Meanwhile, as more and more states legalize medical marijuana, fewer and fewer people with HIV/AIDS need it to relieve symptoms or side effects, thanks to the development of safer, more effective antiretroviral medications.

Search the word “marijuana” on the website for Boston’s Fenway Health, an LGBT health care, research and advocacy organization, and you won’t get a single hit, even though Massachusetts has legalized medical marijuana.

“Because we are a federally qualified and funded health center, we are awaiting federal guidance on this issue and are not currently writing prescriptions for medicinal marijuana,” spokesman Chris Viveiros says.

The AIDS Action Committee of Massachusetts has supported legalized medical marijuana since 1996, says executive director Carl Sciortino, who also pushed for it during his nine years as a state representative. “Our community would have significantly benefited from it in the earlier days of the epidemic.”

But by the time Massachusetts voters approved legalizing medical marijuana in 2012, the percentage of people with HIV who stood to benefit had declined, Sciortino says: “It’s not what it was even 10 years ago.”

Still, AIDS Action’s commitment to the cause never flagged, he says, because the organization wanted to support those with other conditions who had a more pressing need for medical marijuana.

In the early 1990s, when doctors first began thinking that marijuana could relieve symptoms in people with HIV/AIDS, “the whole epidemic was very, very different,” says David Hardy, MD, a Los Angeles infectious disease specialist whose practice tended to attract the sickest patients. “We basically were just slowly staving off the virus. The death and dying was very, very high.”

Two of the most common and debilitating symptoms in that era were wasting and nerve pain, and the best help that doctors could offer was to make patients as comfortable as possible, Hardy says.

They could prescribe anabolic steroids or expensive growth hormone to patients who had lost too much weight, he says, “but unless the person could put the food in their mouth and swallow it, even those very powerful weight-gaining medications did not work.”

So Hardy turned to a pricey prescription medication called Marinol, the brand name for dronabinol, to help patients regain their appetite. Marinol, also used to treat nausea and vomiting caused by cancer chemotherapy, contains synthetic THC, or tetrahydrocannabinol, the compound in marijuana that makes people high and gives them the munchies.

The problem, Hardy found, was that Marinol took as long as two hours to kick in, and the high it produced lasted too long. “What people needed was rapid delivery of appetite-stimulating medication,” he says. And that could be accomplished by smoking marijuana.

Even before California legalized medical marijuana, Hardy began talking about it with the 30 to 40 percent of his patients who needed to pack on pounds. “I would simply ask the patients: Have you ever smoked marijuana before? If they said yes, I’d ask: How did it make you feel?”

If they said, “‘It made me feel like I could eat a side of beef,’” Hardy says, “I would suggest smoking a little marijuana before their meals. I had no qualms about doing that. These were individuals who truly had a terminal disease.”

If patients told him they’d never smoked pot and felt uncomfortable about starting, Hardy says he would not recommend it.

Research suggested that marijuana also could relieve pain in the hands and feet from peripheral neuropathy, a nerve condition caused by HIV infection as well as early antiretroviral drugs that doctors stopped prescribing a decade ago.

Although he has recommended marijuana for peripheral neuropathy pain, Hardy acknowledges that it’s not clear whether patients feel relief because the drug actually reduces pain or whether getting high makes people feel no, or at least less, pain.

Today, Hardy says, fewer than 30 of his 300 HIV-positive patients have peripheral neuropathy, and they include some long-term survivors with intractable pain in their feet. He is reluctant to prescribe narcotic painkillers to them because of the risk for abuse.

And only perhaps three of his patients, all long-term AIDS survivors who nearly died and never regained the weight they had lost, are candidates for smoking marijuana to improve their appetite.

“I have had fewer and fewer requests for medical marijuana,” Hardy says, and he’s increasingly skeptical when patients say they need it.

“You really have to distinguish between the medical use of medical marijuana and the recreational use,” Hardy notes. There are 700 medical marijuana dispensaries around Los Angeles, he says, and most of their clients have no medical need for it.

Nearly 30 percent of the 500 HIV-positive patients in the Norwalk, Connecticut, practice of Gary Blick, MD, use medical marijuana. Half of them had either never smoked pot recreationally or only used it a few times, he says.

Medical marijuana sold at the handful of dispensaries in his state is two to four times as potent as what people can buy on the street, Blick says: “It’s purer.”

He had picked out a space in his office building for a medical marijuana dispensary “when our city said ‘not here.’ Our clients here in Norwalk have to drive pretty much an hour to get medical marijuana.”

Many of them use it as an appetite stimulant because they’ve lost too much weight, says Blick, who regularly smokes it himself to relieve chronic back and nerve pain from spinal stenosis.

His 92-year-old mother, Gloria Blick, started smoking pot in a pipe a couple of years ago, before legal medical marijuana was available in Connecticut, to treat her glaucoma. Now her ophthalmologist recommends it.

Chronic pain from peripheral neuropathy is the main reason Blick’s patients use medical marijuana. While pain isn’t an approved condition for medical marijuana in Connecticut—an omission Blick hopes to correct—HIV/AIDS is. Another common reason his HIV-positive patients smoke medical marijuana is post-traumatic stress disorder (PTSD) related to pain, anxiety and depression associated with their diagnosis, Blick says.

A 16-year study of nearly 3,000 HIV-positive women found that they used medical marijuana for reasons similar to Blick’s patients. In that study, the proportion of women who said they currently used marijuana declined over time, from 21 percent in 1994 to 14 percent in 2010.

“As they aged, there was a pretty substantial decline in marijuana use over time,” says lead author Gypsyamber D’Souza, an HIV epidemiologist at the Johns Hopkins Bloomberg School of Public Health. “Recreational drug use is higher among younger women.”

But daily use of marijuana increased significantly over that period, from 3.3 to 6.1 percent of all of the women in the study and from 18 to 51 percent of the current marijuana users. For D’Souza, that was the most interesting finding, particularly because it paralleled an increase in the use of modern antiretroviral therapy. Still, she notes, her study can’t prove that better HIV treatment caused the increase in daily marijuana use.

In 2009, D’Souza’s team asked the women if their marijuana use was medicinal or recreational. Most users reported either purely medicinal use or medicinal and recreational use. The most common reason the women gave for using medical marijuana was relaxation and stress reduction, which, of course, is also why people smoke it recreationally, D’Souza says. Other common reasons were to boost appetite and reduce nausea.

Frequent, long-term marijuana use carries its own risks, though, according to the National Institute on Drug Abuse (NIDA). “Marijuana use may have a wide range of effects, particularly on cardiopulmonary and mental health,” according to NIDA’s “Drug Facts” publication on marijuana. The drug can irritate the lungs, heightening the risk of infections, and raise the heart rate shortly after smoking, greatly increasing the risk of a heart attack in the following hour, according to NIDA.

Plus, marijuana’s effect on HIV progression has been little studied. Because the federal government considers the drug illegal, scientists are reluctant to spend the time and effort needed to clear regulatory hurdles, says Igor Grant, MD, chair of psychiatry at the University of California, San Diego School of Medicine and director of the University of California Center for Cannabis Research.

“To do more cannabis research, the only legal source is the federal government. To get that requires a lot of approvals,” Grant says. “In the past, it was just kind of seen as a kooky thing.”

Some scientists have turned their focus to Marinol and THC. Although the Food and Drug Administration approved Marinol capsules 30 years ago, there’s little scientific evidence to support its effectiveness in treating wasting, and concerns have been raised about the safety of THC in HIV/AIDS, says Patricia Molina, MD, PhD, director of the Alcohol and Drug Abuse Center of Excellence at Louisiana State University. In fact, Molina says, “multiple studies had found that cannabinoids have immunosuppressant effects.”

So she decided to study the impact of THC on male rhesus monkeys infected with simian immunodeficiency virus, or SIV, a primate version of HIV. “The purpose of the study was never to show that THC can treat HIV,” she says. “The main question we wanted to answer was whether or not chronic use of THC would increase viral load or further decrease the CD4-to-CD8 ratio in infected animals.”

But Molina’s study attracted wide media attention because the twice-daily injections of THC the researchers gave the monkeys lowered the risk of early death in the monkeys with SIV, possibly because its anti-inflammatory effects decreased viral replication.

After a follow-up study, Molina’s team published results that didn’t get nearly as much press. The main difference in the design of the second study was that it used female instead of male rhesus monkeys. In contrast to their study of male monkeys, though, the researchers found that THC did not protect the female monkeys from early death or weight loss from SIV.

“We still do not have an explanation for those differences” between the male and female monkeys, Molina says, although she speculates that female hormones play a role.

Meanwhile, she says, “I would never advocate marijuana as a treatment for HIV.” Molina says she studies THC to help HIV-positive individuals “make informed decisions regarding frequency, amount and duration of their consumption or, alternatively, of the need to quit or decrease use.”

Search: medical marijuana, recreational marijuana, legalization, side effects,peripheral neuropathy, wasting

Read More Articles Here: http://www.poz.com/index.shtml

HIV/AIDS - Diabetes

October 27, 2014

Inflammation May Lead to Diabetes in People on HIV Meds

There is a link between low-level elevations of markers that indicate systemic inflammation and the development of type 2 diabetes among HIV-positive people taking antiretrovirals (ARVs), aidsmap reports. Publishing their findings in the Journal of Acquired Immune Deficiency Syndromes, researchers conducted a retrospective analysis of the relationship between baseline levels of high sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6) and new type 2 diabetes diagnoses among approximately 3,700 people in the SMART and ESPRIT HIV treatment studies. The members of the study cohort were all taking continuous ARVs without any adjunct therapy.

During an average 4.6 years of follow-up, 137 people were diagnosed with type 2 diabetes, for a rate of 8.18 per 1,000 person-years.

The group that developed diabetes had significantly higher median baseline levels of the two inflammatory markers when compared with the group that did not develop diabetes: The respective hsCRP levels were 4.91 and 2.29 micrograms per milliliter; the respective IL-6 levels were 3.45 vs. 2.50 pictograms per mL.

Higher body mass index, older age, coinfection with hepatitis B or hepatitis C virus and the use of lipid-lowering medication were all linked with the diagnosis of diabetes.

The study’s authors concluded that low-grade systemic inflammation is an underlying factor in the development of type 2 diabetes among HIV-positive people taking ARVs. 

To read the aidsmap story, click here.

To read the study abstract, click here.

Search: Diabetes, inflammation, HIV, aidsmap, high sensitivity C-reactive protein, hsCRP, interleukin-6, IL-6, SMART, ESPRIT.

Read More Stories Here: http://www.poz.com/index.shtml

AFFORDABLE HEALTH INSURANCE - HIGHER PATIENT CO-PAYS

February 17, 2015

Study: More Health Exchange Plans Put HIV Meds in Priciest Tier

More health insurance exchanges place medicines—notably those for HIV, cancer and multiple sclerosis—in the highest cost-sharing tier, according to an analysis and related press release by Avalere Health. What’s more, a growing number of plans put all the drugs in a particular class on the highest tier. 

The analysis included 20 classes of drugs. In five of them, the health plans put all the drugs in that class in the highest tier. Specifically, in the protease inhibitor class, 29 percent of plans put all the drugs—even the generics—on the highest tier.

The Avalere analysis looked at the silver plans in Florida, Illinois, Pennsylvania, Texas, Georgia, North Carolina, New York and California. The states represented about 60 percent of the total population enrolled in the exchanges in 2014.

In eight of the 10 classes, the plans were more likely in 2015 than in 2014 to put all single-source branded drugs in the highest tier.

In response to the analysis, Carl Schmidt of the AIDS Institute said: “What is new about this analysis is that the plans in 2015 are much worse than 2014. We believe some insurers are purposefully designing plans in such a way that discourages patients, particularly those with chronic health care conditions, from signing up for them.”

Schmidt continues: “This is clear discrimination and a violation of the Affordable Care Act (ACA). We need the ACA to work for all patients and for the federal government to enforce the strong non-discrimination provisions contained in the ACA. Without enforcement, how will patients afford their medications and who knows what the 2016 plans will look like?”

Search: Avalere Health, Carl Schmidt, AIDS Institute, Affordable Care Act

Read more stories here: http://www.poz.com/articles/avalere_analysis_insurance_1_26823.shtml

What Does HIV/AIDS Stigma Look Like in Your Life?

Follow this link to read about different forms of HIV/AIDS STIGMA: HIV/AIDS STIGMA

Just REMEMBER - YOU ARE NOT ALONE!!!!

Here are a few groups on FACEBOOK to find others who listen and know what you are going through:

https://www.facebook.com/RiseAboveHiv

https://www.facebook.com/groups/mariahiv/

https://www.facebook.com/groups/shelbywelchel/

https://www.facebook.com/shelbywelchel

https://www.facebook.com/hivaboveandbeyond

And if you need prayer or spiritual encouragement you can join my Prayer Page:

https://www.facebook.com/prayerwarriorsforyou