TRUMPINGTON*, D.C.—As I think we all know by now, only heathens get HIV, "true" Christians never do, and only The Lord can cure people who have it—or at least, that's the policy that some in the Trump White House seem to have adopted, and pretty much everyone who's sexually active will be fucked, thanks to that policy.
Start with the White House Office of National AIDS Policy (ONAP), the office created under orders from President Bill Clinton in 1993 as the office that would coordinate the country's "National HIV/AIDS Strategy." The office's purpose was to reduce the number of new infections in the United States, improve health outcomes for people living with HIV, and coordinate federal agencies so their responses to the problems weren't in conflict with each other. The office also worked towards increasing the government's integrated approach to the prevention, care and treatment of HIV/AIDS.
But who needs that, right? So as of January 2017, the Office of National AIDS Policy was closed, its director Amy Lansky fired, and the office's website now looks, except for that photo in the lower right corner, exactly as you see it above. (More on that photo later.)
And see those drop-down menus at the top—"Briefing Room," "Issues," "The Administration," "Participate" and "1600 PENN"? Clicking on any of them offers nothing to do with HIV/AIDS; they're all now pure propaganda for Trump's policies.
"Today is ONAP staff's last day in the office," Lansky tweeted on Jan. 4. "As such, this twitter account will end. Please continue to follow @AIDSgov for updates."
Yup, ONAP has been folded into the Department of Health & Human Services, whose website, AIDS.gov (which is also the site's Twitter handle) is about to undergo a name change to HIV.gov—and because who needs coordination on HIV policy among the different government agencies, right?
But there are still some people connected with AIDS.gov that seem to have the citizenry's health in mind—even if they haven't been very good at publicizing it. For instance, the agency declared Friday, March 10 to be National Women and Girls HIV/AIDS Awareness Day, but a Google search for news of the event brings up no national news coverage, just a few blog posts, a CDC statement reported on TheBody.com, and one mention on USA Today's AZCentral.com news site. Not exactly a good job of getting the news out. National Black HIV/AIDS Awareness Day (February 7) fared even worse, Google News-wise, and we're guessing that the first (and last) you'll hear about National Native HIV/AIDS Awareness Day (March 20), National Youth HIV & AIDS Awareness Day (April 10) and National Transgender HIV Testing Day (April 18) will be here (though since we know AIDS Healthcare reads AVN.com, they may issue press releases on those topics).
OK, so the new federal government isn't that great about publicizing its Awareness Days; what about HIV prevention?
Funny you should ask! As anyone who's been following the Republican attempt to repeal the Affordable Care Act (ACA aka Obamacare) knows, one of the GOP's prime targets is Medicaid, the federal program that provides healthcare through direct funding to the states that have accepted it—31, at last count—to no-, low- and moderate-income individuals and families—74 million of them at last count—at a total cost of $532 billion in 2015.
"Currently, Medicaid payments to states are based on a matching formula, with the federal government paying states a share of their costs," National Public Radio reported. "The GOP proposes capping payments to states, with different amounts going to different categories of recipients—children, the elderly and people with disabilities. The Congressional Budget Office, in its analysis of the GOP program, said those changes would reduce federal spending on Medicaid by $880 billion over the next 10 years, a 17.6 percent cut."
Why does this matter to, among others, adult performers? Well, as most know, there's such a thing as pre-exposure prophylaxis (PrEP) to prevent HIV infection, in the form of the drug Truvada, which currently costs $1,500 per month for those without insurance that covers it. Even with insurance or Medicaid, the cost can still be as much as $500 per month—so of course, Republicans want to gut the plan.
"House Republicans released a long-awaited blueprint to replace the ACA on Monday, confirming plans to eliminate Medicaid expansion and other key Obamacare features," wrote Time magazine's Kristen Bahler on March 8. "The proposed plan would complicate PrEP access, particularly for low-income Americans in the 31 states, plus the District of Columbia, that adopted the Medicaid expansion. The new bill would begin phasing out federal money for the expansion in 2020, likely blocking new applicants and access to meds like PrEP. If the plan passes in its current form, traditional Medicaid will be replaced by per-capita grants, a fixed-sum per person, which could result in cuts over time. And a proposed repeal of the ACA's cost-sharing assistance, which paid insurers to reduce the burden of enrollees based on their income, would make coverage more expensive for poor Americans, says Lindsey Dawson, senior HIV policy analyst of the Kaiser Family Foundation."
The replacement of federal Medicaid funding to the states with block grants could easily impact the adult entertainment community, since many performers easily fall into the low- and moderate-income brackets—and it seems likely that Truvada won't be considered an essential drug worthy of coverage under the new regimen, leaving sexually active adults S.O.L.
Sadly, AIDS.gov gives little clue as to what's in store for people with HIV or those in danger of contracting the virus going forward. The site's "National HIV/AIDS Strategy: Updated to 2020" page contains no information more recent than mid-2016, and with Republicans in charge, there's no doubt that that strategy will change bigly, and not for the better.
Which brings us to that photo mentioned above. It's of Richard Wolitski, Ph.D., who's now the director of the Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human Services—and he's got a message for those infected with HIV: Pray.
Leaving aside for a moment whether any government official should be calling on the populace to pray for anything, Wolitski's screed attempts to downplay the role religious leaders have played in sabotaging government intervention in the growing epidemic that began in the early '80s.
"Since the first cases of AIDS were identified in the early 1980s, churches, faith communities, and their leaders and members have reflected both the best and the worst in us," Wolitski writes. "Faith communities have embraced people living with HIV, provided loving and supportive care for them, brought HIV information and testing to members of their communities, and mobilized to effect changes that make life better for those at risk for, or living with HIV. Some faith communities, however, did not react with the love and compassion their faith calls for. They blamed, ostracized, and stigmatized persons who were at risk for, or living with, HIV and contributed to efforts to discriminate against and marginalize these groups."
No shit—and those that "blamed, ostracized, and stigmatized" were far more numerous than those willing to help and comfort, and it was they who had the ear of President Ronald Reagan to the point that, even though the virus was first identified in 1981, Reagan prevented his Surgeon General, C. Everett Koop, from speaking out about the growing epidemic, and Reagan himself barely mentioned it, even as late as 1987.
But it's true that over the years, many religious leaders have embraced the cause of helping the sick, even AIDS victims—but even so, Wolitski screws up the message.
"Since the earliest days of the epidemic, we've seen leaders in the faith community working to bring about and support a well-informed and compassionate response to HIV," Wolitski writes. "Today, one of the most visible examples of these efforts is the National Week of Prayer for the Healing of AIDS. The week is an initiative of the Balm in Gilead, an organization that works to support faith communities in designing and implementing programs and services that contribute to the elimination of health disparities of people of the African Diaspora." (In case you hadn't guessed, "African Diaspora" means "black people".)
"Today, I worry that too many people do not see themselves as having a role to play in HIV prevention and care," Wolitski later continues. "Rather, they see these efforts as the responsibility of the government, healthcare providers, or well-funded community-based organizations. The efforts associated with the National Week of Prayer and Healing of AIDS lift my spirit and give me a powerful reminder of the good in people and the power of what we can accomplish when we work together to make the world a better, more equitable, place for everyone."
Yep, it's yet another "the private sector always does things better than the government can" message, and it's incredibly disappointing to hear that from the guy who's now in charge of the federal Office of HIV/AIDS and Infectious Disease Policy. Of course ordinary citizens can play a role, but fighting disease is one of the reasons governments exist in the first place, and for Wolitski to suggest that private citizens, through prayer, can do as much or more than "government, healthcare providers, or well-funded community-based organizations" is just ludicrous. The American people deserve better.
*Hey, he puts his name on everything ...