published by We The People Living with AIDS/HIV of the Delaware Valley, Inc.
Fate of HOPWA funding rides on appropriations bill
PCHA, AIN drop out of 1997 AIDS Ride
New Jersey finally adds protease drugs
No benefit seen in switch to ddI
HIV testing increasing among women
Drug treatment helps addicts, U.S. says
Fate of HOPWA funding rides on appropriations bill
The amount of federal funding for AIDS-related housing projects will likely be determined by next week, as the Senate rushes to complete work on the fiscal year 1997 VA/HUD Appropriations bill.
While the normal next step in the legislative process would be the appointment of a conference committee comprised of House and Senate representatives to iron out differences between the houses on the bill, the AIDS Action Council reports that key members of the House and Senate VA/HUD appropriations committees are not waiting and plan to meet this week to reconcile the different versions of the FY '97 VA/HUD appropriations bill, complete the VA/HUD conference report and have it ready for full House and Senate final votes as early as next week.
President Clinton is not expected to veto the VA/HUD Appropriations bill, which means that these conference negotiations are the only opportunity for an increase in funding for the Housing Opportunities for People with AIDS (HOPWA) program.
HOPWA funding was reduced last year by $18 million by the GOP-led Congress, and this year funding is expected to be maintained at that lower level, about $171 million. Advocates for people with AIDS are concerned that because new cities will qualify for HOWPA funding this year, maintaining the same level of funding will actually result in a reduction in money available for programs, since the same pool will have to be stretched to cover more communities.
"Even though the President has sent a revised FY '97 budget request to Congress, asking for an additional $25 million for HOPWA in FY '97 -- for a total of $196 million," an alert from the AIDS Action Council said, "we need to ensure that the Administration stands firm and insists on the $25 million increase, and that members of the House and Senate demand the increase as well."
AIDS Action Council is encouraging advocates and people living with HIV/AIDS to call their Congressional representatives immediately and urge them to insist that FY' 97 funding for HOPWA be increased in the final FY' 97 VA/HUD Appropriations bill conference report. "HOPWA must be funded at the Administration's amended request of $196 million -- a $25 million increase over FY 96," the group said.
Sen. Frank Lautenberg of New Jersey is the only local area representative who may be appointed to the conference committee, according to AAC.
The telephone number to the Capitol Switchboard is 202/224-3121. President Clinton's phone number is 202/456-1111.
"People living with HIV/AIDS and their families rely on HOPWA dollars to provide them with desperately-needed housing," said the AAC alert. "Without stable housing, many people with HIV disease will die prematurely, because it is virtually impossible to link them to care services and life-sustaining treatments if they do not have a stable place to live. A $25 million increase in HOPWA funding will provide housing services to an additional 6,725 individuals and families living with HIV/AIDS."
HOPWA is the only federal housing program that provides cities and states hardest-hit by the AIDS epidemic with the resources to address the housing crisis facing people living with HIV/AIDS in their communities. The housing provided by HOPWA dollars not only allows people to improve the quality of their lives and access life-extending care, it actually reduces unnecessary hospitalizations and reduces the use of emergency health care services by an estimated $47,000 per person per year.
Since FY '95, the number of metropolitan areas and states qualifying for HOPWA formula grants has increased by 23 percent, and the number of new AIDS cases reported by the CDC has increased by almost one-third. Yet in that same time period, HOPWA funding has remained flat at $171 million.
A $25 million increase in FY' 97 will help to stem the cuts in funding existing grantees have experienced as a result of flat funding, the group said. The Administration estimates that providing an additional $25 million will "roughly maintain average award levels to cities and states."
PCHA, AIN drop out of 1997 AIDS Ride
Philadelphia Community Health Alternatives and the AIDS Information Network have announced that they will not co-sponsor AIDS Ride '97.
The withdrawal of support for the fundraising event -- which this year used 79% of the proceeds for promotion and administrative costs, leaving only 21% for services to people living with HIV/AIDS -- leaves only ActionAIDS as a sponsor for the event next year.
Daniel Pallotta Associates, a for-profit public relations firm which sponsors AIDS Ride fundraisers around the country, has been reported to have asked for a fee of $320,000 from Philadelphia organizations benefitting from the Ride for next year's event.
Ennes Littrell, executive director of ActionAIDS, told the Philadelphia Inquirer that her group would decide on its participation in the 1997 event next week.
Daniel steps down from SHAC
Dan Daniel, founder and first convener of the Suburban HIV/AIDS Consortium (SHAC), has told the participants in that group that he plans to step down as convener when his current term expires in September.
In an August 9 memorandum faxed to those who had been participating in SHAC meetings, Daniel told participants, "I am one of the many people involved in the struggle against HIV/AIDS who does not work in an HIV/AIDS-related job, and I have found it increasingly more difficult to keep up my involvement with, let alone my leadership of, SHAC in recent months, both in terms of the demands of my job and as a result of the other HIV/AIDS-related commitments I have taken on." Daniel is also president of the board of directors of Chester County AIDS Support Services, the only social service agency in that county providing exclusively HIV/AIDS services and one which has seen rapid and sustained growth over the past 18 months, and a member of the Philadelphia EMA HIV Commission and its CARE Services Committee.
"This does not mean that I am unable or unwilling to take on other commitments," Daniel told fastfax, "and in fact, I'm quite willing to be involved in other areas as my time and the constraints of my work permit. I hope to continue to participate in SHAC's deliberations as I'm able, though attending meetings has gotten to be something of a problem. Regardless, I will continue to advocate in whatever ways I'm able for full inclusion and representation of the four Pennsylvania suburban counties in the Philadelphia EMA's planning and program activities."
Daniel said that Chester County AIDS Support Services would continue to be represented at SHAC meetings by CCASS executive director Julie Reinke Hazzard.
New Jersey finally adds protease drugs
People with AIDS patients in New Jersey who are uninsured or underinsured will have free access to three new anti-AIDS drugs beginning Oct. 1, state health officials said last month. The drugs will be made available to AIDS patients who earn less than $30,000 a year. If demand for the costly new drugs is too great, however, the state may restrict distribution or require patients to pay a small fee. The drugs--protease inhibitors Invirase (saquinavir), Crixivan (indinavir), and Epivir (3TC)- -will be offered through the AIDS Drug Distribution Program. Norvir, or ritonavir, another protease inhibitor, was not added because of concerns about complications and lack of patient demand. About 400 of the 1,700 people now enrolled in the program will request the new combination therapy, state officials estimate.
Pennsylvania added the three drugs to its Special Pharmaceuticals Benefits Program earlier this summer.
No benefit seen in switch to ddI
People with advanced HIV infection do not benefit clinically with a switch from zidovudine (AZT) to didanosine (ddI), according to Italian researchers.
Previous studies compared the results of switching from AZT to ddI among HIV-positive patients, but these studies were not specifically designed to evaluatepatients with AIDS, explains Dr. Stefano Vella of Rome. Therefore, an open, randomized, multicenter study was designed to compare the clinical benefits of switching to ddI after 6 months or more of AZT. Seventy-nine AIDS patients continued on AZT and 80 AIDS patients were switched to ddI. The baseline characteristics of all subjects were comparable and none had developed a major intolerance to AZT.
At 15-month follow-up, Dr. Vella found no differences between the two treatment groups in estimates of survival and of time to first new AIDS-defining event. In addition, he detected no differences between the two groups in CD4+ count, p24 antigenemia, body weight, and occurrence of severe toxicity. However, 6% of the patients who received ddI developed pancreatitis, which did not occur among the patients who received AZT.
Overall, Dr. Vella concludes, switching from AZT to ddI does not confer a significant clinical benefit once a clinical diagnosis of AIDS had been made.
HIV testing increasing among women
The number of women aged 18 to 44 years who are being tested for HIV infection is increasing in the U.S., according to a report in the Centers for Disease Control's Morbidity and Mortality Weekly Report.
Between 1991 and 1993, the percentage of women in this age group who had ever been tested for HIV increased from 18.8% to 31.8%. Overall, the increases were seen for all sociodemographic groups. However, a higher percentage of black and Hispanic women were tested compared with white women. A higher percentage of women with less than 12 years of education and those living in poverty also reported being tested for HIV during this period.
In 1991, a higher proportion of women who reported having had a live born infant during the preceding five years had been tested for HIV (25.7%) compared with all women aged 18-44 years (18.8%), the CDC report continues.
This trend towards higher rates of testing ...may reflect increased knowledge and awareness about HIV and AIDS among women. CDC officials add that ...the data in this report probably underestimate current rates of HIV testing in pregnant women because they do not reflect recent changes in testing practices and because testing women who had a live-born infant during the preceding 5 years is not a good proxy for recent pregnancy. The trend towards higher rates of testing among black and Hispanic women also reflect the patterns of new AIDS cases in the U.S. In particular, the incidence of AIDS among women and minorities has not declined as it has among white males.
Drug treatment helps addicts, U.S. says
Half the people who go into federally funded drug treatment programs remain drug-free after one year and related crime and unemployment rates drop significantly, a study showed last month.
The results of the study were announced by Secretary of Health and Human Services Donna Shalala and White House drug policy director Gen. Barry McCaffrey.
Since acknowledging last month that teen-age illegal drug use had doubled in four years, the Clinton administration has been under attack by Republican presidential candidate Bob Dole, who accused the White House of neglecting the drug war.
Democrats have countered by blaming congressional Republicans for trying to cut treatment funds.
"Drug treatment ... saves dollars across a broad spectrum of federal government programs including housing, welfare, health care, labor and criminal justice," McCaffrey said.
The National Treatment Improvement Evaluation Study (NTIES) is a five-year survey of drug and alcohol treatment of 5,388 people in federally funded programs. It found that after one year marijuana use dropped by 50 percent, cocaine use by 55 percent, crack by 51 percent and heroin by 46 percent.
The study found a large drop in drug-related crime by those having treatment -- 78 percent fewer engaged in violent crime or drug sales and 82 percent fewer shoplifted. It also reported a 19 percent increase in employment, fewer medical visits related to drug or alcohol use and a drop in sexual behaviors associated with AIDS transmission.
"This study shows that our federal investment in substance abuse treatment is a wise one," Shalala said as the two officials visited a drug treatment facility in suburban Virginia to mark the start of "Treatment Works Month."