August “Buzz” Pusateri played an integral role in the Pitt Men’s Study, a confidential research study of the natural history of HIV and AIDS. Not only did he believe in the importance of recruiting volunteers to help further research, he was one of the project’s first volunteers. Twice a year, sometimes more, Pusateri visited the clinic to give blood and answer detailed questions about his life. He also participated in special studies.
“Buzz got it across to the community … that this had to be done for them to defeat this epidemic of AIDS,” said Charles Rinaldo, a scientist and investigator of the Pitt Men’s Study. “He was central to it. He was always there. He was a tough guy, too.”
Pusateri, a long-term HIV survivor, died on Monday, according to a tribute on the Pitt Men’s Study website. He was 81. Pusateri was a well-known community activist, a founding member of the Pitt Men’s Study community advisory board, and a volunteer with Shepherd Wellness Community. He had been involved in the Pitt Men’s Study since recruitment began in 1984.
More than 160,000 Americans with HIV are unaware they have the virus because they have not been tested and diagnosed. Yet we know that early diagnosis and treatment with ART are associated with better health outcomes for those with HIV. There are profound prevention benefits as well—a CDC analysis found that the nearly 15% of people with HIV whose infections are undiagnosed account for 38% of all HIV transmissions in the U.S. By finding ways to help more people get tested, we can prolong lives and prevent further transmissions.
That’s why HIV testing is a key strategy in Ending the HIV Epidemic: A Plan for America (EHE), the nation’s plan to reduce new HIV infections in the U.S. by 75% by 2025 and by 90% by 2030. The first of the Plan’s four strategies calls for diagnosing all people with HIV as early as possible after infection so they can begin care and treatment that can protect their health and prevent transmission of the virus to their partners.
Stakeholders across the country are exploring innovative ways to pursue this EHE strategy and seeking to make HIV testing more available to previously unreached populations, such as those who live far from the nearest testing site or who are concerned about confidentiality. One innovative model includes HIV self-testing programs, sometimes called “home HIV test giveaways.” These are programs in which city or state health departments advertise free self-test kits via the internet and/or dating apps, and distribute the kits by mail so that users can perform their own HIV tests in private.
Biomedical advances against HIV since the dawn of the epidemic have been nothing short of astonishing. An almost always fatal disease is now, for those with the privilege of access to treatment, a manageable chronic illness, treated with a single daily pill. A person who acquires HIV today has every reason to expect to live a normal life span.
Yet with such astonishing success in treatment, why is HIV stigma worse today than ever before? Why do so many long-term survivors, including many who were exceptionally open about their HIV-positive status for years, find they must now keep it a secret, sometimes going deeply into closets they thought they had left for good years ago?
Many people—especially those who do not have HIV—find these questions startling. That’s because they remember the days when one had to wear a spacesuit to visit a person with AIDS in a hospital or was afraid to eat in a restaurant with gay waiters or refused to touch a person they thought might have the virus.
Black people make up 12 percent of Pennsylvania’s population of about 12.8 million people. But they accounted for 49 percent of HIV diagnoses in 2018 — and to Rep. Brian Sims that’s “racist as hell.”
“A racist system produces a racist result. You don’t need to look at the data to know that,” Sims, D-Philadelphia, said Wednesday, adding, “If medicine only reaches people who look like me, in a state that doesn’t look like me, we’re doing something wrong.”
Jeannine Peterson, CEO of Harrisburg’s Hamilton Health Center, speaks during a Capitol press conference on Wednesday, 2/5/2019 (Capital-Star photo by John L. Micek)
Sims, one of two openly gay House members, was one of several lawmakers and public health advocates who were on hand during a Capitol press conference Wednesday for the 21st annual observation of National Black HIV/AIDS Awareness Day in Pennsylvania.
Prevention Point provides sterile syringes and other supplies to reduce spread of HIV and Hepatitis C.
Prevention Point Pittsburgh was founded in 1995 when James Crow and Caroline Acker, along with a handful of dedicated volunteers, began providing needle exchange services once a week in the Hill District to prevent the spread of injection-related blood-borne disease. In April 2002, PPP established a county-authorized needle exchange site in Oakland. Since that time, over 7,000 injection drug users have enrolled in our program for critical prevention services. PPP’s services are authorized by the Allegheny County Board of Health and The Allegheny County Council.
In addition to needle exchange services, PPP provides comprehensive case management services, assistance to drug treatment, individualized risk reduction counseling, health education, condom and bleach distribution, overdose prevention training with naloxone, and free HIV, Hepatitis C, and syphilis screening in collaboration with the Allies for Health + Wellbeing (formerly the Pittsburgh AIDS Task Force).
National Black HIV/AIDS Awareness Day (NBHAAD) is February 7. NBHAAD is a day to increase awareness about HIV among blacks/African Americans and encourage people to get involved in prevention efforts, get tested, and get treatment if they have HIV.
HIV diagnoses have fallen in recent years among black/African American women (25% decline from 2010 to 2016) and heterosexual men (26% decline). Diagnoses among young black/African American gay and bisexual men (aged 13 to 24) decreased 5%. This good news shows that the nation’s HIV prevention efforts are helping reduce HIV infections among some blacks/African Americans.
Although the latest data show progress, we must continue our efforts. In 2017, nearly 17,000 blacks/African Americans received a new HIV diagnosis. Blacks/African Americans accounted for 43% of all HIV diagnoses in the United States and 6 dependent areas,** despite making up 13% of the U.S. population. Also, from 2010 to 2016, HIV diagnoses increased 40% among black/African American gay and bisexual men aged 25-34.
Facebook has quietly started removing some misleading ads about HIV prevention medication, responding to a deluge of activists, health experts and government regulators who said the tech giant had created the conditions for a public-health crisis.
The ads at issue — purchased by pages affiliated with personal-injury lawyers and seen millions of times — linked drugs designed to stop the spread of HIV with severe bone and kidney damage. Lesbian, gay, bisexual and transgender advocates long have said such claims are “false,” pointing to multiple studies showing the class of medication, known as PrEP, is safe.
After initially declining to disable the ads, Facebook began on Friday retroactively labeling some of them as rule violations in its archive, limiting their visibility. The company’s third-party fact-checkers concluded the ads were misleading and lacked context, according to a copy of an email sent by those fact-checkers to LGBT groups that was shared with The Washington Post, which first reported on the matter earlier this month.
Ending the HIV Epidemic: A Plan for America aims to close this implementation gap. NIH-funded advances in effective HIV prevention, diagnosis, treatment and care are the foundation of this effort. In addition, expanded partnerships across HHS agencies, local community organizations, health departments, and other organizations will drive new research to determine optimal implementation of these advances. This type of research is called “implementation science,” and is essential to translate proven tools and techniques into strategies that can be adopted at the community level, particularly for communities most vulnerable to HIV.
Understanding what works to prevent and treat HIV at the community level is critical to the success of the Ending the HIV Epidemic plan. More than 50% of new HIV diagnoses in 2016 and 2017 occurred in just 50 geographic areas: 48 counties; Washington, D.C.; and San Juan, Puerto Rico. Seven states also have a disproportionate occurrence of HIV in rural areas. For its first five years, the new initiative will infuse new resources, expertise, and technology into communities in those key geographic areas.
However, communities are more than just geography. On World AIDS Day, we are reminded that Ending the HIV Epidemic must take place “Community by Community.” The people affected by HIV are a part of unique communities often shaped by differences in race, ethnicity, gender, culture, and socioeconomics. To reach people who have different needs, preferences, and choices, and ensure that HIV treatment and prevention tools can work in their lives, we must go beyond a “one-size-fits-all” approach.
Stigma did not create AIDS. Yet it prepared the way and speeded its ravaging course through America and the world. First stigma delayed understanding of the disease: it’s a gay cancer, it’s a punishment from God, they brought it on themselves, so who cares? Then stigma delayed government action, research, and assistance for the sick and dying. Stigma made people afraid to get tested for HIV and treated. Stigma made people ashamed, isolating and alienating them from friends and family. Stigma cost people jobs, professional standing, housing, a seat on an airplane or in a dentist’s chair. Stigma made many afraid to live, and want to die. But then it began to make some brave people very angry and AIDS activism was born. The activists quickly realized that to end AIDS we must end stigma.
AIDS activism did more to fight the stigma on being gay or having AIDS than any other social force. In this way, AIDS activism, like the civil rights movement, became a great moral movement of our time, defending the innocent, restoring dignity to the violated, giving hope to the desperate, and reviving faith in the disillusioned. AIDS activism gave LGBT people courage, dignity, and power they had never held before. It inspired many to stand up and proudly proclaim who they are and who they love. Twenty-six of the world’s most advanced countries now recognize gay marriage and today a gay man openly married to another man is a prominent candidate for President of the United States.
How do we reduce rates concentrated among black and Latino men who have sex with men? Or meet the needs of HIV-positive patients caught between insurance plans or places to live? To end the epidemic, we must start where we began — by focusing on those most affected, uniting advocacy efforts, pushing for a cross-sector response and focusing on the social determinants of health.
As someone who has spent the better part of my professional career as both an advocate and HIV public health expert, I’ve been reflecting on the decades-long fight for gay rights sparked by people who gathered together at Stonewall in 1969 to demand change for the LGBTQ+ community and put an end to years of discrimination. Not long after, the AIDS epidemic swept across the country, closely intertwining the movement for increased LGBTQ+ rights with the AIDS response. Gay rights groups were relentless in pushing for increased government attention and funding as thousands died from the disease. Activists organized “buyers clubs,” lobbied for faster FDA approval of promising drugs and countered the fear and discrimination people living with AIDS faced.