What's New in Science and Public Policy

A Message from CEO Mark Cloutier on the State Budget

In the 2010-11 budget proposed on Jan 08, Governor Schwarzenegger committed to providing $87.5 million in general fund support for the AIDS Drug Assistance Program (ADAP), a cornerstone of California’s public health effort to fight HIV/AIDS. As you know, ADAP is a program of last resort for uninsured and underinsured people with HIV/AIDS. Without it, more than 34,000 Californians with HIV would have nowhere to turn for their meds and would be at risk for getting sick or dying.

This is an important early victory in statewide efforts, particularly given the crippling budget crisis currently facing the state. It is the result of advocacy led by San Francisco AIDS Foundation and other HIV/AIDS service organizations to persuade the governor to preserve ADAP back when the anticipated program shortfall was approximately $100 million and ADAP was in serious jeopardy.

But we’re not out of the woods yet there's more work ahead. Specifically:

• The Governor’s budget eliminates ADAP services in county jails, which shifts cost for this program to already cash-strapped counties. County jails are a critical setting for targeted HIV/AIDS intervention. We must continue our work with state and local officials to ensure that HIV positive people in county jails aren’t denied treatment, and preserve today’s commitment of general fund support for ADAP in the final July budget.
  
• We are deeply concerned by proposed cuts to public health insurance programs such as Medi-Cal and Healthy Families, and other essential services including in-home supportive services and state-funded social security income (SSI/SSP) for the elderly and disabled. These reductions will place an impossible burden on people with HIV in California, nearly half of whom rely on Medi-Cal for health care coverage. This will be a focal point of our efforts to fight budget cuts alongside our health advocacy colleagues.
  
• We must also redouble advocacy focused on the restoration of funds for statewide HIV prevention and testing programs. As our experience shows, these evidence-based interventions are the most powerful way of fighting an effective battle against HIV/AIDS in San Francisco, California and across the nation.
  

We will continue to work collaboratively with state and local officials and our colleagues in the HIV/AIDS community to ensure adequate statewide funding for the fight against HIV/AIDS.

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Evidence Reports

Transgender Persons and HIV

Read the San Francisco AIDS Foundation’s report on factors that contribute to disproportionate HIV prevalence in the transgender population. Download the PDF and read about HIV risk, prevention, and care for transgender persons.

 

Effective Behavioral Interventions for Reducing HIV Risk and Transmission

Read the newest report on interventions that have been proven successful at decreasing risk of HIV transmission in the San Francisco AIDS Foundation’s HIV Evidence Report

 

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Confronting the "Evidence" in Evidence-Based HIV Prevention: Challenges and Opportunities

The past three decades have seen evidence-based medicine emerge as an approach to assess the effectiveness of clinical interventions that can shape HIV prevention. However, funding sources (including the CDC) increasingly define “evidence” as a product of randomized controlled trials—putting the development of new interventions beyond the reach of most community-based HIV prevention organizations, which typically lack the resources to hire professional researchers. Over the next year, the San Francisco AIDS Foundation in partnership with the Caucus for Evidenced-Based Prevention, is spearheading a series of focused discussions with all stakeholders, with the goals of defining and advancing a more productive way forward for evidence-based HIV prevention; reaching a consensus on an inclusive—yet still rigorous—notion of evidence, encompassing biological, behavioral, and social sciences; and including the lived experiences of individuals and communities affected by HIV/AIDS. Please visit http://www.sfaf.org/evidence to learn more about these activities and the overall initiative. We’re also compiling an archive of some of our conference sessions on this topic. Most recently, we’ve added video and audio from the 2007 United States Conference on AIDS and the 2007 National HIV Prevention Conference.

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Science and Public Policy at the San Francisco AIDS Foundation

Since its earliest years, the San Francisco AIDS Foundation has played a leading role in the development of sound HIV/AIDS policies at the federal, state, and local levels and ensuring that elected officials develop an appropriate response to the epidemic. The agency has fought to protect the human rights of people living with HIV and to promote the development of effective HIV treatment and prevention strategies.

Working alongside other advocates, our Public Policy Department has had many successes and accomplishments over the years, including:

• the development and passage of the, Ryan White CARE Act, which now provides over $2 billion in critical funding for services for people living with HIV/AIDS, including drug treatments, primary medical care and essential supportive services;
• the enactment of the Housing Opportunities for People with AIDS program, which provides nearly $300 million annually in funding for housing support for people living with HIV/AIDS;
• the creation of the Minority HIV/AIDS Initative which provides $400 million for HIV/AIDS programs that directly benefit racial and ethnic minority communities who are disproportionately affected by HIV;
• full funding of California's AIDS Drug Assistance Program, a life-saving program that provides HIV/AIDS treatments to over 30,000 individuals who otherwise could not afford these medications;
• passage of legislation in California that allows jurisdictions to legalize needle exchange programs and the sale of sterile syringes at pharmacies without the requirement for a prescription; and
• the development of materials and policies to assist Medicare eligible individuals living with HIV/AIDS in understanding and preparing for the implementation of the newly created Medicare Prescription Drug Benefit, also known as Medicare Part D.

The grassroots power of the individual, working in coalition with others, continues to be a critical force in assuring a compassionate and effective response to the HIV/AIDS epidemic. To that end, the Public Policy Department runs and mobilizes the HIV Advocacy Network to engage community members directly in our advocacy work. We encourage readers to sign up for the San Francisco AIDS Foundation Action Center and to subscribe to receive HIV Advocacy Network alerts and HIV Policy Watch, our monthly bulletin on key HIV policy issues.