The National HIV/AIDS Strategy for the United States: Updated to 2020 (“NHAS 2020”) is a critically important and compelling review of the status of our nation’s response to the HIV epidemic in America and an action plan for the continuing fight.
At the end of the session, the students shall be able to
Describe the HIV AIDS introduction, epidemiology of HIV AIDS, diagnosis of HIV AIDS, treatment of HIV AIDS and prevention control of HIV AIDS.
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
A Presentation Presented To orient about HIV, AIDS and STIs for Development of Knowledge, Attitude, and Practice for Prevention of HIV and STIs for College Students.
HIV/AIDS among Persons aged 50 years and older
United States Population Boom
HIV/AIDS Risk Factors for Persons aged 50 years and older
Age-related Disparities in HIV/AIDS Prevention Barriers for Older Persons
Major Efforts to Address HIV/AIDS among Older Persons
Next Steps
At the end of the session, the students shall be able to
Describe the HIV AIDS introduction, epidemiology of HIV AIDS, diagnosis of HIV AIDS, treatment of HIV AIDS and prevention control of HIV AIDS.
This is a lecture by Katherine A Perry from the Ghana Emergency Medicine Collaborative. To download the editable version (in PPT), to access additional learning modules, or to learn more about the project, see http://openmi.ch/em-gemc. Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike-3.0 License: http://creativecommons.org/licenses/by-sa/3.0/.
A Presentation Presented To orient about HIV, AIDS and STIs for Development of Knowledge, Attitude, and Practice for Prevention of HIV and STIs for College Students.
HIV/AIDS among Persons aged 50 years and older
United States Population Boom
HIV/AIDS Risk Factors for Persons aged 50 years and older
Age-related Disparities in HIV/AIDS Prevention Barriers for Older Persons
Major Efforts to Address HIV/AIDS among Older Persons
Next Steps
This is a presentation on HIV more commonly known as AIDS. There are lot of HIV possitive patients in this world, and we need to treat them with sympathy and care. Let's not hate them.
This year i would like to request all my friends to show solidarity with the 34 million people living with HIV world-wide - by wearing the universal symbol of HIV awareness, the red ribbon. Go get creative - put it on landmarks, people, clothes, buildings, food. There is nowhere the red ribbon cannot go! Let's make AIDS Out Life In.
Country environments vary in terms of policy and capacity to address Hepatitis C. Check out these snapshots of how these 20 countries are addressing HCV!
An overview of the issues related to the criminalisation of HIV exposure and transmission in Australia.
This presentation was given by Sally Cameron, HIV Education and Health Promotion Officer with AFAO, at the AFAO National HIV Forum, 17 October 2014.
Sustaining the HIV and AIDS Response in the Countries of the OECS: Regional I...HFG Project
In 2014, the six countries of the Organization of Eastern Caribbean States (OECS) of Antigua and Barbuda, Dominica, Grenada, St. Kitts and Nevis, St. Lucia and St. Vincent and the Grenadines developed HIV and AIDS Investment Case Briefs, with the support of USAID’s Health Finance and Governance (HFG) and Strengthening Health Outcomes through the Private Sector (SHOPS) projects. This document provides a summary of the findings of these briefs, which includes an analysis of the costs of HIV and AIDS programs that respond to the disease in the six countries, the resources that are available, the funding gaps, and the potential impact of different levels of investment in programming on the progression of the disease in the region.
Sustaining the HIV and AIDS Response in St. Vincent and the Grenadines: Inves...HFG Project
National surveillance reports estimate that there were about 649 persons living with HIV in St. Vincent and the Grenadines at the end of 2011, which translates to 1.2% of the adult population (15-49 years) or 0.7% of the total population. The epidemic is male-dominant, illustrated by the fact that the cumulative case reporting from 1984-2013 indicates that 60.6% of new cases are reported among males and 38.1% females (1.3% unknown). In response to the growing epidemic, the country quickly scaled up its national HIV/AIDS program in 2004. While care and treatment remains a high priority, St. Vincent and the Grenadines has devoted significant resources to preventative activities, including HIV counseling and rapid testing, education and workplace programs, and other behavioral interventions.
Despite a marked decline in HIV and AIDS cases, significant challenges for the country’s response remain. Close to 20% of persons with advanced HIV infection discontinue treatment within 12 months of initiation, suggesting the need to reinforce adherence and retention to care. The country also faces an imminent decline in donor funding and domestic reprioritization of chronic and non-communicable diseases; without renewed sources of external funding or greater domestic resources allocated to HIV/AIDS, progress made since 2004 could regress.
In response to these challenges, key priorities outlined in the country’s strategic framework (2014-2025) include: 1) institutionalizing HIV education through collaborative programs with different sectors, 2) targeting high risk groups, 3) strengthening HIV testing and counseling, including routine testing for pregnant women and, 4) ensuring access and retention to care and treatment for those with HIV and AIDS and TB. St. Vincent and the Grenadines has also taken steps to integrate HIV and AIDS services into the broader health system and included the HIV and AIDS program as part of the Ministry of Health, Environment and Wellness’ overall health framework. These actions are the beginning of efforts to improve access to care, reduce costs, and improve efficiencies.
Barreras y motivaciones para la afiliación al Seguro Familiar de Salud de per...HFG Project
This report describes the findings and recommendations of the qualitative study on the barriers and motivations to enrolling people living with HIV/AIDS in the Family Health Insurance plan in the Dominican Republic. The study was conducted with the goal of informing institutions in the Dominican Republic, such as the Standardized System of Beneficiaries (SIUBEN), the National Council for HIV and AIDS (CONAVIHSIDA), the National Health Insurance (SENASA), and the United States Agency for International Development (USAID) about the recommended strategies to increase the number of people living with HIV/AIDS enrolled in Family Health Insurance plan. Target populations such as men who have sex with men (MSM), transgender people, and sex workers, and other prioritized populations, such as migrants, were the main focus of the study in order to meet national and international commitments on HIV, aiming to increase access to antiretroviral treatment, as well as to generate the financial sustainability of the Dominican Social Security System (SDSS).
This webinar discussed how to educate Nurse Practitioners who have completed Community Health Center. Inc’s NP Residency or NPs who have significant experience as a Primary Care Provider on the integration of specialty care for key populations, including:
• HIV care
• Hepatitis C management
• Medication-assisted treatment for opioid use and other substance use disorders
• Sexually transmitted disease (STI) screening and management
• Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, Asexual (LGBTQIA+) health, including hormone replacement therapy and gender affirming care.
Panelists:
• Charise Corsino, MA, Program Director, Nurse Practitioner Residency Programs, Community Health Center, Inc.
• Marwan Haddad, MD, MPH, AAHIVS, Medical Director, Center for Key Populations, Community Health Center, Inc.
• Jeannie McIntosh, APRN, FNP-C, AAHIVS, Family Nurse Practitioner, Center for Key Populations, Community Health Center, Inc.
The National HIV Prevention Inventory provides the first, comprehensive inventory of HIV prevention efforts at the state and local levels in the United States. Based on a survey of 65 health departments, including all state and territorial jurisdictions and six U.S. cities, the Inventory is intended to offer a baseline picture of how HIV prevention is delivered across the country in an effort to provide policymakers, public health officials, community organizations, and others with a more in depth understanding of HIV prevention and the role played by health departments in its delivery.
Similar to Statement on the National HIV/AIDS Strategy for the United States (20)
The "Fetal Assault Law" is Done: Resources for Treatment ProvidersDana Asbury
In July 2016, Tennessee's "Fetal Assault Law" officially ended. This short resource provides context and explanation for how the law harmed pregnant people and families, a short outline regarding current challenges in treating pregnant individuals and supporting their families, and some recommendations for future action from the Tennessee Association of Alcohol, Drug, and Other Addiction Services (TAADAS).
The "Fetal Assault Law" is Done: Resources for LawyersDana Asbury
Tennessee's "Fetal Assault Law" (Public Chapter 820) has sunset and is no longer law. Pregnant people can no longer be prosecuted or held under these charges. This brief introductory resource explains how the law harmed pregnant people, babies, and families and provides information for defense attorneys in need of pro bono counsel.
A resource list of individuals and organizations to explore that understand art as a powerful way to push for positive change. Just a few to get our wheels turning.
How to Have Difficult Conversations: Notes Nov 2015Dana Asbury
Slide notes from HFTN webinar "How to Have Difficult Conversations," complete with some additional context, talking points, and links to other resources.
Pregnancy, Drug Use, and The Law Report and RecommendationsDana Asbury
In October of 2015, more than 250 participants from around the country came together in Nashville, TN for a series of events looking at the legal and medical responses to pregnant women and drug use. Today, we are releasing a report examining pregnancy and drug use and providing a comprehensive set of recommendations in a range of areas including state medical protocols, health coverage and the licensing of treatment facilities.
Welcome to “Pregnancy, Drug Use, and the Law”, a one day public policy conference examining Tennessee law as it relates to pregnant women and new mothers, people who use and are sometimes dependent on drugs, and how we can create fair and effective policies that will support all Tennessee women and families.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Top 10 Best Ayurvedic Kidney Stone Syrups in India
Statement on the National HIV/AIDS Strategy for the United States
1. STATEMENT
ON
THE
NATIONAL
HIV/AIDS
STRATEGY
FOR
THE
UNITED
STATES:
UPDATED
TO
2020
August
11,
2015
2.
3. 1
STATEMENT ON THE NATIONAL HIV/AIDS STRATEGY FOR THE UNITED STATES: UPDATED TO 2020
The National HIV/AIDS Strategy for the United States: Updated to 2020 (“NHAS 2020”) is a critically important and
compelling review of the status of our nation’s response to the HIV epidemic in America and an action plan for the
continuing fight.
We commend the White House Office of National AIDS Policy (“ONAP”) for outlining key focus areas, plans and
goals in the nation’s efforts to “become a place where new HIV infections are rare, and when they do occur, every
person . . . will have unfettered access to high quality, life-extending care, free from stigma and discrimination.”
Importantly, ONAP has endeavored to address a glaring gap in the previous NHAS by recognizing the unique needs and
barriers related to health and prevention services for women, including transgender women, as well as sex workers and
young people. Identifying the need for quantitative indicators to monitor progress on the treatment of transgender
people living with HIV is indeed an important step; the development of these indicators and concrete action to address
barriers faced by transgender people is vital. Others (e.g., the Positive Women’s Network (PWN) – USA) have
addressed in more detail the NHAS 2020 as it affects women and over-criminalized populations.
Our statement does not address the whole of the NHAS 2020 in terms of either improvements or unaddressed issues.
The assessment and needed action steps we set out below are limited to the NHAS 2020 as it concerns 1) broad public
ignorance about HIV, STIs and identities associated with stigmatized diseases; 2) the criminalization of HIV; 3) the
mistreatment of individuals living with or at risk of HIV in criminal justice and immigration detention facilities, and in
the military; and 4) the need for focused prevention and health services for sex workers and people who inject drugs,
including reform of law enforcement policies that are barriers to service access.
I. ADDRESSING BROAD PUBLIC IGNORANCE ABOUT HIV, STIS AND STIGMATIZED IDENTITIES
We are pleased that the NHAS 2020 recognizes the need to address the widespread public ignorance about HIV and
STIs through broad, multiple education campaigns targeting Americans, and through the commitment to make
scientifically accurate information about HIV transmission risks and prevention universally available through multiple
technologies and access points that reach the broadest number of Americans possible. However, the public’s HIV
literacy has not measurably improved since this need was flagged in the original NHAS, and consequently the CDC and
other responsible public health agencies must develop a more aggressive, effective education campaign.
Ignorance about the routes, risks and current-day realities of HIV transmission is at the root of most forms of
discriminatory treatment of people living with HIV, from their exclusion from schools and employment to their
inclusion in criminal felony laws across the country. We also know that the visible engagement of medical and public
health experts in responding to this ignorance is essential. As reflected in the NHAS 2020, sexual health literacy and
anti-stigma campaigns must explicitly address the intersection of HIV stigma and stigma related to sexual orientation
and gender identity. For those most affected by the HIV epidemic to enter and remain engaged in care, there must be
plans and goals for education and training of health care workers about gender identity, sexual orientation and related
sexual health needs.
By recognizing the need for quantitative indicators for monitoring progress on stigma —including stigma based on
substance abuse, mental health, sex work, race/ethnicity, sexual orientation, and gender identity as well as stigma based
on HIV itself—ONAP has appropriately increased focus on a long-recognized barrier to ending the epidemic. Reducing
stigma is essential and achievable. Identifying specific drivers of stigma, as well as concrete ways to address them is a
prerequisite for true progress.
Necessary action includes, in part:
• Direct DHHS/CDC to develop concrete plans and deadlines, including collaborations with state public health
agencies, to address public misperceptions about HIV and STIs (including issuance of a Surgeon General
letter to the American people on HIV/STIs).
• Direct the Department of Justice (DOJ) and DHHS to adopt written policies that establish minimum
requirements of, and access to, sexual health care and literacy programs for inmates of federal and federally
funded correctional and detention facilities.
4. 2
• Direct the Department of Justice (DOJ) and DHHS to develop standards and training curricula to ensure that
the most up-to-date information about HIV/STI transmission routes and risks is part of sexual health care and
literacy programs in all federal or federally funded correctional and detention facilities.
• Direct the Department of Justice (DOJ) and DHHS to implement regular staff trainings based on these
standards and curricula for all criminal justice personnel.
• Direct DHHS to develop model goals, policies and plans on LGBT/HIV cultural competency training for
health care professionals and students to ensure that LGBT people and people living with HIV are treated
fairly and respectfully.
• Direct DHHS to require all health care facilities and education programs that receive government funding to
adopt training policies and plans that ensure that LGBT people and people living with HIV are treated fairly
and respectfully by all health care staff and students.
II. ADDRESSING THE CRIMINALIZATION OF HIV
It is appropriate that the NHAS 2020 incorporates, in several sections, the need for legislators to “reconsider” whether
their HIV criminal laws are consistent with current science or in fact undermining the public health goals of promoting
HIV screening and treatment while ruining the lives of people living with HIV. We agree with the NHAS 2020
statement, “HIV-specific laws do not influence the behavior of people living with HIV in those States where these laws
exist.” The NHAS 2020 also correctly states that “[i]n too many instances, the existence and enforcement of these types
of laws run counter to scientific evidence about routes and transmission and effective measures of HIV prevention, and
undermine the public health goals of promoting HIV screening and treatment.”
However, these observations and the call on state legislators to reconsider state HIV criminal laws mirror those of the
original NHAS; clearly, they have been insufficient to incentivize reform. Despite the original Federal Implementation
Plan’s directive to DOJ and HHS to develop materials and technical assistance to support state legislative change by the
end of 2011, we are not aware of any instances where either agency has been asked, or reached out, to provide such
assistance to state policy makers. In a number of states, state health officials actively participate in the prosecution of
people charged with having sex without disclosure; in some cases, HIV and STI surveillance and testing records are
provided for prosecutors’ use. It is apparent that without plans to proactively reach out to states that continue to impose
decades-long sentences on sexually active people because they are living with HIV, the NHAS will have little or no
impact on the United States’ deplorable status as world leader in the arrest and prosecution of people living with HIV.
Necessary action includes, in part:
• Direct DOJ to develop a plan and timeframe for meaningful follow-up to the July 15, 2014, best practices
guide (highlighted as a significant achievement by ONAP) to reform HIV-specific criminal laws, with priority
given to states with significant HIV-specific prosecutions (e.g., Missouri, Florida).
• Direct DHHS/CDC to prioritize the development of guidance restricting the use of disease surveillance data
for criminal law enforcement purposes.
• Direct DOJ to develop proposals, in consultation with advocates and key stakeholders, to develop national
recommendations for criminal justice reforms that eliminate the use of specific and general crimes (including
sex offenses and other offenses) related to consensual adult conduct.
III. ADDRESSING THE TREATMENT OF PEOPLE LIVING WITH OR AT RISK OF HIV IN CRIMINAL JUSTICE AND
IMMIGRATION DETENTION FACILITIES, AND IN THE MILITARY
The NHAS 2020 recognizes “the particular needs of those in the criminal justice system,” which includes the sexual
health and prevention needs of institutionalized populations, particularly young people confined in foster care and
detention facilities that hold a significant percentage of all youth affected by HIV. Federal agencies must make good on
the promise of the original and updated NHAS through specific plans to address the rights and needs of those who are
confined in or work in these systems. Plans must include steps to engage with state and local corrections and juvenile
justice professionals to encourage them to address these issues in their facilities as well.
The NHAS 2020 also identifies the Department of Defense as an essential federal agency partner, and calls on the
EEOC to address the restriction of employment opportunities for people living with HIV, yet is silent on the armed
services’ long-outdated HIV policies. True progress will require abolishing the DOD’s ban on the enlistment of people
living with HIV, and overhauling HIV policies among the various branches of the military to be consistent with science
5. 3
and medical facts. These measures will help to ensure the federal government’s credibility in calling for zero
discrimination.
Necessary action includes, in part:
• Direct the Bureau of Prisons, Immigration Custom and Enforcement, and the Office of Refugee Resettlement
to adopt and enforce written policies and practices supporting people living with HIV who are held under
federal authority in public and private confinement and detention facilities to ensure:
o Adequate medical, mental health, family and re-entry support; and
o Comprehensive sexual health care and sexual health literacy programs that include counseling about
and access to condoms and other HIV/STI prevention tools
• Direct the Bureau of Prisons to assess and revise all policies affecting inmates living with HIV to reflect
current science and to eliminate all housing or program restrictions based on HIV status (e.g., FBOP Program
Statement 5214.04, “HIV Positive Inmates Who Pose Danger to Others, Procedures for Handling Of,” dated
2/4/98).
• Direct the Department of Defense to develop a clear plan and timeframe for complying with the requirements
of the 2014 DOD Reauthorization Act (requiring that DOD evaluate and report on all HIV-related policies to
ensure they comply with current science) and eliminating scientifically and medically unsupported restrictions
on the admission, classification, promotion and deployment of people living with HIV in all branches of the
armed services.
IV. ADDRESSING THE NEED FOR FOCUSED PREVENTION AND HEALTH SERVICES FOR SEX WORKERS AND PEOPLE
WHO INJECT DRUGS, AND FOR REFORM OF POLICIES THAT ARE BARRIERS TO SERVICE ACCESS
The NHAS 2020 recognizes the need to prioritize the treatment and prevention needs of sex workers and people who
inject drugs. Unwarranted barriers to care impose human and financial costs on individuals and society that call for fact-
based, sound policy reforms. Recognition of these problems is not enough. Implementation should specifically address
prevention plans for these communities that respond to the shortage of adequately supported legal syringe services and
the impact of over-criminalization on their access to essential services.
Necessary action includes, in part:
• Direct DHHS and DOJ to create joint policy guidance, recommendations and support for best practices and
programs to reduce HIV transmission among sex workers and people who inject drugs, including a range of
supportive and syringe services.
• Direct DOJ to develop guidance, in consultation with advocates and key stakeholders, for modernization of
current enforcement practices to harmonize them with current government-supported HIV prevention policies
and recommendations, including condom use/access for sex workers.
We look forward to working with ONAP and other members of the Federal Interagency Task Force to address these
critical issues.
6. 4
Organizational Signatories:
ADAP Advocacy Association,
Washington, DC
African Services Committee, NY
AIDS Alabama
AIDS Athens, GA
AIDS Care Ocean State, Rhode Island
AIDS Foundation of Chicago
AIDS Network of Western New York
AIDS Project Los Angeles
AIDS Research Consortium of Atlanta
AIDS United
American Medical Student Association
APLA Health & Wellness
Association of Nurses in AIDS Care
Best Practices Policies Project
The Center for HIV Law and Policy, NY
Choices: Memphis Center for
Reproductive Health
Clinica Sierra Vista
Community Access National Network,
Washington, DC
Desiree Alliance
Friends For Life, TN
Georgia Equality
HIV Prevention Justice Alliance
Health GAP
Healthy and Free Tennessee, TN
HIV Medicine Association
Human Rights Campaign
Latino Commission on AIDS, NY
Lambda Legal
Legacy Community Health
Lee's Rig Hub
Medical University of South
Carolina/Lowcountry
AIDS Services, South Carolina
Michigan AIDS Coalition
Michigan Coalition for HIV Health and
Safety
MrFriendly.org
Nashville Cares, TN
National Center for Transgender Equality
National LGBTQ Task Force,
Washington, DC, NY
New York Lawyers for the Public Interest,
NY
Northern Nevada HOPES, NV
Northern Nevada Outreach Team, NV
Okaloosa AIDS Support and
Informational Services, Inc.
PFLAG National
Positive Women’s Network
Project Inform, CA
Public Health Alliance for Safety Access,
NV
queer latin@ social justice
SERO
SMART Youth, NY
Individual Signatories:
Lauri Appelbaum, MN
Stan Baker
Melinda Brewer, IN
Wanda Commander, Baltimore, MD
J. Craig Phillips, Utah and Ottawa,
Canada
Lawrence W. Crawford, MO
Julie/JD Davids, NY
Fernando De Hoyos, FL
Kelsey Ding, CT
Margaret Drew, MA
Alice Nelson Ferguson
David W. Finwall, MN
Anna Forbes
Timothy Frasca, NY
Thomas Huseby, LA
C.H. Johnson
Sterling Johnson
Tory Johnson, MO
Bryan C. Jones, OH
Kate Lind, CO
Randy Mayer, IA
Dulce Medina, CA
Brian Minalga, MI
Megan Moran, IL
Susan Mull, PA
Kevin M. Ponthier, LA
Peter Richards, IL
Dan Royles, FL
Nathaniel Scruggs, MD
Debbie Sergi-Laws, FL
C. Peter Stoker, UT
Jason and Jamie Tafoya, CA
Steven Vargas, TX
Gwen Verlinghieri
Craig Washington