Virginia Gov. Ralph Northam on Thursday signed a bill that decriminalizes HIV transmission, but advocates continue to call for the removal of a felony penalty left in place.
“Although we see this as a victory, we acknowledge the call of people living with HIV in Virginia to continue to fight to change the criminal penalty level of the modernized law from a felony to a misdemeanor level,” said Cedric Pulliam, co-founder of the ECHO VA Coalition, in a press release. “And we accept that fight and will continue efforts until this has been successfully accomplished.”
Senate Bill 1138, sponsored by Sens. Mamie Locke (D-Hampton) and Jennifer McClellan (D-Richmond), removes HIV from a list of “infectious biological substances” under the infected sexual battery section of the state code.
Supporters say this change will reduce stigma and other challenges faced by Virginians who are HIV positive and modernizes Virginia Code in accordance with current understanding about the disease and current guidance from the Centers for Disease Control and Prevention.
As the bill advanced through the General Assembly, the Virginia Senate lowered the penalty for HIV sexual transmission from a felony to a misdemeanor. The House of Delegates, and now the governor, kept the felony punishment in place.
Equality Virginia and HIV advocacy groups ECHO-VA, Positive Women’s Network-USA, and the Sero Project on Thursday stated in a press release that they approved of Northam’s signing the decriminalization bill into law, but they were disappointed the felony penalty was not removed.
“We’re thankful for the many advocates who shared their lived experiences and pushed for changes to Virginia’s HIV laws,” said Equality Virginia Executive Director Vee Lamneck in the released statement, which included a report Northam commissioned that found Black Virginians were almost seven times as likely to be living with HIV in 2015 than white Virginians.
“This new law is an important step towards reducing stigma and breaking down barriers to HIV care and prevention,” Lamneck said. “Moving forward, Equality Virginia remains committed and determined to educate and advocate for removing the felony penalty.”
With the inauguration of President Joe Biden, I hope we may now see the kind of leadership on LGBTQ issues we need. As a gay African-American man living with HIV, I have lived through two pandemics. Under both HIV/AIDS and COVID-19, LGBTQ people have had to shoulder the burden of discrimination while fighting to survive. I hope that 2021 is the year that changes.
I was diagnosed with HIV in 1984, in the early years of the epidemic. I lost many friends in the years that followed. So many of us in that time never expected to live a full life ourselves. After watching our friends die, it became hard to imagine that we’d ever make it to our 40th birthday — let alone retirement. The discrimination we experienced and the looming threat of the virus made it difficult to build careers and save for the golden years we never thought we’d see. I’ve lost jobs due to discrimination myself, and the stress of it nearly killed me. That’s why today, I help advocate for LGBTQ elders and folks on social security.
I have seen every stage of the HIV/AIDS crisis, from the pandemic, to its aftermath, to the present day. I know how much work it takes to survive and thrive in the face of this virus. As the administrator of a group home for folks recovering from HIV-related hospital stays, a member of the local HIV Planning Council, and a care outreach specialist for a community clinic, I’ve seen the kind of discrimination people still face. I once worked with a pregnant woman who was turned away from a local hospital for being HIV-positive. Because our clinic existed, she got the care she needed and her baby was born healthy.
In recent years, advances in prevention and access to testing and treatment have led to encouraging declines in new diagnoses. But stigma and anti-LGBTQ bias continue to have consequential effects on testing decisions. Time and again, I have spoken with clients who choose to hide their condition or status to avoid ostracization and discrimination. According to a recent research report by the Williams Institute at the University of California, Los Angeles, 44 percent of Black LGBTQ adults have either never been tested, tested when they felt at risk, or once every two years or less. It’s an alarming statistic that falls far too short from CDC recommendation for testing frequency for HIV, which is at least once a year or more frequently.
Despite these challenges, it’s possible to live a full and healthy life with HIV/AIDS. As Americans, we should be able to participate in all aspects of daily life with dignity and respect, and without fear of discrimination. If we wholeheartedly want to end the HIV epidemic in the United States, we must seize the moral high ground and ensure LGBTQ Americans are provided with equal rights, better access to care, and increased secure housing. Federal nondiscrimination legislation will help us get there.
Although it’s important to celebrate how far we’ve come, right now, 50 percent of LGBTQ people live in the 29 states that lack comprehensive statewide laws explicitly prohibiting discrimination against LGBTQ people, including here in my home state of Georgia. And in the midst of a pandemic and the accompanying economic crisis, it’s inhumane that millions of us can still be denied housing or medical care just because of who we are or who we love. Situations like these enable the spread of HIV.
Our nation is going through a profound change, but our values of treating others as we would want to be treated remains the same. The Equality Act would ensure that all LGBTQ Americans can live, work, and access public spaces and medical care free from discrimination, no matter what state we call home. It’s the right thing to do — which is why this type of legislation has broad and deep support across lines of political party, demographics, and geography. Public support is at an all-time high, with 83 percent of Americans saying they favor LGBTQ nondiscrimination protections, including 68 percent of Republicans and a majority in every state in the country.
After all, equality is not a Democratic or Republican value, it’s an American value. It’s also the smart thing to do as we work to end the HIV epidemic in America.
Nathan Townsend is a 66-year-old Black gay man living and thriving with HIV for 36 years. He devotes his time and efforts helping to promote health equity and equal access to care for his community.
Virginia lawmakers have approved legislation modernizing laws around HIV exposure.
Passed after two versions of the bill were reconciled, the legislationwould repeal the felony criminal ban on blood, tissue or organ donation by people with HIV and other sexually transmitted infections; make HIV-testing for people convicted of certain crimes, including prostitution and drug charges, optional rather than mandatory; and strike down a statute making failure to disclose HIV-positive status before sex a Class 1 misdemeanor punishable by up to 12 months jail time.
Intentional transmission of HIV, or “infected sexual battery,” would remain a felony in Virginia, rather than a misdemeanor, as proponents had hoped, but the new legislation would require proof of actual infection, rather than just exposure.
The bill now heads to Gov. Ralph Northam, a Democrat, who has until March 31 to sign the measure into law. While Northam has not specifically said he would sign the bill, he has previously signed pro-LGBTQ bills, including one requiring schools to create policies related to the treatment of trans students and a ban on so-called conversion therapy.
Virginia state Sen. Jennifer McClellan, a Democrat, who introduced the bill with fellow Democrat and state Sen. Mamie Locke, said HIV criminalization laws are an ineffective public health tool that disproportionately affect the LGBTQ community and people of color.
“They target and stigmatize people who are HIV positive, even though being HIV positive is itself not a threat to public safety.” McClellan told NBC News. “It makes people less likely to disclose or get tested.”
There’s also the question of determining someone’s intention to expose a partner.
“It’s so hard to prove,” McClellan said. “There have been instances where you’ve had a bad breakup and someone will swear out a warrant, saying ‘You tried to infect me,’ or use it as a threat.”
In the intervening decades, understanding and treatment of HIV have grown exponentially. But leading health organizations, including the American Medical Association, the World Health Organization and the CDC itself, say the laws have not caught up with advances in science.
According to the CDC, many HIV laws criminalize behavior that cannot transmit the virus — including spitting or biting — and can be applied whether or not there is actual transmission. They also don’t account for advances in HIV medication, which can keep an individual’s viral load undetectable, presenting zero risk of transmission.
Before Saturday, only six states had modernized their criminalization laws since 2014: California, Colorado, Iowa, Michigan, North Carolina and Washington, according to the advocacy group Equality Virginia. Just one, Texas, has repealed its laws.
While Virginia’s law has rarely been enforced, between 2019 and 2020 three people in the state were convicted of felony infected sexual battery and misdemeanor sexual battery, according to the Roanoke Times.
McClellan’s bill, which made infected sexual battery a misdemeanor, passed the Senate 21-17 earlier this month. But a version keeping the felony charge intact cleared the House of Delegates 56-44 Friday. In negotiations to reconcile the two bills, the House version prevailed.
Some lawmakers were concerned the language in McClellan’s bill would allow someone to intentionally transmit HIV without fear of prosecution.
“I find it stunning that we would want to eliminate the felony for what is potentially fatal, deadly conduct,” state Sen. Mark D. Obenshain, a Republican, told The Washington Post.
McClellan argues there are other laws about intentionally infecting someone with a disease, including those prohibiting “malicious wounding.” “There’s no reason to specifically single out people with HIV,” she said.
Cedric Pulliam, co-founder of Ending Criminalization of HIV and Overincarceration in Virginia, or ECHO VA, said the group will continue to work with advocates and legislators to change the law, “whether it’s this year or the next.”
“When you’re a felon, it messes up your career, your housing, your education — your entire mental state,” said Pulliam, a public health expert at the CDC. “We want to focus on the rehabilitative things we can do rather than punish people.”Last session ECHO VA didn’t back a less comprehensive version of the bill, because it “didn’t push the needle far enough,” co-founder Deidre Johnson told NBC News. She wasn’t sure McClellan’s bill, which included repeals of the donation ban and mandatory testing, would succeed. “We knew we wouldn’t get everything but we were shocked we got what we did,” she said.
Just last week, a bill banning the use of the so-called panic defense, used to mitigate violent crimes against LGBTQ people, passed with clear majorities in both houses.
“We’ve made generational change in less than two years,” McClellan said. “I think the public was there, I think there were even Republicans that were there. But the GOP leadership wouldn’t let [LGBTQ rights legislation] out of committee.”
The bill’s passage helps to cement Virginia as a leader on LGBTQ rights. On Tuesday, the Congressional HIV/AIDS Caucus reintroduced the REPEAL Act, which provides incentives to states that reform their HIV exposure laws.
Sponsored by Reps Barbara Lee, D-Calif., and Jenniffer González Colón, R-Puerto Rico, the bill also directs the Health and Human Services and Justice departments to review policies that criminalize people living with HIV.
“We cannot achieve our shared goal of an AIDS-free generation while these laws are on the books,” Lee said in a statement. “It is past time that we repeal these harmful and discriminatory laws and instead focus our efforts on promoting public health equity and public awareness.”
President Joe Biden has indicated he supports the REPEAL Act on his policy site, saying HIV exposure laws have no basis in science and “perpetuate discrimination and stigma towards people with HIV/AIDS.”
A study that could one day lead to a potential HIV vaccine has shown promising results, scientists have said.
Researchers from the International AIDS Vaccine Initiative (IAVI) and Scripps Research say that a phase-one trial has shown “proof in principle” for a new type of vaccine that could be used against the virus.
An effective vaccine to prevent HIV infection has proved elusive for nearly four decades, not least because the virus constantly evolves into different strains to evade the immune system.
However, the trial found success in “stimulating production of rare immune cells needed to start the process of generating antibodies” that could neutralise diverse strains of HIV.
The trial succeeded in generating cell production in 97 per cent of participants, though researchers stressed it is only a first step.
Professor William Schief, executive director of vaccine design at IAVI’s Neutralizing Antibody Center, said in a release: “This study demonstrates proof of principle for a new vaccine concept for HIV, a concept that could be applied to other pathogens, as well.
“With our many collaborators on the study team, we showed that vaccines can be designed to stimulate rare immune cells with specific properties, and this targeted stimulation can be very efficient in humans.
“We believe this approach will be key to making an HIV vaccine and possibly important for making vaccines against other pathogens.”
The researchers are now partnering with biotechnology company Moderna to develop and test an mRNA-based vaccine – the same radical approach employed in the creation of coronavirus vaccines.
U.S. regulators have approved the first long-acting drug combo for HIV, monthly shots that can replace the daily pills now used to control infection with the AIDS virus.
Thursday’s approval of the two-shot combo called Cabenuva is expected to make it easier for people to stay on track with their HIV medicines and to do so with more privacy. It’s a huge change from not long ago, when patients had to take multiple pills several times a day, carefully timed around meals.
“That will enhance quality of life” to need treatment just once a month, said Dr. Steven Deeks, an HIV specialist at the University of California, San Francisco, who has no ties to the drug’s makers. “People don’t want those daily reminders that they’re HIV infected.”
Cabenuva combines rilpivirine, sold as Edurant by Johnson & Johnson’s Janssen unit, and a new drug — cabotegravir, from ViiV Healthcare. They’re packaged together and given as separate shots once a month. Dosing every two months also is being tested.
The U.S. Food and Drug Administration approved Cabenuva for use in adults who have had their disease well controlled by conventional HIV medicines and who have not shown signs of viral resistance to the two drugs in Cabenuva.
The agency also approved a pill version of cabotegravir to be taken with rilpivarine for a month before switching to the shots to be sure the drugs are well tolerated.
ViiV said the shot combo would cost $5,940 for an initial, higher dose and $3,960 per month afterward. The company said that is “within the range” of what one-a-day pill combos cost now. How much a patient pays depends on insurance, income and other things.
Studies found that patients greatly preferred the shots.
“Even people who are taking one pill once a day just reported improvement in their quality of life to switch to an injection,” said Dr. Judith Currier, an HIV specialist at the University of California, Los Angeles. She consults for ViiV and wrote a commentaryaccompanying one study of the drug in the New England Journal of Medicine.
Deeks said long-acting shots also give hope of reaching groups that have a hard time sticking to treatment, including people with mental illness or substance abuse problems.
“There’s a great unmet need” that the shots may fill, he said.
Separately, ViiV plans to seek approval for cabotegravir for HIV prevention. Two recent studies found that cabotegravir shots every two months were better than daily Truvada pills for keeping uninfected people from catching the virus from an infected sex partner.
When Jeff Taylor, a longtime AIDS advocate and survivor, learned about clinical trials for the new Covid-19 vaccine in his hometown, Palm Springs, California, he leapt at the opportunity to participate.
“I always want to be the first person to try something,” he said.
But Taylor’s enthusiasm was short-lived. As soon as he told a recruiter over the phone that he was HIV-positive, Taylor was informed that he was ineligible to join.
“I argued with him, but he said: ‘I don’t make the rules. This is what our sponsor told us to do,'” Taylor, 58, said.
Taylor understood, in a sense, why they were rejecting him. As head of the HIV + Aging Research Project-Palm Springs, he had read plenty of studies that excluded people who were immunocompromised or on immune-modularity drugs.
“It’s something that happens all time,” Taylor said.
A study published this year in the Journal of Clinical Oncology found that 73 percent of over 1,090 analyzed cancer immunotherapy trials specifically excluded patients with HIV.
Not including a sample for the estimated 1.2 million HIV-positive people in the U.S. in the most significant vaccine trial in a generation seemed to him unwise. On July 18, Taylor notified a private listserv for HIV activists and researchers called IBT-Cure. Shortly thereafter, he got a response from Lynda Dee, executive director of AIDS Action Baltimore, another heavyweight in the HIV advocacy world who has been agitating for an AIDS vaccine since the 1980s.
“Vaccine protocols change, and there are usually 20 iterations before they actually get sent to the FDA for approval,” she said. “Someone must have stuck [the HIV exclusion] in there.”
She speculated that researchers didn’t want to include a population that they thought could compromise their results.
“Somebody must have thought: ‘Well, this is about immune systems. I don’t want to confound the data by including someone with HIV,’” she said. “They had no idea what something like that looks like and what hell they were going to get from people like us.”
Written with a palpable urgency and more than a whiff of anger, the letter, which the activists also posted to Change.org, said the agency was shooting itself in the foot by excluding HIV-positive people from Covid-19 vaccine trials. Black and Latino residents of the U.S. had been disproportionately affected by both HIV/AIDS and Covid-19, the letter said, and now both communities were the most likely to express skepticism about the coronavirus vaccine.
The activists also pointed out that people with HIV who were responding well to antiretroviral therapy weren’t considered so “immunodeficient” that they were barred from getting other vaccines. (The Centers for Disease Control and Prevention doesn’t recommend certain live vaccines for people with HIV whose CD4 white blood cell count is below 200.)
Dee said she also reached out to her contacts in the U.S. government, including Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases. She said Dieffenbach was able to quickly begin discussions with Moderna, because the drugmaker was using government-run clinical trial networks to test its vaccine. (Pfizer didn’t rely on funding from the U.S. government’s Operation Warp Speed.)
Dieffenbach did not respond to a request for comment.
On Aug. 5, about eight days after Dee posted the letter on Change.org, Moderna changed course and announced plans to drop its exclusions. Moderna recruited 176 people living with HIV out of 30,000 participants, according to data on the FDA’s website. Of those with HIV, one who received the placebo and none who received the vaccine developed Covid-19, according to the data.https://platform.twitter.com/embed/index.html?creatorScreenName=NBCNews&dnt=false&embedId=twitter-widget-0&frame=false&hideCard=false&hideThread=false&id=1291056643464192001&lang=en&origin=https%3A%2F%2Fwww.nbcnews.com%2Ffeature%2Fnbc-out%2Finside-fight-include-hiv-positive-people-covid-19-vaccine-trials-n1252458&siteScreenName=NBCNews&theme=light&widgetsVersion=ed20a2b%3A1601588405575&width=550px
Pfizer made a similar announcement a day later and ended up enrolling a relatively small number of HIV-positive people — 120 out of 43,000 participants — in the last phase of its trials, according to information on the FDA’s website. An efficacy rate for the HIV-positive participants in Pfizer’s vaccine is not yet available.
The CDC’s website says people with HIV “may receive the vaccine” but notes that the safety data specific to this population “is not yet available.” The agency adds that people with weakened immune systems “should also be aware of the potential for reduced immune responses to the vaccine, as well as the need to continue following all current guidance to protect themselves against COVID-19.”
Even though Dee was able to exert pressure on much of the hulking bureaucracy that decides who gets injected first, she still laments that it took so long for the vaccine makers to change their rules.
“We got ’em in,” she said, “but my God, what a mistake,” she said of the initial exclusion of those with HIV.
Neither Pfizer nor Moderna responded to multiple requests for comment.
Dr. Larry Corey, a virologist who was chosen by Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, to run vaccine testing operations for Operation Warp Speed, said the pressure on Pfizer and Moderna has been immense, “similar to playing Wimbledon Center Court.”
“I think there were an overwhelming number of priorities and things to do, and it just fell off the radar,” he said.
Corey said there was never “any worry” in the advocacy world that people successfully managing their HIV infections on antiretroviral therapy would have bad responses to the Covid-19 vaccine. Other experts at the Joint U.N. Program on HIV/AIDS, the British HIV Association and Aidsmap have also said the Covid-19 vaccine should be considered safe and effective for people with HIV.
Now, Dee and others are working to amend CDC guidelines and prioritize HIV-positive people for vaccination after the elderly and essential workers, as Germany has done. Some data have emergedthat suggest that people living with HIV are also at an increased risk of severe Covid-19 (although more research is needed), and nearly half of Americans who are HIV-positive are over age 50 and thus more likely to live with co-existing conditions that can complicate the course of the illness, like diabetes or cardiovascular disease.
Dee, who watched all of her friends die of AIDS in the ’80s, said she’s ready for this next fight.
“I’m a pushy old broad, and I’ve been doing this for 33 years,” she said. “People know me, they trust me, and they’re often a little afraid of me because I’m this East Coast battle-ax, and I say what I think.”
A new pilot study funded by the Food and Drug Administration could be the first step toward lifting restrictions on blood donations by gay and bisexual men.
The program, called Assessing Donor Variability and New Concepts in Eligibility (Advance), has been launched by three of the nation’s largest blood centers — the American Red Cross, Vitalant and OneBlood.
Approximately 2,000 men who have sex with men (MSM) will be recruited at community health centers in San Francisco; Los Angeles; Memphis, Tennessee; Atlanta; Orlando, Florida; Miami; Washington, D.C.; and Baton Rouge, Louisiana. Participants must be 18 to 30, have had at least one male sex partner in the last three months and be willing to donate blood. The results could ultimately determine whether the FDA changes its blood-donor history questionnaire, asked of all potential donors to assess risk factors for infection by transfusion-transmissible diseases such as HIV and Hepatitis B.
“If the scientific evidence supports the use of the different questions, it could mean men who have sex with men who present to donate would be assessed based upon their own individual risk for HIV infection and not according to when their last sexual contact with another man occurred,” a statement on the Advance website reads.
Restrictions on certain blood donors date to the early 1980s, during the height of the AIDS epidemic in the United States, when the FDA instituted a lifetime ban on any man who had had sex with another man since 1977. That rule, intended to keep HIV out of the blood supply, was replaced in 2015 with a year-long abstinence requirement.
After the 2016 Pulse nightclub massacre in Orlando, more than 100 members of Congress — including Sens. Tammy Baldwin, D-Wis., Elizabeth Warren, D-Mass., and Bernie Sanders, I-Vt. — signed letters urging then-FDA Commissioner Dr. Robert Califf to eliminate the deferral policy.
“We can’t say some people can give blood, other people can’t based on their sexual orientation,” then-Rep. Alan Grayson, D-Fla., who represented Orlando at the time, told reporters, according to The Washington Blade.
Gay, bisexual and other men who have sex with men are the group most affected by HIV in the U.S., according to the CDC: In 2018, they accounted for 69 percent of the nearly 38,000 new HIV diagnoses across the country.
In April, as coronavirus lockdowns caused donations to plummet, the FDA quickly lowered the eligibility requirement for MSM to just three months.
The pandemic’s impact on available blood was swift and severe: By mid-March, the American Red Cross had canceled some 2,700 blood drives, resulting in 86,000 fewer donations. In April, donations at the New York Blood Center were down from an average of 9,500 a month to fewer than 2,000, according to New York state Sen. Brad Hoylman, who is gay and was initially rejected as a donor despite meeting the new criteria. “A regular month they host about 600 blood drives,” Hoylman told NBC News in May. “Last week, they hosted two.”
The three-month deferral also affects women who have sex with MSM, sex workers, injection drug users and those with recent tattoos or piercings.
In an April letter to the FDA, two New York Democrats, Rep. Carolyn B. Maloney, chair of the Committee on Oversight and Reform, and committee member Rep. Alexandria Ocasio-Cortez, called the change “a good first step” but urged the agency to move toward assessing potential donors by individual risk.
“A policy that fails to do this perpetuates stigma and falls short of ensuring that every person who can safely donate blood in the United States has the opportunity to do so,” they said.
The Red Cross, which had encouraged the FDA to adopt the three-month deferral model, also called it “a scientifically based interim step” toward abolishing restrictions altogether.
“Blood donation eligibility should not be determined by methods that are based upon sexual orientation,” the relief organization said.
“Italy, Spain and other nations modernized their donor policies years ago, before the U.S. even ended its lifetime ban,” he told NBC News.
More than a dozen nations — including Argentina, Brazil, Mexico and Colombia — have adopted a risk-based questionnaire in place of a blanket policy based on sexual orientation. Earlier this month, the U.K. became the latest.
Franzone said he’s confident the Advance study will bear out what advocates like him have been saying all along: “Individual, risk-based assessment is safer for recipients of lifesaving blood.”
Jason Cianciotto, senior managing director of institutional development and strategy at New York’s Gay Men’s Health Crisis, said it’s exciting to reach this point after more than a decade of advocating for policy change.
He did have concerns about the Advance study, though, saying 2,000 individuals “is not a representative sample,” especially as no health centers in Chicago, New York, Boston or other Northeastern cities are involved.
He speculated that the pilot study, like the three-month deferral, was spurred by the pandemic.
“When we’ve lobbied the FDA in the past, their statements showed they didn’t really see an imperative” to change the current policy, Cianciotto told NBC News. “Even though we explained the ban contributed to stigma against people with HIV.”
But when advocates had mentioned gay and bisexual donors could help alleviate blood shortages, Cianciotto said, the FDA has always claimed it didn’t really have any. “Of course, no one could have predicted a nationwide shortage of blood and blood products caused by a pandemic,” he added.
That the program has started under the Trump administration, which has been accused of rolling back LGBTQ rights, increases the likelihood that it was being driven by necessity, he said.
An FDA spokesperson told NBC News that the agency “remains committed to considering alternatives to time-based deferral by generating the scientific evidence that is intended to support an individual risk-assessment-based blood donor questionnaire.”
The spokesperson indicated there is no announced timeline for the study’s completion, although ABC News reported that researchers aim to present their findings by late 2021.
Cianciotto said he hopes the program is completed and implemented before the next election.
“In a Biden administration, we’ll have an advocate like we had in the Obama administration — in fact, one who actually was in the Obama administration,” he said. “But we can’t risk this becoming a campaign issue.”
Public Health England has finally confirmed where people living with HIV land on the coronavirus vaccine priority list.
On Tuesday (8 December) the UK became the first country in the world to start administering the Pfizer/BioNTech vaccine after it was approved my regulators last week.
The government has now released the order of priority in which the vaccine will be given out, and those who are HIV-positive will be in the sixth group, along with other “adults aged 18 to 65 years in an at-risk group”.
“At-risk” adults also include those undergoing chemotherapy or radiotherapy, people diagnosed with a blood cancer like leukaemia, and people with severe asthma, diabetes, heart problems or kidney disease. The group also includes those with a severe mental illness or learning disability.
The sixth risk group follows care home residents and staff, those over and 80 and health and social care workers, people over 75, people over 70 and the extremely clinically vulnerable individuals, and people over the age of 65.
Some studies have shown that those living with HIV are at an increased risk of dying from COVID-19 and, although information is conflicting, one small London study found that HIV-positive people with low CD4 cell counts were more likely to be admitted to hospital with COVID-19 than other people with HIV, according to HIV and AIDS charity NAM/ aidsmap.
NAM/aidsmap executive director Matthew Hodson told PinkNews: “Although there is little evidence that people living with HIV are more likely to acquire COVID, there may be a slightly increased risk of dying from COVID-19.
“People who are not virally suppressed on treatment for HIV are likely to be at greater risk. COVID has underlined the importance of prompt HIV diagnosis and treatment access.
“Some of the vaccines, such as the Oxford and Pfizer vaccines, specifically recruited people living with HIV, although the full results of these studies have not yet been released.
“On a personal level, as someone who has been living with HIV for 22 years, I will not hesitate to get vaccinated.”
Vaccine misinformation has been spreading like wildfire on social media, and this is no different when it comes to the safety of the coronavirus vaccine for people with HIV.
NHS HIV consultant Dr Rageshri Dhairyawan wrote on Twitter: “A WhatsApp message is circulating saying that people living with HIV should not accept the vaccine, as it is a way for the government to kill them, as they are too expensive to look after on the NHS. THIS IS NOT TRUE. It’s vital we discuss people’s fears!”
She added: “Made sure to recommend COVID-19 vaccines to all of my patients in clinic today. A lot of concerns, so it was great to discuss and address them.
“Interestingly, some people said it was reassuring to hear I was going to get one, as it made them feel more confident about them.”
The United States is the only major economy on the planet where health care is a for-profit industry instead of a free public service; it’s also the only place where the government allows health care not just to be run as an industry, but allows that industry to be run as a cartel. What this means in practice is that pharmacology — the study and development of pharmaceuticals — has become more a branch of industry than of science, and it is therefore controlled by lobbying interests rather than either science or the public good.
The only better example of this than the infamous price gouging of insulin in America is how the drug companies have a captive audience for their many still-patented products not only in HIV-positive Americans but also in the nation’s millions of LGBT people who are encouraged to take the sole HIV-prevention drug, Truvada, to avoid HIV infection.
Last year, for the first time, it was announced that a generic version of Truvada — the pill used since 2004 to fight HIV infection and since 2012 as pre-exposure prophylaxis (PrEP) for HIV — would finally be available in the U.S. Generic versions are already sold elsewhere in the world and, usually, when drugs go generic in America, it’s an open field, which dramatically lowers prices.
Truvada’s patent holder, Gilead, however, granted rights to produce a generic U.S. alternative to just one company — the Israeli firm Teva — for a six-month period, as the result of a settlement. Truvada currently costs American users roughly $1,700 a month; Teva’s generic, which debuted in October, is marketed for around $1,455 per month.
Gilead’s all-but-proprietary access to sell Truvada is the equivalent of Hershey’s controlling who has access to chocolate milk.
Of course, few people pay the full price of a medicine out-of-pocket. Insurance, for those who have it, helps lower out-of-pocket costs in many cases, though private insurers aren’t required to do so until 2021. Gilead provides some patients a coupon for $7,200 worth of purchasing assistance per year, with no monthly limit (which means some months it might be free and others it might be full price). Teva’s patient discounts are also $7,200 per year, but they’re limited to $600 per month — knocking its monthly cost down to around $855. Unfortunately, California and Massachusetts both forbid the use of pharmacological coupons that made Truvada somewhat accessible if a generic alternative exists; patients who relied on those discounts must now apply for access to other programs or pay out of pocket for the medications they couldn’t afford.
Meanwhile, generic versions of Truvada — Ricovir, Tavin-EM, or Tenof-EM — elsewhere in the world cost $210 to $720 per year.
Ironically, Gilead put little of its own money into the research that developed Truvada, which is a combination of two medicines, tenofovir disoproxil and emtricitabine (though the company says otherwise). The former input was, in fairness, developed as an oral medication by Gilead (heavily based on a drug first developed by a Czech scientist, after a collaboration with scientists at the University of California-San Francisco showed it was effective in treating HIV), but its patent expired in 2018.
Emtricitabine, the second drug in Truvada and its generic equivalents, was developed at Emory University with NIH grants; Emory then entered into an agreement with a company Gilead eventually acquired to give it control of the drug in exchange for a sliver of the profits. (Until Teva’s generic debuted, Gilead owned 100 percent of the Truvada market in the U.S, pulling in roughly $3 billion a year.)
But the basic research, animal trials and human trials for the combination of the two as preventative drug were all publicly financed by the National Institutes of Health and the Centers for Disease Control and Prevention. The 1980 Bayh-Dole Act, though, allows private grabs of public science; the government can claw patents back under certain circumstances, but Sen. Birch Bayh, D-Ind., and Robert Dole, R-Kan., argued in 2002 that pricing was deliberately not conceived as one such circumstance .
The federal government has the ability to compel broad generic production of Truvada virtually overnight and has refused to act on it.
So the only Truvada-related patent Gilead now owns — until September 2021 — is for emtricitabine; its all-but-proprietary access to sell Truvada is the equivalent of Hershey’s controlling who has access to chocolate milk.
It doesn’t have to be this way, as advocacy groups like PrEP4All have been arguing for years. Empowered with the intellectual property equivalent of eminent domain, the federal government has the ability to compel broad generic production of Truvada virtually overnight and has refused to act on its ability — whether in the Obama administration or the Trump administration. (There are few indications that the Biden administration will be any different.)
The problem with patents thus persists because toxic agents in soulless systems have created a ruthless market for its ostensible solutions.
Unaffected politicians and policymakers — including lobbyists and Big Pharma C-suite cynics — instead cast unsustainable, unaffordable drug prices as a result of tough decisions, difficult circumstances or unavoidable economic realities. But they are wholly avoidable. Such anguish is not a necessary evil of market forces or political gridlock; every other industrialized nation manages to recognize how unnecessary profit-driven health care is.
The most bitter pill in all of human health is the one we prescribe the least: the truth, without a spoonful of sugar. And the truth is that we are fighting late-stage, metastasized cowardice here, a societal immunodeficiency in which we are unable to defend people over profits, or dignity over dollars. Sadly, as far as we’ve come in our understanding of immunology — a knowledge built almost entirely on the bones and blood of the world’s 32.7 million AIDS deaths and 75.7 million HIV infections — such cowardice is wholly incurable because it is more dictum than dysfunction.
As Americans and the world have witnessed the planet’s greatest economy suffer some of the planet’s poorest Covid-19 health care, it is increasingly clear to everyone that government has all the legal and political power it needs to improve the lives of millions with a snap of its fingers, but none of the willpower. When America’s founders committed — and condemned — us to a government ruled by values of life, liberty and the pursuit of happiness, they unfortunately allowed no checks or balances against how much happiness the powerful can find in their fellow Americans’ misery.
Dr. Anthony Fauci’s effort to educate the public on the coronavirus pandemic has earned him scores of admirers, but his work on the global HIV/AIDS crisis saw him cheered on Tuesday by one star-studded fan — Elton John.
“What a wonderful and fitting way to mark World AIDS Day, by honoring one of the biggest champions in the history of the AIDS epidemic,” John said in remarks at the US Global Leadership Coalition’s virtual tribute celebration, where Fauci was presented with the organization’s Lifetime Achievement Award.
“There are very few people on this planet who have dedicated themselves to a lifetime of service to save millions of lives like Dr. Fauci,” said the global music superstar, who founded an eponymous foundation that works to combat HIV/AIDS and its stigma.