Wednesday, November 24, 2010

Still Fighting For NJ's Family Planning Funds

Monday November 21, 2010

NJ Democrats, led by state Senator-elect and Assemblywoman Linda Greenstein (D-Plainsboro) put forth a valiant effort to restore state funding for women’s health and family planning services. This legislation was passed in the NJ state assembly 44-25 and now moves to a vote in the state senate. To date, Governor Christie has been adamantly opposed to this bill as it requires the governor to apply for expansion of Medicaid coverage for women's health and family planning. This legislation would provide the state with nine federal dollars for every State dollar spent.

Monday’s vote was the latest of three attempts by NJ legislators to restore a portion of the $7.5 million cut from family planning services. In July 2010 Governor Christie vetoed legislation that would have restored the full $7.5 million despite the fact that funding for family planning services was found in the budget. An attempt to restore this funding failed again in September 2010 when seven republicans, who originally voted in favor of restoring the money, voted in opposition. However, earlier this month, the Assembly Appropriations Committee approved two bills that would restore $5 million for family planning services, targeting untapped money from other inflated funds. In order to restore the $5 million, the state will be required to apply for federal matching dollars for Medicaid-eligible health care consumers.

According to the New Jersey Star Ledger, restoring NJ’s family planning budget would fund 58 women’s health clinics. These clinics provide vital services such as birth control, breast and pelvic exams, HIV testing, pregnancy testing and treatment for sexually transmitted diseases. In NJ, these services are vital as NJ has the highest rate of HIV infection amongst women in the United States. Family planning services exist as a barrier to growing HIV rates, something NJ cannot forego. Based on budget cuts, the number of women who are able to afford family planning services is expected to drop 40% and many clinics throughout the state have already closed their doors or reduced hours of operation.

These clinics are vital for NJ’s working and financially struggling as they provide affordable health services, including basic gynecological care. A reduction in services is detrimental to the women and families who work inflexible hours and depend on this health care. Not only is family planning money essential to NJ healthcare but investing money in family planning makes good financial sense. Studies cited in the September vote found that for every $1 spent on family planning services, the state saves $4 in other programs. New Jersey Women and AIDS Network is dedicated to advocating for policies that reduce the rate of HIV infection in NJ. Family planning money is essential to reducing the affects of HIV on NJ’s women. NJWAN will not stop fighting for the restoration of family planning funds and asks that you do the same. Please contact your legislators by clicking on the link below and ensure that he or she knows how important family planning money is to NJ.

http://www.njleg.state.nj.us/districts/njmap210.html

Wednesday, November 17, 2010

Medical Marijuana Rules Reconsidered

Emotion filled the State House Annex Committee Room on Monday November 8th, as a host of people suffering from various chronic illnesses appealed to the Senate Health, Human Services and Senior Citizens Committee, providing personal testimonies of the pain relief and symptom management that marijuana provides. Though a variety of diseases were represented, the patients had a common factor among them: they were all willing to implicate themselves of the illegal use of marijuana in hopes that the NJ law that has been signed since January 2010 finally be enacted. The legislation allows patients diagnosed with such severe illnesses as AIDS, cancer, Lou Gehrigs Disease, muscular dystrophy, and multiple sclerosis, to have access to marijuana grown through state-monitored dispensaries. Although many pharmaceutical pain and symptom management medications exist and are legal and readily accessible, the effect on quality of life is what seems to make marijuana the alternative of choice, even in the face of it being stigmatized as a “gateway drug”. Commonly prescribed opiates, like morphine and oxycontin, relieve pain but they also render the user lethargic and disoriented. Marijuana is said to have a more beneficial effect, providing pain relief, while leaving functionality intact. It also increases hunger, which is a major benefit for those who experience nausea and loss of appetite due to the side effects of medications and other complications of chronic illness. Jay Lassiter, 38, of Cherry Hill spoke of his experience of living with HIV and using marijuana as a way of managing the side-effects of his anti-retroviral therapy. "I was a criminal yesterday, and as long as this is in limbo, that's just a choice I have to make," he said. Detractors of the law were in attendance as well, and held the view that such a law might encourage recreational drug use. Candice Singer, of the National Council on Alcohol and Drug Dependence, stated that it is important to have strict limits. Despite the fact that both views were represented, support for a more accessible and user friendly marijuana law was overwhelming.
Over the last 9 months, the law that was signed by former Governor John Corzine before leaving office has been mired in the controversy and bureaucracy of current Governor Chris Christie’s draft regulations of the Medical Marijuana Program, who boldly stated that he would not have signed the bill if he was governor when it was passed. (See draft regulations: http://www.nj.gov/health/draft_mm.pdf) Upon its signing, New Jersey became the 14th State in the nation to legalize marijuana for medical uses. It also preliminarily became the only state to present such restrictive rules in regards to accessibility for patients and unattractive restrictions on physicians and those who want to apply to open one of the six proposed dispensaries. These regulations present new restrictions that are not included in the law, and prompted Senator Nicholas Scutari to introduce a resolution to the Senate Committee and the Assembly that, if successful, would force the re-evaluation of the regulations for the Medical Marijuana Program.
Since the November 8th meeting, the resolutions supporting Medical Marijuana have passed and Governor Christie’s Administration has 30 days to rewrite the rules. These changes will surely impact disease management as we know it, particularly that of HIV/AIDS. In a time when anti-retroviral therapy has proven to extend life, it does not come with out it complications. Often times those who are living with HIV/AIDS and are on medication have to craft a quality of life between bouts of nausea, diarrhea, neuropathy, and appetite loss. Not being able to do so greatly affects self-care, mental and emotional health, employment and earning potential, just to name a few life factors. There are many people who manage well using tools that are legal and readily available, and there are those who choose marijuana use despite its current stigma and social repercussions. Whatever the case, fairness in access is a right that everyone should have.

Friday, September 10, 2010

Disclosure Distress

On August 16, 2010, the German “No Angel’s” pop star Nadia Benaissa testified that she knowingly had unprotected sex with multiple partners without disclosing her HIV status. In Germany, this act comes with a ten year prison sentence. In NJ this is a 3rd degree crime punishable by up to 5 years imprisonment and up to $15,000 fine. New Jersey’s disclosure law is amongst the most ambiguous of the states, addressing disclosure must take place before “sexual penetration.” The definition of penetra-tion is left to the discretion of the jury (who penetrated what? With what?) and in this state of HIV stig-ma, ignorance and misinformation, this does not bode well for the people living with HIV/AIDS (PWLHA).

The real question is who is at fault for contracting HIV from a partner through unprotected sex? The law says the responsibility falls in the lap of PLWHA but what if that individual hasn’t been tested and is un-aware of their status? Through their initial irresponsibility (not getting tested) they are relinquished of the burden of fault in the eyes of the law. What about the other partner, the one who may or may not have been tested, may or may not be positive… is he or she in any way accountable for his/her exposure to HIV? HIV stigma allows people to blame the HIV positive, not the individual who was infected by an HIV positive person through unprotected sex. In an attempt to deny personal vulnerability, there is a communal desire to blame the infected rather than accept responsibility for one’s actions.

Stigma as we know it today is not an unexplained phenomenon but rather a strategically developed mindset. Back in the 1980’s, through misguided efforts to protect oneself, the population demanded to know who was positive out of fear of contracting the virus. People were uninformed and concerned about contracting HIV through casual contact or by an HIV+ individual maliciously exposing them. This resulted in disclosure laws forcing PLWHA to disclose their status before, according to NJ, sexually “penetrating” or being “penetrated.”

Currently 23 US states have laws that make it a crime for PLWHA to engage in any sexual activity without disclosing their HIV-positive status to their prospective partners first. One question this raises is why are we punishing the people who were responsible and got tested, but not those who were irresponsible and did not? Disclosure laws are not inherently intended to prevent people from getting tested. Laws are created for many reasons, one of which is to establish social norms. Prevention efforts championing opposition to domestic violence and drunk driving are supported by criminalization of such activities. The same holds true in the world of public health; while health educators emphasize personal responsibility and encourage individuals to take control of their own health, the legal system has the ability to take an authoritative role in prevention by criminalizing certain behaviors.

NJWAN finds fault with several aspects of the criminalization of nondisclosure including the fact that disclosure laws often disregard whether or not safer sex took place and thereby undermining national prevention efforts. Disclosure laws endorse a norm of disclosing one’s HIV status before jumping in bed, car, or bathroom stall, with each other. This parallels how domestic violence laws endorse an anti-domestic violence norm. But, in the world of HIV disclosure law, the norm being promoted is in direct conflict with public health messages of individual responsibility. Community health educators have encouraged consumers to protect themselves in all situations under the assumption that every partner is HIV+. This is not an unrealistic philosophy as 20% of all PLWHA are unaware of their status. NJWAN would like to see the law catch up with what health educators have known for years…it takes two to tango, or to contract HIV and only you can protect yourself. It is not who you are, but what you do that puts you at risk.

Tuesday, September 7, 2010

What’s Good For the Goose…

Women around the world are making headlines, and not for winning Pillsbury’s cherry pie bake-off…Recently, German pop singer Nadja Benaissa has been reported to be facing 10 years in prison, after she testified that she knowingly had sex with three men and did not disclose her HIV positive status. She stated that she did not tell anyone for fear that the press would make this information public and damage the lives of her daughter, as well as the reputation of “No Angels”, the hit singing girl-group that she was a part of.

Also recent, in Tanzania, a woman by the name of Regina Joseph stood accused of “dressing indecently” on her way to a local market, and was subsequently attacked by a group of young men who felt that she was dressed in an alluring manner with the intention of passing the HIV virus to whomever would have a sexual encounter with her. According to Ms. Joseph, the group of men said that she wanted to pass HIV, yet they didn’t know her status.

HIV disclosure is a hot-button issue all over the world. Some people feel that those with a positive diagnosis owe it to their sexual partners to inform them (regardless of whether protection is used); to not do so is criminal, and the law agrees. Although disclosure might be difficult and rejection is possible, many feel that this does not let anyone off the hook. This article doesn’t suggest amnesty in that respect, but what it does call for is gender equality when addressing responsibility in these instances.

The last time I checked it took two to tango, so why do the women get the hot seat and the men get to hide in the shadows? I noticed that the names of the women in question are available, but the names of the men involved are not. Apparently they are nameless, or at least they are in the eyes of the media. After reading several articles about both accounts, the search for the identities of the men in each situation became futile. It can be argued that in the case of Ms. Benaissa, her “victims” had been through enough and don’t need the burden of having their identities revealed. After all, the stigma attached to HIV is alive, and well. However, I was hard pressed to find any article that even called to question any responsibility that each man had to himself to insist on using protection.

And in the case with Ms. Joseph, unfounded accusations led to her assault, and she remains charged by her society of the crime of being “attractive”, while a group of woman-beaters are allowed to maraud the town, punishing women for their own lustful thoughts. This speaks volumes about the level of responsibility that continues to be placed on women in society, while men are allowed to shift blame and remain protected. This is irresponsible journalism, wrought with misogynistic slant and opinion masked by omission.

By continually charging women with “the Fall of Adam”, men will feel justified in the blame game, and shirk responsibility at their own expense. I’m not saying to let women off the hook, but I am saying that we must make room on that same hook for men. As the saying goes, what’s good for the goose is good for the gander.

Wednesday, August 4, 2010

NJWAN's Response to President Obama's National AIDS Strategy

The New Jersey Women and AIDS Network (NJWAN) commends the White House for releasing the nation’s first domestic HIV strategy and looks forward to the implementation of a plan that improves the care of people living with HIV/AIDS as well as reduces the rate of new infections.

The strategy is made up of three basic goals:

Goal 1: reduce new HIV infections by 25%- Many have criticized that this goal is not nearly enough. However NJWAN recognizes that there are many human elements at play, and that 25% may be a realistic starting place.

Goal 2: Increase access to care- NJWAN sees the President’s goal of increasing access to care as an essential component in improving the quality of life of our consumers. Hopefully, President Obama’s recognition of HIV as a US epidemic will influence a change in Gov. Christie’s current budget decisions that will leave over 950 HIV positive individuals without access to the medications that currently support their life through the AIDS Drug Assistance Program.

Goal 3: Reduce Health disparities- NJWAN commends the President for acknowledging HIV Stigma as a key opponent in the fight against saving the lives of NJ’s women. NJWAN has long acknowledges stigma to be a factor worth addressing and is currently studying the effects of stigma and disclosure on women.

Along with this strategy plan, President Obama has devised an implementation plan in which he charges that the job “does not fall to the Federal Government alone, nor should it.” The success of this plan is also hinged on the cooperation of United States society at large. We must all get involved.

In order for such goals to reach fruition, NJ must find the resources to successfully fund such a strategy. NJWAN appreciates President Obama’s leadership and its commitment to address the disparate rate that HIV is infecting families and communities but is concerned about the lack of available resources to carry out the proposed plan. Without adequate financial support, grassroots organizers will meet on-going challenges in an attempt to meet the goals.If the new strategy is going to work it must address the needs of women and the social justice issues that intersect with HIV risk associated behaviors, like poverty, homelessness and discrimination. Prevention and treatment programs must take into account the dynamics of gender and power in our society and how that shapes women’s lives and health behaviors. Without understanding and addressing the social backdrop of HIV in the lives of women, the rate of infection in the women of NJ will continue to grow and our state will continue to have the highest proportion of women living with HIV of all 50 states. NJWAN remains hopeful that this plan will be an success and looks forward to doing its part in the National HIV/ AIDS Strategy to ensure its success.