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A City Vision on AIDS

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In his first major speech on AIDS policy, Mayor Michael R. Bloomberg laid out a vision for the city’s response to the AIDS epidemic that was expansive. “I know that the topic that brings us together is a tragic and challenging one, but I can’t help but feel that this is a great day,” Bloomberg said on March 13 at the Community Planning Leadership Summit for HIV Prevention. “Meeting with such an esteemed group, so many dedicated, hardworking people, gives me a sense that there is no chance, no solution, no cure that is beyond our reach.” Bloomberg defined two goals for his administration in its response to AIDS––advancing HIV prevention and improving AIDS care. “First, to become the national model in leading the Centers for Disease Control and Prevention goal of reducing new HIV infections in the United States by 50 percent by 2005 and, second, to provide the best HIV/AIDS care and treatment in the world,” Bloomberg said during the summit’s opening session. The annual summit draws thousands of representatives from government and AIDS groups who spend three days discussing the latest developments in AIDS care and HIV prevention. This year’s meeting was the eleventh summit. “We must strengthen our commitment to combating the evolving HIV/AIDS crisis here at home,” Bloomberg said after praising the Bush administra­tion’s efforts to combat AIDS outside the U.S. “There are more that 100,000 New Yorkers living with HIV of whom more than 50,000 have already been diagnosed with AIDS. To put that in perspective, although this city represents less than three percent of the country’s total population we have 16 percent of the AIDS cases.” Bloomberg promised improved city efforts at defining where HIV infections are increasing, a greater emphasis on HIV testing, and programs that would engage HIV-positive New Yorkers in prevention efforts. “Knowledge about where HIV infection is spreading will permit us to direct prevention services where they are most needed,” Bloomberg said. “Our prevention plan includes promoting safer sex, a reduced number of partners, and access to condoms.” The crowd gave its loudest applause to Bloomberg’s comments on needle exchange, or programs that allow drug users to swap used needles for unused ones. Needle exchange programs are highly effective in reducing HIV transmission among drug users. “We also will continue the practice of exchanging syringes,” he said. “These programs have been operating in New York City for over ten years. The sky has not fallen. Drug use and drug related crime have not gone up, in fact, they’ve gone down. HIV infections among injection drug users, their spouses and their children have also gone down.” While Bloomberg said the city would “establish a new standard of accountabi­lity” for AIDS services his most specific, and unexpected, comments came when he said he would seek to amend Local Law 49, a 1997 bill that formalized what is now called the HIV/AIDS Services Administration (HASA). “The city’s HASA program was created in 1985 early in the AIDS epidemic,” Bloomberg said. “It is governed by a local law passed in 1997 which locked in place a service model that existed at that time. Simply put that model is no longer sufficient. By mandating that case management be done by the city, it shortchanges community based service providers, overlooks the critical role of medical providers, and prevents funds from being used to foster creative new programs.” That restructuring could include more services for women and greater access to job training for HASA clients who want to return to work. Much of the responsibility for implementing Bloomberg’s proposals will fall to Frank J. Oldham, Jr. “The challenge for achieving both of these goals is in Frank Oldham, Jr., our recently appointed citywide coordinator for AIDS policy,” Bloomberg said. “He will insure that all city agencies, community organizations, medical providers, and partners are working together and I will be directly involved to make sure that New York has the most innovative, effective and comprehensive plan to confront HIV/AIDS in our city’s history.” Given the lack of detail in Bloomberg’s plans, AIDS advocates were reserved in their responses. “We’re in a wait and see mode,” said Regina R. Quattrochi, executive director of Bailey House, an AIDS housing group. “We’ve been advocating for the last 15 months that the mayor make a major policy speech on AIDS. He has now done so. The devil is in the details. We need to see the details and some of the plans he announced today.” Activists have long sought reforms to make HASA a more effective agency even as they have battled to protect it from cuts. “[Local Law 49] was enacted because the Giuliani administration was attempting to dismantle [HASA],” Quattrochi said. “It also established the right to same-day emergency housing for homeless people with AIDS. Many of the lawsuits that have been brought against the city for its inadequate response on AIDS have been based on it… Hearing kind of sketchy remarks about the city trying to amend it has a number of us concerned.” Similarly, Ronald Johnson, associate executive director at the Gay Men’s Health Crisis (GMHC), approved of the speech, but he also wanted more detail. “I thought it was a very positive speech,” Johnson said. “His comments on needle exchange were the most forceful that a mayor in this city has expressed… I want to reserve judgment on amending Local Law 49. We want to see what is being proposed. Local Law 49 was, from the community’s point of view, a great accomplish­ment.”

Updated 5:17 pm, July 20, 2018
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