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The Republican Convention, circa 1992

Randy Potts

August 29th, 2012

20 years ago, at another Republican National Convention, Mary Fisher stood up to say that “the AIDS virus is not a political creature” and challenged her party to see her as “one with the lonely gay man sheltering a flickering candle from the cold wind of his family’s rejection.”

It’s not far-fetched to believe that George W. Bush’s  record on worldwide HIV/AIDS (called PEPFAR, the “President’s Emergency Plan For AIDS Relief”) was partly inspired by this amazing speech given when his father was up for re-election. In 2012, however, “HIV” and “AIDS” do not exist in the party platform in terms of US-based efforts (PEPFAR’s focus is Africa); instead, where the platform mentions publicly-funded research it says that “research must consider the special needs of formerly neglected groups” and lists things like “breast and prostate cancer, diabetes and other killers.” If HIV/AIDS were implied here, it is at the very least unclear and, by any reckoning, an obvious repudiation of Mary Fisher’s call to action.

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This year, the Log Cabin Republicans in their most recent National Update in July had this to say:

As Republicans it is time to recommit to the defense of life and liberty and renew the fight against the HIV/AIDS epidemic.  This month the International AIDS Conference was held in Washington, DC, focusing on the need to fight complacency, particularly among gay and bisexual men.  Despite medical advances, LGBT minorities continue to be devastated by the crisis.  While GOP leaders work to rein in government spending, funding for HIV/AIDS programs should remain the priority they were to the Bush administration.

Strong words and yet, thus far in Tampa, not a word has been breathed about HIV/AIDS.  The focus for LCR in addition to a full page ad in Tampa has instead been on marriage equality.

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Timothy Kincaid
August 29th, 2012 | LINK

From the Republican Party 2012 Platform:

Advancing Hope and Prosperity in Africa

PEPFAR, President George W. Bush’s Plan for AIDS Relief, is one of the most successful global health programs in history. It has saved literally millions of lives. Along with the Global Fund to fight AIDS, Tuberculosis and Malaria, another initiative of President Bush, it represents America’s humanitarian commitment to the peoples of Africa, though these are only one aspect of our assistance to the nations of that continent. From Peace Corps volunteers teaching in one-room schools to U.S. Seabees building village projects, we will continue to strengthen the personal and commercial ties between our country and African nations.

We stand in solidarity with those African countries now under assault by the forces of radical Islam and urge other governments throughout the continent to recognize this threat to them as well. We support closer cooperation in both military and economic matters with those who are under attack by forces which seek our destruction.

Timothy Kincaid
August 29th, 2012 | LINK

Interesting side note: in school, Mary Fisher briefly dated Mitt Romney.

Jim Burroway
August 29th, 2012 | LINK

Oh, well, sure. A word about AIDS in Africa

Timothy Kincaid
August 29th, 2012 | LINK

OH COME ON!!

If the article talks about PEPFAR specifically and then says “not a word has been breathed about HIV/AIDS”, it is ABSURD to mock me for posting the portion about PEPFAR.

That’s not “oh, well, sure.” That’s correcting an error in the reporting.

You really are letting your bias show on this one, Jim. Yes, it’s a bad platform. But to denigrate my correction is really inappropriate.

Randy Potts
August 29th, 2012 | LINK

I believe the error is corrected.

Timothy Kincaid
August 29th, 2012 | LINK

As now revised, it seems to say,

1. Bush was inspired to create PEPFAR
2. however the platform only mentions PEPFAR
3. so therefore Log Cabin should be criticized.”

I just don’t follow it.

However, I certainly agree with you that the “ignored other illness” part seems to be sour grapes from those who resent AIDS research.

Jim Burroway
August 29th, 2012 | LINK

I wasn’t denigrating your correction. You were correct. I was denigrating the only mention of HIV/AIDS in the entire platform.

Timothy Kincaid
August 29th, 2012 | LINK

Well, then, on that denigration we agree.

Jim Burroway
August 29th, 2012 | LINK

By the way, I had forgotten Mary Fisher’s address until Randy posted this. I remember watching it and being so incredibly impressed by her speech. By then, I had already decided to vote Democratic for the first time in my life, but she gave me pause. I was still very much in the “persuadable middle” category then. That was long before the GOP became so incredibly radicalized that I could never go back. But I was living in Texas then, and I could see the early signs of it — I lived in Dick Armey’s district — and was very alarmed by what I was seeing.

Fisher’s address was the only positive thing about that infamous Houston convention where Pat Buchanan introduced all of America to the term “culture war.” Thank God we had Molly Ivins to come to Buchanan’s defense: “It probably sounded better in the original German.” I do so miss her.

Timothy Kincaid
August 29th, 2012 | LINK

And that, kiddies, is how the authors squabble in public. :)

Randy Potts
August 29th, 2012 | LINK

I don’t see where the LCR are criticized, but I do see the progression confusion. What I inelegantly expressed was the progression from an outspoken Fisher who was well-received when calling for action on HIV/AIDS here in the US, then W.’s subsequent later for funds in Africa, to a party that, while keeping a reference to PEPFAR, subtly mocks the the monies spent on HIV/AIDS research here in the U.S. The LCR are the only branch of the Republican Party willing to discuss more resources for HIV/AIDS here in the US; at the same time, they dropped that discussion at the actual convention. It might be smart politics on their part, but it’s something that needed to be pointed out.

Randy Potts
August 29th, 2012 | LINK

Thanks for the squabble boys . . . my prose gets worse with every comment so I’ll quit while I’m, well, wherever I am.

Priya Lynn
August 29th, 2012 | LINK

I got what you were saying Randy.

Joe Beckmann
August 30th, 2012 | LINK

The real challenge will be whether the Democrats recognize their own achievement, and, most ironically, the achievement of Romney-the-Governor: The HIV epidemic has largely ended because of universal health care in key jurisdictions like Massachusetts, New York, and San Francisco.

In California they ARE reviewing the data, but in Massachusetts they are afraid to. The overall drop in “new cases” is over 50%, from 2003 to 2011, but the more significant drop in “new infections” they are afraid to assess, since that would affect the HIV service community, Ryan White funds, and would seriously undermine funding for many other services that no longer contribute (much) to the reduction of the epidemic.

The real drop is due to more people in treatment, safely funded by RomneyCare, and by precluding insurers from dropping their HIV+ customers. More in treatment means more no longer infectious means fewer, far fewer new infections.

Will the Democrats recognize their own achievement – since California is creatively anticipating ObamaCare and the model works – or will they hide it? We shall see.

Robert
August 30th, 2012 | LINK

Joe Beckman Said:
“The HIV epidemic has largely ended because of universal health care in key jurisdictions like Massachusetts, New York, and San Francisco.”

Seriously? Please provide ANY type of link to show that the HIV epidemic has “largely ended”. That is one of the most outrageous pieces of drivell I have seen in a VERY long time.

With over 42,000 new case of HIV (and a low estimate because a number of states-TEN-don’t report those numbers) and over 34,000 new cases of AIDS one can hardly state the Epidemic of HIV is largely “ended”.
San francisco, one of the cities you noted, has only reported a ten percent drop in new HIV infections, New York City has only reported a decrease of 25 percent,and MA reports an increase of cases by 35 percent.

So, again, where do you get the idea that the HIV Epidemic is largely ended?

Priya Lynn
August 30th, 2012 | LINK

Robert said “MA reports an increase of cases by 35 percent.”.

Did you mean to say a decrease of cases by 35 percent?

Robert
August 30th, 2012 | LINK

Priya Lynn, No, I mean INCREASE.

from the latest report from the State of MA on HIV in the state (2009 is the latest I could find):

http://www.mass.gov/eohhs/docs/dph/aids/2011-profiles/epidemic-glance.pdf

where it says: “From 2000 to 2009 the number of people living with HIV/AIDS has increased 35%.”

They do note a decrease among men, and an increase among women, and they show a slight decrease in 2008 but an increase in 2009 and an overall increase of 35 percent, if I read the report correctly.

Robert
August 30th, 2012 | LINK

There is also this article from the NYT that shows there are still at least 50,000 new cases each year, which is hardly an epidemic that is “largely ended”. I think it dangerous to claim an “end” to the epidemic, even with the descriptor “largely”.

http://www.nytimes.com/2011/08/04/health/04hiv.html

I am unsure of Mr. Beckman’s ethnicity, but the only group where the virus is lessened is the White catagory. So it is possible that in his category it has been largely reduced. It is increasing across the board for young black men, and latinos and women of colr.

Jim Burroway
August 30th, 2012 | LINK

Robert and Joe Beckmann are comparing apples to oranges. I think there is a degree of hyperbole over Beckmann’s claim that the epidemic has “ended,” but the link that Robert supplies supports what Beckmann said about new cases.

According to the report, “The number of annual HIV diagnoses reported decreased from 1,193 in 2000 to 619 in 2008.” That’s new cases, to John Beckmann’s point. That’s a 48% drop in new cases since 2000, and the falling rate has been most consistent since about 2004-2005.

But because there has continued to be new cases added to the system, and because the number of deaths has continued to fall during the same period and remains lower than the number of new cases each year (which is more good news, actually), the total number of people in Massachusetts with HIV has continued to increase, per Robert’s point.

But back to John Beckmann’s point here:

More in treatment means more no longer infectious means fewer, far fewer new infections.

I do think that this is correct, and there’s a pretty good mound of research that backs that up. People with undetectable viral loads are much, much less infectious than those who are not on HAART and have higher viral loads.

To really impact the rate of HIV transmission, the best new approach, I think, is to ensure universal access to HAART. I’m not saying that we should get away from condoms, water-based lube, and other safe-sex practices. But we’ve been stuck with that as our only weapon against HIV/AIDS for more than 25 years, and I think it’s time we finally recognize that there are limits to that as our only approach. It’s time to add more tools to our toolbox.

Universal access to HAART should be a no-brainer. Romneycare is one way to dramatically increase the availability of HAART to those who need it. It’s sad though that there has been no mention of this, or anything like it, or even anything remotely close to it, in the GOP platform. They’re tickled pink to talk about PEPFAR in Africa, but nothing for Americans at home.

Timothy Kincaid
August 30th, 2012 | LINK

“To really impact the rate of HIV transmission, the best new approach, I think, is to ensure universal access to HAART.”

I agree. It’s pretty obvious when you look at the numbers. I would also include a concerted effort to identify those who are unaware of their infection.

(That does not mean that I support health care which is administered by the government. That’s a different question.)

But it is essential that every person with HIV be able to have access to the HAART protocol. It’s a public health issue. It is the one method that appears to have the potential of eliminating HIV as an epidemic and perhaps even eventually eradicating the virus – much like polio have been virtually eradicated.

If Republican leadership had the ability to set aside their hostility to certain demographics, they could actually find a way to use this to their advantage.

If they had the balls to tell Tony Perkins to take a hike.

They don’t, of course.

Jim Burroway
August 30th, 2012 | LINK

By the way, in contrast to the “Massachusetts Miracle” (to borrow a phrase from a presidential campaign from a long time ago) where the number of new cases has dropped 48% since 2000, the number of new cases nationally has remained relatively flat and has actually gone up slightly over the same period. Massachusetts is definitely doing something right.

So is San Francisco:

http://www.sfdph.org/dph/files/reports/RptsHIVAIDS/AnnualReport2010_2.pdf

In 2000, there were 556 new AIDS cases. In 2008, to keep a consistent comparison with Massachusetts, there were 414 new cases, a 26% drop. Not as dramatic as Massachusetts, but in 2009, there were only 314 new cases, making for an astounding 25% drop in just one year. The CDC would kill to see those kinds of numbers nationwide.

What I find interesting is page 72 of the San Francisco report, where the Department of Health came up with an estimated average community viral load and compared it with the number of new cases. There is definitely a rough correlation.

Jim Burroway
August 30th, 2012 | LINK

(That does not mean that I support health care which is administered by the government. That’s a different question)

( Which is a good thing that neither Romneycare nor Obamacare do that. ;-) But yes, it is a different question. )

Timothy Kincaid
August 30th, 2012 | LINK

I suspect that when the 2010, 2011, and 2012 numbers are made available the drop will be even greater. It is my impression that the rate of undetectability is much much higher with each year.

With the availability of over the counter HIV tests and with the approval of a revised truvada based single drug, the next few years could be unrecognizable to anyone who came out after 1981

Robert
August 30th, 2012 | LINK

Jim, I’m not sure how my examples are an apples to oranges comparison. I reported the percentage off the decrease in HIV conversion. A 26 percent drop in San Francisco as the example, would mean that the HIV epidemic is far from “largely ended”. I saw the rest of his post detailing some drops in the percentage in some areas, but the national number is still relatively the same over the past few years. My “beef” so to speak is the issue of careless statments like “largely ended”. In many circles, talk like that is thought to increase the amount of new cases as it leads individuals to a belief that they have less to worry about. I have been active in outreach programs, and you’d be shocked, or not, at how many younger gays think they have less to worry about. Thus my umbrage with the term.

In regards to MASS, I believe I mentioned they had a drop up until 2008 but they have had an increase following that. Yes, it is decreaced from 2000, but it is worrisome that in 2009 it started an increase in cases again. Doesn’t that wipe out some of the loss prior?

And I agree that neither Romney Care, nor the Affordable Care Act is government run. If it were, Tim, we wouldn’t have a need to purchase Insurance through a Private NON-governmental for profit Insurance Company.

Priya Lynn
August 30th, 2012 | LINK

That’s the shortcoming of Romeny Care and the Affordable Care Act, they aren’t government run. The profit incentive encourages private companies to ration care by minimizing how much they spend on it. The profits people pay for in health care raise the cost over government run health care which only needs to cover costs rather than maximize profits. You poor, poor, Americans.

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