The 2012 International AIDS Conference has raised hopes that the U.S. will increase its efforts to end the epidemic both globally and here at home, where HIV/AIDS continues to pose a major health threat. Every 10 minutes someone in the U.S. is infected with HIV, and many people living with the virus don’t even know it. People of color, especially women and gay men, bear the overwhelming burden of the disease. We’re joined by Dazon Dixon Diallo, a pioneer in the HIV/AIDS and reproductive justice arena, and by Democratic Rep. Barbara Lee of California, a leader in the global fight against HIV/AIDS who has worked to establish a national AIDS strategy. Lee represents the United States on the U.N. Development Program’s Global Commission on HIV and the Law and recently introduced H.R. 6138, calling for a global strategy for an AIDS-free generation. "The Affordable Care Act has been a really important part of the success of getting people living with HIV, for whom many are diagnosed with pre-existing conditions, to protect them in health insurance coverage," says Diallo. “Most of the states, if not all of the states in the South, are already currently planning to not opt in on Medicaid expansion. And so, that directly speaks to the level of access to care and the coverage of medications that most people who have low income or live below the poverty level can actually afford." [includes rush transcript]
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NERMEEN SHAIKH: We return now to the 19th International AIDS Conference, underway in Washington, D.C. The event has raised hopes that the United States will increase its efforts to end the epidemic both globally and here at home, where AIDS continues to pose a major health threat. Every 10 minutes, someone in the U.S. is infected with HIV. Many people living with the virus don’t even know it. People of color, especially women and gay men, bear the overwhelming burden of the disease.
AMY GOODMAN: Meanwhile, studies show about half of Americans living with AIDS are in the South. According to a 2010 Human Rights Watch report, the region has the highest rate of new infections, the most AIDS deaths, and the largest number of adults and teens living with HIV/AIDS. The Southern epidemic also reflects a national trend that women of color account for 70 percent of new HIV infections among women.
We’re joined now by Dazon Dixon Diallo, a pioneer in the HIV/AIDS and reproductive justice arena. Diallo founded SisterLove in Atlanta, Georgia, in 1989, established a partner office in South Africa in 2001.
Dazon Dixon Diallo, we welcome you to Democracy Now! from Washington, D.C., where you’re attending the AIDS conference. Welcome. And tell us the message you’re bringing from the South. It may surprise many. You know, a third of the country’s population is in the South, but more than half of the new HIV/AIDS infections are occurring in the South of the United States.
DAZON DIXON DIALLO: Absolutely. And it’s such a pleasure to be with you this morning, Amy. Thank you.
Sure. My organization, SisterLove, we’ve arrived here at the International AIDS Conference with a delegation of about 15 women, half of whom are living with HIV both from the U.S. and from South Africa. And there are three things that we framed our purpose for coming to this conference. One is because in this international meeting, in the last 22 years that it hasn’t been held here in the U.S., women of color, poor people, people of color, in general, affected by HIV in the U.S. have been virtually invisible, because we don’t get to travel and attend a lot of these conferences in large numbers enough to represent the situation that’s going on in the U.S., particularly in the South. So that’s one of our first reasons.
And the second reason is to literally bring the voices of women of color in the South to say that we’ve been largely ignored at home domestically, despite the fact that we have largely disproportionate numbers of women at risk and women living with HIV, and we’re in conditions in the Southern region of the United States that actually mirror the experience of a lot of our counterparts and our sisters in the Global South. So we’re here to also exemplify the bridge between the Deep South and the Global South.
And thirdly, it is also to amplify the fact that the intersection of many issues of reproductive justice, including sexual and reproductive health and rights, the ending of violence against women, and increasing the access to education, prevention, treatment and care for women at risk for HIV and women living with HIV are all critically intersected issues, and that we take a human rights lens to those issues. And that’s what we’ve come here to make sure that message is finally heard loud and clear, that the rest of the world doesn’t see the U.S. as the shining panacea of how we get the HIV/AIDS story right, because we’re not. We’re behind in the rest of the world in intersecting these issues for women so that we can advance the strategies that are working in other areas and other regions, and also to share what we’re trying to succeed with in the South.
NERMEEN SHAIKH: We’re also joined by Democratic Congresswoman Barbara Lee of California. She’s been a leader in the global fight against HIV/AIDS and has worked to establish a national AIDS strategy. She is the U.S. representative on the U.N. Development Program’s Global Commission on HIV and the Law. Last week she introduced H.R. 6138, calling for a global strategy for an AIDS-free generation.
AMY GOODMAN: Congressmember Barbara Lee, welcome to Democracy Now! Explain what this legislation is all about.
REP. BARBARA LEE: Sure. This is the next step in our global response, which means, of course, we’ve included the domestic issues and epidemic, as well as international. And, in fact, one of the reasons we really wanted to have the conference here—and I want to thank SisterLove and all of the wonderful activists who helped me lift this travel ban—because it’s so important that the voices of African Americans and people of color and women of color in our own country be put now on the international stage and put front and center in a response. And so, my legislation really puts this in context. It moves forward and says we have to remove stigma as it relates to men who have sex with men, as it relates to injecting drug users, as it relates to sex workers, that we have to have comprehensive sex education, that we have to address marginalized communities and vulnerable communities with targeted resources. I mean, that’s the next step both here at home and abroad.
NERMEEN SHAIKH: Congresswoman Lee, could you elaborate on the racial dimensions of HIV/AIDS infections here in the U.S.? There are over a million Americans living with the virus, and they are disproportionately African American.
REP. BARBARA LEE: Yes, and that’s really tragic, because we’re seeing the same disparities here as we see everywhere in the world, and, in fact, it’s a continuation of racial and ethnic injustice. When you look at the fact that African Americans, for example, account for approximately 14 percent of the population, while over 50 percent of the infections are African Americans, when you look at the fact that African-American women constitute about two-thirds of the new infections, you know, when you look at the South and what is taking place in Southern states, you’re looking at huge, huge disparities. And so, if we’re going to address this, we’re going to have to have a comprehensive strategy that recognizes that racial disparities exist and then target resources toward that, because, if not, we’ll never see an AIDS-free generation. But I think we’re at a turning point, we’re at a tipping point, and I think we can do it, because now, thank goodness, again, this conference is here in our own country, and we’re raising these issues over and over and over again throughout the conference, and hopefully my legislation will move forward, and we have to build support for that kind of a comprehensive bill.
AMY GOODMAN: Congressmember Lee, I want to play a comment from Phill Wilson of the Black AIDS Institute, speaking Monday about access to treatment for HIV-positive Americans.
PHILL WILSON: Bottom line, in the richest nation on the planet, barely a quarter of the people with HIV are in fully effective treatment. More than 70 percent are either not on treatment at all, or on suboptimal treatment. That’s bad for them, and it’s bad for everyone else, because when they are not on treatment, they are much, much more likely to spread the virus.
AMY GOODMAN: Phill Wilson of the Black AIDS Institute addressing the 19th International AIDS Conference in Washington, D.C. Your response, Congressmember Lee?
REP. BARBARA LEE: Phill is absolutely right. And he is, quite frankly, a warrior in this struggle. And let me tell you, there have been waiting lists in a variety of states for people who need treatment, who need access to these antiretroviral drugs, who have not heretofore had that access. The Affordable Care Act finally included provisions where now people will be part of this new healthcare system. But also we’ve been working to try to make sure that the resources are there to eliminate these long waiting lists for treatment. And so, my bill, of course, calls for the elimination of the waiting list and to fund everyone who—whether they have money or not, access to drugs. I mean, that’s just basic in order to live a long and healthy life. But also, I’m very pleased that the Obama administration has come forward and developed a national HIV/AIDS strategy and come forward to put some resources into these areas of our country where in fact these waiting lists should now begin to be reduced and eliminated. We have to do that, Amy. We have to do it.
NERMEEN SHAIKH: Congressmember Lee, could you talk about another piece of legislation you introduced last year, H.R. 3053, the Repeal HIV Discrimination Act?
REP. BARBARA LEE: Well, let me say, I’m—you know, I’m part of the United Nations Global Commission on HIV and the Law. And one of the issues we looked at around the world—and I was so delighted—we came to Oakland, California, in this country, to look at what was taking place in America. We have 34 states and two territories which have discriminatory laws on the books which were developed way back in the early '80s. They're archaic. They criminalize people who have the virus and subject to prosecution. We have one individual, I believe in Texas, who’s in prison, got a 35-year sentence because he spat on a police officer—didn’t even have the virus. And so, there’s some—there’s some laws on these books that have to be repealed.
What my legislation does is require the Department of Justice to put resources into helping these states, because the federal government cannot repeal these laws. But what we can do, through my legislation, is help, state by state, get these laws off of the books so people can come forward, because, you know, when you have fear and stigma and discrimination, people aren’t going to come forward and get tested. They’re not going to disclose their status. They’re in the shadows, and we want people to come out and to realize that, once treated, once tested and treated, they can live long and healthy lives.
AMY GOODMAN: We’re talking to California Congressmember Barbara Lee and Dazon Dixon Diallo, a pioneer in women’s HIV/AIDS and reproductive justice, founder of SisterLove in Atlanta, Georgia. Dazon, I wanted to ask you about the Supreme Court decision on the Affordable Care Act and what it means for people living with HIV/AIDS?
DAZON DIXON DIALLO: Yes, thank you, Amy. I also wanted to just follow up with what Congresswoman Lee was talking about with criminalization and how it’s also tied directly to your conversation with the sisters from New Zealand and India, in that right now we have an opportunity with testing and getting people treated. Criminalization of people living with HIV is also counterproductive to helping us get to zero.
And in addition to that, the Affordable Care Act has been a really important part of the success of getting people living with HIV, for whom many are diagnosed with pre-existing conditions, to protect them in health insurance coverage, and the expansion of Medicaid would actually include a lot of people living with HIV who are currently living and getting their treatment and care through the Ryan White Care Act, which expires actually in 2013. And so we have to look at what Ryan White Care has done as a primary care and last payer of resort for the poorest Americans who are affected with HIV and how they’re going to be included in the Affordable Care Act.
And while we’re appreciative that there are so many things especially for women, such as the preventive services around HIV and sexually transmitted infections and contraception and family planning and as well as violence prevention and counseling, that at the same time we have now, with the Supreme Court decision, given states the opportunity to opt out of that expansion, which still might exclude 17 million Americans. And the problem with that, as you were mentioning and talking about the problems in the South, is that most of the states, if not all of the states in the South, are already currently planning to not opt in on Medicaid expansion. And so, that directly speaks to the level of access to care and the coverage of medications that most people who have low income or live below the poverty level can actually afford.
And so, it shows to us that we still have a lot of work to go through or to do to make sure that the Affordable Care Act is implemented in full. It also speaks to the need why having a healthcare law that is still decided, at this point after the Supreme Court, now state by state and not universally applied across the country, is that we also won’t have a universal opportunity to curb the tide on HIV, on the spread of HIV, and that speaks back to Phill Wilson’s message, is if we can’t get people into treatment, if we can’t get them into care, then we also are losing the battle in preventing the transmission.
NERMEEN SHAIKH: Congressmember Lee, I’d like you to comment on what Dazon said. In Washington, D.C., where you are, the prevalence of HIV is higher than in the Congo, Ethiopia, Nigeria or Rwanda. And even though HIV infection rates have fallen in 33 countries, in the U.S. the rate of HIV infections, 50,000 a year, have remained stable since the 1990s. Can you say a little about why that might be the case and whether the Affordable Care Act might improve those statistics?
REP. BARBARA LEE: Well, as Dazon said, we have a lot of work to do. First of all, you know, there’s a needle exchange ban. That’s outrageous. That should have never happened, because so many injecting drug users need to have clean needles, and they need to be able to get the counseling and the assistance to help transition off of drug use.
You know, secondly, men who have sex with men. People have not allowed for forthright programs funding, you know, initiatives that would really address marginalized individuals, people who really need to be included in all of our strategies. There’s been stigma and discrimination in our whole system. And that’s part of what we are trying to do at this conference.
And I have to say, you know these states that are opting out of the Medicaid provisions? Elections have consequences. And I’ve been urging, you know, for 20 years for people who are involved in the movement, AIDS activists—political action is extremely important, because we have to hold these governors and these states accountable. They cannot just allow people to fall by the wayside. We have a federal law, an Affordable Care Act. States should be pleased that they’re going to get the resources to be able to begin to turn this around. And here we have states now opting out. And so, if there’s any message that I want to leave with our domestic activists and our people who are here at the conference, is go back to your states and hold these elected officials accountable. Register to vote, and get involved in these elections, because this is unconscionable what is taking place now.
AMY GOODMAN: I want to play a bit more of Phill Wilson of the Black AIDS Institute addressing the International AIDS Conference in Washington, D.C., Monday.
PHILL WILSON: Everyone living with HIV must come out. We all must come out. Living openly and proudly with HIV not only confronts HIV stigma, but it also helps build demand for essential services. Openly HIV-positive people serve as living, compelling reminders of the importance of knowing one’s HIV status. And that is that—and that it also communicates that it’s possible to live a full, healthy life with HIV, and that’s important. When you come out about your HIV status, you not only save your life, but you save other lives, as well.
AMY GOODMAN: That’s Phill Wilson of the Black AIDS Institute. Dazon, I wanted to bring us back to the South and the growing HIV infection rate of gay black men in the South and the significance of this and what is being done about it.
DAZON DIXON DIALLO: Absolutely. And I just have to say, Phill is also one of my heroes. He’s an absolute warrior. And being in this movement with people like Phill Wilson, who have just stood on the front line for people living with HIV, as a gay black man living with HIV, has been amazing in terms of helping us mobilize in our different regions. We work in partnership with the Black Treatment Advocates Network for that very purpose. And we also produce our own video work to make sure that women who are facing stigma and shame in disclosure are able to have outlets to do exactly what Phill was talking about.
I think what’s challenging for us in the South, of course, is that the stigma around HIV is not just the virus itself for young, gay black men, but it’s the sexual stigma in a very conservative region of the country, in an area where coming out even about your sexuality is very, very difficult, if possible at all, especially in more rural areas. What we have lacked over time is the inclusion of education in our schools, of comprehensive prevention, interventions for young gay men of color and young men who have sex with men. We don’t have support systems for these young men. Their families are often not educated or aware or informed enough to give them the support that they need to practice safer behaviors. And so, we’re really looking at what new interventions or what homegrown interventions around the South have been developed and are successful.
AMY GOODMAN: We have to leave it there. Dazon Dixon Diallo and Congressmember Barbara Lee, thanks so much for being with us.
DAZON DIXON DIALLO: Thank you, Amy.
AMY GOODMAN: And I remember fondly Dr. Mike Alcalay, who lived with AIDS for 20 years. We co-hosted the Sixth International Conference on AIDS in San Francisco.