HIV

There are approximately 33 million people living with HIV worldwide, and there were 2.5 million new infections in 2007. Access to life-saving medications is often not available to those most effected by the disease, and there is still no cure for HIV disease.

This World AIDS Day Lambda Legal called on all sectors of society — including private businesses, civil society organizations, individuals and governments — to become leaders in the fight against the AIDS epidemic. Help us fight the stigma and discrimination faced by people living with HIV around the world.

The United States continues to have one of the world's largest populations of people living with HIV and the epidemic continues to have an overwhelming impact on gay men, including a disproportionate impact on black gay men. Despite important advances in medical treatment for people living with HIV, not everyone — even in the United States — is able to obtain HIV medications and needed treatment. And people living with HIV, whether receiving medical care or not, continue to face stigma and discrimination in employment, health care, insurance, immigration, parenting and other areas of life.

Lambda Legal recently called on the leaders of our nation's LGBT organizations to join in placing an aggressive response to the HIV epidemic at the center of their agendas. The theme of this year's World AIDS Day, is "Stop AIDS: Keep the Promise — Leadership." Since the earliest years of the epidemic, Lambda Legal has taken a leading role in the courts and the court of public opinion on behalf of people with HIV. This World AIDS Day we affirm our commitment to provide leadership — not only in stopping the epidemic, but also in ending the stigmatization and discrimination against those living with HIV.

This year on National Black HIV/AIDS Awareness Day (February 7), Lambda Legal continues to examine the Centers for Disease Control and Prevention’s revised recommendations for expanded HIV testing. Scott Schoettes, Lambda Legal’s HIV Project Staff Attorney, will join a lineup of HIV and health care professionals at Morris Brown College in Atlanta to discuss the new regulations and the impact they could have on Black communities.

In 2006, the CDC revised its HIV testing guidelines for all health-care providers in the public and private sectors. The agency now recommends that the nation’s health care providers test all individuals between the ages of 13 to 64 on an “opt-out” basis, regardless of identified risk factors.

Lambda Legal and approximately 70 community-based organizations have questioned these requirements. Among many concerns is the abandonment of specific, informed consent for HIV testing, the lack of clear recommendations for pre-test counseling and the recommended routine testing of vulnerable populations (undocumented immigrants, prison inmates, etc.) without specific safeguards.

In response to the CDC’s revised guidelines, Lambda Legal has helped develop 15 Fundamental Principles to Guide Implementation. Grounded in sound medical and public health science, the principles should be followed by public and private decision makers as they implement expanded HIV testing services. Among other things, the principles state that HIV testing must always be informed, voluntary, confidential, offered by someone trustworthy, accompanied by counseling and supported by health care and other services.

"HIV/AIDS in the Black Community: Testing, Discrimination and Stigma" is Thursday, February 7, 2008 3pm — 5pm, at Morris Brown College

In letters sent to Rep. Nancy Pelosi, Speaker of the House, and Rep. John Boehner, House Republican Leader, Lambda Legal urged the House of Representatives to pass H.R. 3195, a bill that would clarify the definition of what qualifies as a disability.

"This bill makes it clear that people with HIV are protected from being discriminated against because they have HIV, consistent with the purposes of the ADA," says Bebe Anderson, HIV Project Director at Lambda Legal.

According to Anderson, "the Supreme Court and lower courts have narrowed the definition of disability," and in doing so "have limited the protections that the ADA provides." So this bill is welcome news for people with HIV and others with disabilities.

On June 18, 2008, the bill was approved unanimously by the House Judiciary Committee and by a 43 to 1 vote by the House Committee on Education and Labor. A floor vote in the House is expected soon.

Did you know that an estimated 1 in 4 people with HIV do not know that they have HIV? This is one of the many reasons for National HIV Testing Day, on June 27.

The CDC is currently recommending that the nation's healthcare providers offer HIV testing to all individuals from the ages of 13 to 64, without regard to identified risk factors. While this testing may reveal the HIV status of more people, it fails to educate test takers about HIV transmission or provide care to those who test positive.

In response to this Lambda Legal, working with other HIV legal, medical and service providers including the AIDS Foundation of Chicago and the Center for HIV Law and Policy, launched a set of guiding principles to highlight the fundamentals of effective HIV testing. The guidelines emphasize that testing must be informed, voluntary, confidential and pay attention to the continuing health needs of people with HIV and give respect for the civil and human rights of patients. "We cannot lose sight of the people who will be tested," said Bebe J. Anderson, HIV Project Director of Lambda Legal.  "Respect for the civil and human rights of patients must be at the heart of successful efforts to increase testing."

The General Public Lacks Basic Information About HIV Transmission

Far too many people still lack basic knowledge about how HIV is and is not transmitted. According to a 2006 national survey conducted by Kaiser Family Foundation:

• 37 percent mistakenly believed that HIV could be transmitted through kissing.
• 22 percent mistakenly believed that transmission could occur through sharing a drinking glass.
• 16 percent mistakenly believed that transmission could occur through touching a toilet seat.
• And more than 4 in 10 adults held at least one of the above misconceptions about HIV transmission.

Find out more about the importance of HIV testing and how to break down barriers to it in the joint publication from Lambda Legal and the ACLU, "Increasing Access to Voluntary HIV Testing: The Continuing Relevance of Stigma and Discrimination."

The Foreign Service will no longer automatically reject job candidates based on their HIV status but will instead assess each on a case-by-case basis — as the federal Rehabilitation Act requires.

Lambda Legal has represented Lorenzo Taylor since 2003 in his fight against the State Department for denying him employment because he is HIV-positive. Taylor, who speaks three languages and holds a degree from Georgetown University's Walsh School of Foreign Service, received a conditional offer of employment after passing the rigorous application process required to be a Foreign Service Officer.

The offer was retracted because he has HIV. Lorenzo Taylor was denied medical clearance even though he has never had any HIV related illness and his medication had completely suppressed the virus in his system.

This case challenged a federal policy of bias and discrimination. It barred the door not just for Taylor, but for all people living with HIV, limiting their opportunities for government service based on outdated notions about the ability of people living with HIV to work.

Lorenzo Taylor
Lambda Legal Client
“I wanted to serve my country as a Foreign Service Officer, but was told, ‘Sorry we don’t need your kind,’" Lorenzo says. "Now people like me who apply to the Foreign Service will not have to go through what I did. They and others with HIV will know that they do not have to surrender to stigma, ignorance, fear, or the efforts of anyone, even the federal government, to impose second-class citizenship on them. They can fight back.”

Case History

• September 2003 Lambda Legal files lawsuit in federal court arguing that the STATE Department illegally prohibits anyone with HIV from being hired as a Foreign Service Officer, regardless of applicant’s qualifications or health status.
• April 2005 Federal district court rules in favor of the state Department, saying that the government should not have to accommodate Taylor by letting him use some of his sick and vacation leave, available to all Foreign Service Officers, to travel to see his doctor.
• June 2005 Lambda Legal files an appeal To ask a higher court to reverse the decision of a trial court with the U.S. Court of Appeals for the District of Columbia.
• April 2006 Lambda Legal presents oral arguments in the case.
• June 2006 U.S. Court of Appeals for the District of Columbia issues decision stating that Taylor presented "more than enough" evidence for the matter to go to trial.
• February 2008 Less than two weeks before our trial date, the U.S State Department adopts new hiring guidelines and lifts its ban against hiring people with HIV as Foreign Service Officers.
  

If you are HIV-positive and want to enter the United States on a short-term visa, make sure to plan your trip far in advance. The Department of Homeland Security has proposed additional rules that force those living with HIV to overcome serious obstacles before visiting the U.S. — which include unfair restrictions on them once they're here. Lambda Legal opposes these discriminatory and misguided regulations.

Based on outdated ideas regarding HIV/AIDS treatment and transmission, there is currently a ban on admission into the U.S. of people living with HIV. Some travelers are able to qualify for a waiver of the bar against admission, but that is a difficult and lengthy process. Last year, President Bush called for new rules that would make it possible for more people to get a waiver. But instead DHS has proposed an extremely burdensome process that would require an individualized, detailed, case-by-case assessment of every applicant's medical condition, treatment regimen, HIV counseling and financial assets before allowing entry.

The suggested regulations continue the stigmatizing discrimination against people living with HIV, create greater barriers to their entry into the U.S. and significantly curtail their legal rights once here. In fact, the proposed application would force applicants to waive all rights to change their visa status once in the U.S. — which would prevent them from requesting to stay longer, applying for a work visa while in the U.S., or obtaining U.S. citizenship down the road if they qualify for political asylum.

The U.S. is only one of 13 countries, including Sudan, Saudi Arabia and China, that bars people with HIV from entering the country. Lambda Legal has urged DHS not to adopt the proposed regulations and, instead, to revise them significantly to allow more people living with HIV to visit the United States — and to do so without waiving important rights.

When Gay Men's Health Crisis (GMHC) opened its doors 25 years ago, gay men were dying at alarming rates from what in a few months would be known worldwide as Acquired Immune Deficiency Syndrome, or AIDS. It was a devastating time for our community, and we were fortunate to have an organization respond so quickly with information, support and advocacy for all of us who were being increasingly affected by the disease.

As someone who lived through those terrifying early years, I remember the leading role GMHC took in our communities on behalf of people with HIV. I was proud to collaborate with the organization when I came on board as executive director of Lambda Legal 15 years ago and am now proud to honor GMHC for its quarter century of service to our communities next month at Lambda Legal's 2007 Liberty Awards ceremony in New York City. 

Lambda Legal's work on behalf of people living with HIV predates my tenure with the organization. We won the first HIV discrimination lawsuit in the nation, and early on we helped force hospitals to treat people with HIV. We also played a key role in major U.S. Supreme Court cases interpreting the Americans with Disabilities Act, which protects people with HIV from discrimination.

Thanks to HIV testing, antiretroviral drugs, better HIV prevention and education services and stronger laws, life today can be better for people living with and affected by HIV. But I fear these advances may have made us a bit complacent — and prematurely at that. In its third decade, HIV continues to have devastating effects nationwide, not to mention the numerous other places around the world that have been ravaged by the epidemic.

Among people living with HIV in the United States, more than 45 percent are men who have sex with men, and the disease is having a particularly serious impact on black gay men and young communities of color. Despite the availability of treatments, an estimated 500,000 people with HIV in this country are not in regular care, primarily because they lack health insurance. And while there are some confidentiality protections and antidiscrimination laws, LGBT people and others affected by HIV continue to face discrimination in the workplace, denial of health care and other services, barriers to parenting and reproductive health and violation of privacy rights, among other things.

At Lambda Legal we continue to address these difficulties through litigation — our current case challenging the U.S. State Department's ban on Foreign Service applicants with HIV, for example. We also do a great deal of policy advocacy, closely aligned as always with service organizations like GMHC. Right now, for instance, we are working with a number of national and local HIV and health organizations to make sure the new testing guidelines issued by the Centers for Disease Control and Prevention don't violate people's confidentiality or curtail access to important counseling services.

Over the years we've seen how homophobia remains a serious barrier to HIV prevention and treatment, sound public policy and antidiscrimination efforts. We've also learned that discrimination against people with HIV undermines the rights of all LGBT people. In other words, we are all living with and affected by HIV, and we need to come together once more to combat the crushing effects of this disease.

Which brings me to another important anniversary this spring: the 20th anniversary of ACT UP (AIDS Coalition to Unleash Power). While most of the organization has been quiet for more than a decade, founder Larry Kramer revived it a couple of weeks ago with protests in New York and San Francisco. On Wall Street — the site of ACT UP's first demonstration in 1987 — people shouted "Heath care for all!" They demanded lower drug costs and expansion of services for people with HIV. There was even a "die-in," where people lay down amid body bags and some were arrested.

It's great to see the fighting spirit and anger of the eighties coming alive again. What's tragic is that the fight itself feels all too familiar.

*Kevin Cathcart is a featured monthly columnist for 365Gay.com.

Read Kevin's previous columns:

March 2007: The ABC's of Discrimination

Reverend Dr. Robert Franke, a 75-year-old retired university provost and Unitarian minister, relocated to Little Rock to be closer to his daughter, Sara Franke Bowling. Franke moved into Fox Ridge of North Little Rock, an assisted living facility, after fulfilling all residency requirements — including submitting medical evaluation forms from a local physician.

But the day after Franke moved in, Fox Ridge officials forced him from the facility when they learned he has HIV, despite the fact that he requires no special medical attention beyond daily medication and regular check-ups with a physician. A Fox Ridge staffer went so far as to tell Bowling that her father's personal effects could stay, but that the "body" had to be out by the end of the day.

Lambda Legal filed suit in U.S. District Court for the Eastern District of Arkansas against Fox Ridge, on behalf of Franke and Bowling. We seek damages for our clients under the Fair Housing Act, the Arkansas Civil Rights Act and the Arkansas Fair Housing Act and, by seeking intervention from the court, intend to prevent Fox Ridge from continuing to engage in this kind of discriminatory conduct. "I was stunned," says Bowling. "The people at Fox Ridge were supposed to make sure that he was comfortable and cared for, and instead they shunned and rejected him, making him feel like a complete outcast."

Fox Ridge is licensed by the state to provide Dr. Franke with the kind of assistance he and his daughter were seeking for him. "This isn't about money to me," says Franke. "I want to make sure something like this doesn't happen to anyone else — because no one should ever be made to feel the way I did."

The case is Franke v. Parkstone Living Center, Inc.