The Weekly Updates

This Week in Washington
1. AIDS Action Takes HIV Awareness to the March for Women’s Lives
On Sunday, April 25, a team of AIDS Action staff members joined the up to 1.15 million people who participated in the March for Women’s Lives, an event organized to support women’s sexual health in general and their reproductive choice in particular—issues that, though often overlooked, are essential for policy-makers to consider when developing strategies for researching, preventing, and treating sexually transmitted infections, including HIV.

According to the Centers for Disease Control and Prevention, women accounted for 30% of the estimated new HIV infections in 2001. Women also represent an increasing share of new AIDS cases. While women accounted for only 7% of new AIDS cases in 1986, they accounted for 26% in 2001.

“For many women, HIV prevention, testing, and treatment take place in the context of their general reproductive and sexual health care. It therefore is critical that we partner with projects like the March for Women's Lives in an effort to educate and inform all women about HIV,” stated AIDS Action Government Affairs Associate Jessica Tytel, who served as team lead for the March. She continued, “Yet, despite the availability of many HIV related services at family planning and reproductive health care clinics, many women still are not getting the information they need to make informed choices about HIV and their sexual health.

“The lack of education and awareness, combined with a host of competing priorities—such as caring for children and sick or aging relatives, and a lack of health insurance—means that women tend to be diagnosed with HIV at a later stage than men, and such delays mean that HIV positive women do not always begin HIV treatment as early as recommended.” Ms. Tytel further noted. “Clearly, there is a need to identify more opportunities to reach women with messages about the importance of early HIV diagnosis and treatment, as well as effective HIV prevention. And the March for Women’s Lives was such an opportunity.”

To view photos from the March for Women’s lives, link to http://www.aidsaction.org.

2. AIDS Action Executive Director Speaks on Women and the U.S. Global AIDS Strategy
On Friday, April 23, the International Working Group of the March for Women’s Lives held a workshop, Globalizing Radical Agendas: The Impact of U.S. on the policies on women’s reproductive rights in conjunction with the weekend’s March. As the second of two panels in the workshop, The U.S. Global AIDS Strategy featured Jodi Jacobson from Center for Health and Gender Equity (CHANGE); Pauline Muchina from Population Services International (PSI); Dazon Dixon from Sister Love; and Dr. Marsha Martin from AIDS Action.

Jodi Jacobson opened the panel with worldwide statistics on HIV infections in women. She explained that there has been an increase in HIV infection rates for girls and women, and sex with men is the leading mode of transmission for women. In commenting further on the rising infection rates in women, Ms. Jacobson noted that “there is no difference between sex to get pregnant and sex to get HIV.” Therefore, it is important that any policies regarding HIV in women take into account the larger issue of general reproductive health.

Turning to a discussion of Bush Administration policies, Ms. Jacobson commented that the “sound bites” from the Administration are good, but the “follow through” has not measured up. Some of the points of concern raised by Ms. Jacobson revolve around the legislation authorizing the President’s global AIDS initiative (PEPFAR – the President’s Emergency Plan for AIDS Relief). PEPFAR includes language barring U.S.-funded organizations from any HIV prevention work with sex workers and includes language which ensures that, beginning in 2006, 20% of PEPFAR’s prevention funding will go to abstinence-only programs. What’s more, there is no mention of female condoms in the legislation, nor is there any intervention targeted at the large number of married women who are contracting HIV even though they are following the PEPFAR prevention guideline “be faithful in marriage.” Ms. Jacobson also raised a note of concern about a question that remains unanswered in the legislation: Will HIV positive women who get treatment to prevent mother-to-child transmission of HIV have the option of receiving family planning and reproductive health information to prevent further pregnancies?

Jacobson was followed by Pauline Muchina, who is from Kenya. Ms. Muchina spoke about African faith-based organizations’ long history of involvement in the care and treatment of people living with HIV and AIDS. Ms. Muchina reminded the audience that faith-based organizations are not a homogenous group; there are many differences in their respective beliefs and practices. However, she noted one similarity: most faith-based organizations have large numbers of women within their membership. In addition, many faith-based organizations have a significant impact on people’s lives since they typically see their congregations at least once a week. Thus, they have been a tremendous resource in addressing the HIV epidemic in Africa,–a role which, Ms. Muchina asserts, can and should be expanded. She concluded by emphasizing that faith-based organizations want to do more to help their communities, but they will need additional training if they are to deliver the most effective HIV prevention, treatment, and care possible.

Dazon Dixon spoke next, sharing some of the challenges small community-based organizations face here in the U.S. when they receive a large portion of their budget from federal agencies. Ms. Dixon confided that she must exercise discretion in her selection of meetings to attend and program issues to discuss, since half of her organization’s budget is from the Centers for Disease Control and Prevention (CDC) and could be threatened if her work does not meet this federal agency’s specific guidelines. In addition, Ms. Dixon- noted that she must continually revise her programs to keep up with changes in the federal government’s funding priorities. These revisions are challenging because so few U.S. models have been designed for women and communities of color; consequently, she must look outside the U.S. to find relevant program models for her clients who are African American women. Ms. Dixon concluded by urging the women’s movement to build strategic alliances worldwide to ensure that more women are included in clinical trials, have access to more programs and organizations targeted specifically to women’s needs, and share best practices.

The last speaker on this panel was Dr. Marsha Martin. Dr. Martin began by sharing some of her experiences working with former Secretary of the Department of Health and Human Services (DHHS) Donna Shalala. According to Dr. Martin, reproductive health was not a priority for DHHS prior to Secretary Shalala’s tenure.

Dr. Martin then went on to share select points from an article on women and HIV, written in December 1990. The article noted that when it comes to HIV, women face “triple jeopardy”: 1) women themselves may become HIV positive; 2) a pregnant women may transfer the virus to her unborn child; and 3) women are usually the main caretakers in their families; so, when they fall ill, there often is no one to care of them. Her objective was to show how little has changed for women in 14 years. Fourteen years later, advocates are still facing these same concerns both domestically and internationally. Further, women are not being researched, tested, treated, targeted for outreach, or even identified as being at risk for HIV infection, except in the context of mother-to-child transmission.

Dr. Martin stated that in order to have a “real conversation” about women and HIV in the U.S., “We must change the HIV risk categories to fit women in the equation.” Currently, the behaviors that place women at risk for HIV are not clearly conveyed in the CDC’s categories. Yet data have demonstrated that women are at higher risk for HIV infection than men. Despite this greater risk, the CDC categories do not help women to recognize that they may be at risk and why they are at risk. Dr. Martin believes that the CDC must revise its categories so that people in general, and women in particular, can more appropriately understand what behaviors place them at risk.

She continued by stressing that advocates must not walk away from the abstinence question. She polled the parents in the audience and by asking them how them if they think it is okay for their 12 to16 year-old children to engage in sexual behavior. She then pointed out that no one in the audience seemed to be in favor of the idea. Dr. Martin then added that this question must be considered in abstinence conversation. Although abstinence is not appropriate for everyone, abstinence messages can and should be embraced by young people. Dr. Martin concluded her remarks by saying that advocates “must embark on a critical analysis of where we are in the HIV epidemic in our work for women” and build a strategy based on that analysis. Her closing comment placed this challenge in an optimistic context: “We are not winning,” she said, “but we can.”

3. Coalition for Health Funding Gets Budget Update
AIDS Action staff joined other health advocates at a monthly membership meeting, on Monday, April 25, of the Coalition for Health Funding (CHF)—a coalition of almost 50 organizations that advocates for increases in discretionary health spending in the federal budget and appropriations. This month’s meeting featured two presentations on the fiscal year (FY) 2005 appropriations process: one by Rob Nabors, the Minority Chief of Staff for the House Appropriations Committee, and the other by David Reich, the lead Minority staff person for health programs for the Labor, Health and Human Services, and Education (Labor-H) Subcommittee of the House Appropriations Committee.

Mr. Nabors began the meeting with a discussion of the budget resolution (i.e., the annual decision made by Congress to set spending and revenue levels, providing a voluntary framework within which Congress agrees to limit subsequent money bills). He informed CHF members that the budget resolution will likely go to the House floor for a vote next week, despite many Members concerns over its low allocation levels overall. Mr. Nabors said it is likely that total discretionary funding (i.e., optional funding that is determined each year by Congress) for FY 2005 will be 3% less than FY 2004. As a result, Mr. Nabors explained, setting funding levels for discretionary programs will be akin to “rearranging deck chairs on the Titanic” because there is too little money for too great a need.

According to Mr. Reich, the Labor-H appropriations bill—which is used to fund the majority of discretionary federal health programs that serve HIV positive people—is at particular risk; thus, it is likely that Labor-H programs in FY 2005 will face funding challenges similar to those they have faced this current fiscal year.

As it stands, the bill contains a 1.6% overall increase for health programs; but even that modest increase is questionable because it fails to take into account other factors that will drive down total funding for the bill. These factors include offsets in the President’s budget, an administrative cut, evaluation taps (money that is set aside from program budget and used to fund evaluation and measurement of program outcomes), and a possible across-the-board funding cut, similar to the one enacted last year for all discretionary programs except defense and homeland security.

The current funding picture, combined with a Congressional year that is unusually short due to the November election, makes it increasingly likely that the Labor-H appropriations bill will be folded into a larger omnibus appropriations package. The shortened calendar gives Members of Congress significantly less time to work on the bill. Further, Members of Congress are unlikely to vote on the bill as separate legislation because it is so under-funded and may instead pass it as part of a larger package. Both Nabors and Reich agree that movement on the Labor-H bill is unlikely before the November election, and the fate of the appropriations process for Labor-H programs may depend on the election’s outcome. Regardless of which candidates prevail in November, a long-term continuing resolution (a bill which allows the federal government to remain open in the new fiscal year without a budget by continuing to fund programs and agencies at the previous fiscal year’s level) is likely, since Congress will miss its October 1 deadline for passing the appropriations bills.

The only funding areas in which Congress is likely to make progress before the summer recess are the appropriations bills for Defense, Homeland Security, and Military Construction. These bills may pass individually and then be sent to the President for signature before the beginning of FY 2005 on October 1, 2004. In addition, Nabors believes that Congress may consider a supplemental funding bill before the election. This bill would be used to fund the war in Iraq and would contain $50-60 billion in funding. The exact form, timing and amount of the supplemental will of course impact all of the other appropriations bills, including
Labor-H.

Both Nabors and Reich strongly encouraged CHF members to continue to advocate for their respective programs. They believe that the current Congressional majority will continue to cut funding for critical health programs until there is substantial public outcry against the funding shortfalls. Members are most likely to take action when they hear from their constituents, and until that time they will continue to assume that their actions meet with public approval. Advocacy groups therefore must hold Members of Congress accountable for their votes, especially those who say they support health programs yet vote in favor of budget resolutions and appropriations packages that severely under fund these initiatives.

AIDS Action encourages our members to contact their Members of Congress and let them know how the funding levels proposed in the President’s budget will impact their programs. For information on contacting your Representative and Senators, visit AIDS Action’s Legislative Action Center at http://capwiz.com/aac/home/.

4. Labor-HHS Subcommittee Holds Hearing on Global Diseases
On Wednesday, April 28, the Labor-HHS-Education (Labor-H) Subcommittee of the House Appropriations Committee held a hearing to discuss the current state of global diseases and the U.S. response to them. Testifying at the hearing were Dr. Julie Gerberding, director of the Centers for Disease Control and Prevention (CDC) and Dr. Anthony Fauci, director of the National Institute of Allergy and Infection Diseases (NIAID) at the National Institutes of Health (NIH).

Following initial remarks made by Chairman Regula, Dr. Gerberding gave her testimony. Gerberding’s prepared comments did not discuss HIV in a significant way; rather, she focused on the challenges faced by the CDC in our global society and the agency’s response to these challenges. She cited “globalization, connectivity, and speed” as the major obstacles to the CDC. As evidenced by the SARS (Severe Acute Respiratory Syndrome) outbreak, the spread of disease is greatly enabled by our ability to quickly travel from one country and/or region to another.

Covering the CDC’s response to these challenges, Gerberding reviewed two high-profile programs under development: BioSense and e-CDC. BioSense “is a state-of-the-art, multi-jurisdictional data sharing initiative that will improve the nation’s capabilities for near real-time disease detection and surveillance by using data from existing health databases.” It will apply science and algorithms to predict bio-terrorism events using data submitted by multiple agencies; meanwhile, no patient identifiers will be used, thereby protecting patient confidentiality. The international e-CDC initiative “will consist of CDC extension offices around the world that will work with the governments in which they are based and global businesses to achieve public health goals.” In short, the goal of the e-CDC will be global disease detection.

Dr. Fauci began his comments stressing the importance of biomedical research to public health practice—the latter being the response to both emerging (HIV, SARS) and re-emerging (West Nile virus, Monkeypox, flu) diseases. Further, Fauci pointed out, that the consequences of bio-terrorism are a variation of emerging and re-emerging diseases; the only difference being that the former is caused by the deliberate action of humans, while the former is not. He went on to cite HIV as an NIH success story. According the NIAID’s director, the amount of efforts put into developing therapeutics for the virus has resulted in the ability to control HIV to a significant degree (when people are able to access treatments). Citing an article written by his predecessor at NIAID, he characterized the many microbes that pose a threat to humankind as a “restless tide.” The successful efforts of NIH and CDC enable us to stay ahead of this tide.

The question and answer period that followed featured several discussions relevant to the HIV/AIDS community. First, Congresswoman Nita Lowey (D-NY) asked the witnesses about the U.S. reliance on more expensive brand-name drugs in its international HIV programs, as opposed to more inexpensive generics. Her understanding was that the Administration does not trust the “generic,” or World Health Organization (WHO) approved, drugs which are being used by other programs. Dr. Fauci responded by clarifying that this issue is not really about generic drugs per say; rather, it is an issue of using non-FDA approved generic drugs, going so far as to call them “knock-off” drugs. He assured the subcommittee members that negotiations are ongoing between Ambassador Tobias (the State Department global AIDS coordinator), WHO, and the pharmaceutical companies to solve this problem.

Congressman Sherwood (R-PA) questioned Fauci and Gerberding about the realistic timeline for developing an effective HIV vaccine. Dr. Fauci responded by saying that he cannot give a dependable timeline for the vaccine. He attributed this inability to the “uniqueness” of HIV disease.

Most vaccines for viral infections, such as measles, polio, and small pox, have relied on research into the way the human body successfully “clears” the invading virus. In contrast, there are no documented cases of people who have entirely cleared HIV from the body, thus researchers have no model of success on which to base a vaccine.

Finally, Congresswoman Lowey, on the second round of questions, asked the witnesses about the stipulation in the foreign operations spending bill (which funds the President’s Emergency Plan for AIDS Relief) which states that any promotion of condoms must be medically accurate. The Congresswoman asked if there should be a similar stipulation made in the Labor-H spending bill. Dr. Gerberding responded by saying that medically accurate condom promotion is standard practice at the CDC. She was not certain that such a policy needed to be included in the Labor-H bill, as she felt such promotions were already being practiced by the CDC, if not all relevant U.S. agencies.

While HIV was mentioned at the Labor-H hearing only as one of many challenges to the global community, it was clear from the testimony that the full scope of HIV’s impact is still unfolding.

In the News
1. Ambassador Tobias Wary of Using Generic ARVs
During a trip to Johannesburg, South Africa, Global AIDS Coordinator Randall Tobias spoke to journalists on Wednesday, April 28 about the U.S. government’s reluctance to support the use of certain generic antiretroviral (ARV) medications in the President’s Emergency Plan for AIDS Relief (PEPFAR) until their quality has been assured by a “more transparent and stringent review process,” an April 28 report by the Associated Press (AP) on Yahoo! News revealed.

According to the AP report Ambassador Tobias, who visited South Africa’s capital city as part of an eight-day, three-country tour of Africa, justified the U.S. position by stating, ‘Patients here in Africa deserve to have assurances about the safety and effectiveness of drugs in the same way that people in the United States do.

PEPFAR has set the goal of treating two million HIV positive individuals in 14 countries over a five year period, a White House press release, issued on January 23, 2003, stated. (The number of PEPFAR countries has since increased to 15; however, the fifteenth country has yet to be identified.) Currently, only a fraction of the HIV positive people residing in the 14 selected countries have access to ARV therapy. In Africa, where 12 of the 14 PEPFAR countries are located, only 50,000 of the estimated four million people who have “a sufficiently advanced stage of the disease to warrant ARV treatment” are receiving the life-prolonging therapy, the press release informed. These data have reinforced the sense of urgency that has been created by the AIDS pandemic.

Yet, while the World Health Organization (WHO) has certified certain generic drugs as meeting international standards for quality, safety, and efficacy, the U.S. wants more assurance that these drugs are safe and effective, the AP indicated. Further, U.S. officials argue, inappropriate and widespread use of generic ARVs could lead to drug resistance; thus, the U.S. needs to” gear up” the provision of drugs with caution. ‘The risks associated with doing something that ends up resulting in increasing drug resistance is quite significant,’ Ambassador Tobias explained in the AP article.

However, some critics, including the international medical aid group Doctors Without Borders, charge that the U.S. government true motivation is to protect the interests of pharmaceutical companies that hold patents to the drugs that generic manufacturers are replicating for use in developing countries.

Nevertheless, Ambassador Tobias’ statements suggested a degree of flexibility on certain points. For example, the AP noted, Ambassador Tobias countered his critics by stating that the U.S. policy is ‘to buy the least expensive drugs that we can find without regard to who manufactures them or where they come from as long as we can be satisfied as to their safety and effectiveness.’ Moreover, although Ambassador Tobias stressed that the U.S. wants a “more transparent and stringent review process,” he conceded that it does not necessarily have to be carried out by the Federal Drug Administration, AP reported.

To read the AP report on which this article is based in part, go to http://news.yahoo.com/news?tmpl=story&u=/ap/20040428/ap_on_he_me/africa_us_aids_1. To read the January 23, 2003 White House press release, consult http://www.whitehouse.gov/news/releases/2003/01/20030129-1.html.

2. Access to Life Insurance Difficult for HIV Positive People
The San Jose Mercury News reported on the difficulty for HIV positive people to obtain a life insurance policy this Tuesday, April 27. With advancements in treatment, more people are living longer with HIV, yet HIV positive people are still routinely excluded from individual life insurance policies.

According to the Mercury News article, an HIV positive person has three primary options to purchase life insurance. One option is to buy a guaranteed issue policy. For these policies, it is not required to have a medical examination. However, such policies are very expensive as compared to policies where a person has a medical exam, and they offer significantly smaller dollar amounts. The second option is to buy into group coverage. HIV positive individuals cannot be denied life insurance coverage within a group policy, making this a good option for many living with HIV. However, the coverage only applies as long as the individual remains employed at the company that purchases the group policy. The third option is to try to buy individual coverage.

In the United States, only one company—Guarantee Trust Life Insurance Company—offers individual coverage to a person with HIV. Yet the Mercury News reports that this coverage plan has many restrictions, and roughly half of those who apply for the coverage turned down. People who become HIV positive through intravenous drug use or through a blood transfusion are immediately disqualified from this coverage plan, further, the coverage is available to individuals with low T-cell counts only when they fall between the ages of 20 and 49. It is also very expensive. For instance, a 35-year-old, non-smoking, HIV positive man pays $1,631 per month for a quarter million dollar policy, while a 35-year-old man living with cancer pays $653 per month.

Such exclusions are not imposed as frequently on other chronic and life-threatening conditions. This leaves many people living with HIV to ask questions similar to one posed by Stephen LeBlanc in the Mercury News. (Though Mr. LeBlanc is HIV positive, he has a nearly undetectable viral load.) ‘If you're willing to insure people who have a cancer diagnosis or some other catastrophic illness, why treat AIDS any differently?' he asked.

For more life insurance companies to offer individual coverage to HIV positive people, the industry needs more data about the life expectancy of a person living with HIV, asserted Jack Dolan, a spokesman for the American Council of Life Insurance spokesman. ‘Life insurance companies want to provide coverage and they want to provide it to as many people as possible,’ commented Dolan in the Mercury News. ‘We really want to see more data.’ Bryan Freeman, the president of the Viatical and Life Settlement Association of America added, ‘The life insurance industry is built on statistical data, and the data has to catch up with the reality.’

Others suggest that the stigma associated with HIV is what prevents more life insurance companies from offering individual coverage to HIV positive people. `’It's how the person got the disease, what that implies about lifestyle,'’ said Guarantee Life's Vice-President of Underwriting Dean Zivkovic. ‘Not a lot of people want to take that to their CEO.'

To read The San Jose Mercury News story about, which this reports is based on, link to https://registration.realcities.com/reg/login.do?url=http://www.mercurynews.com%2Fmld%2Fmercurynews%2F8525242.htm.

CARE Act in Brief
(An occasional series about the Ryan White CARE Act)

1. A Look at the HIV Funding Pie
The Ryan White CARE Act is the largest federal source of “discretionary” funding for HIV. Discretionary funds result from a budget authority that is provided and controlled by appropriation acts. This means that each year Congress takes a look at the overall budget and decides what, if anything, should be assigned (or appropriated) to a particular program.

In contrast, “entitlement funds” result from a legal obligation of the federal government to make payments that are not controlled by the level of budget authority provided in an appropriation act. Congress generally controls spending for entitlement programs by setting eligibility criteria and benefit or payment rules. Social Security, Medicare and Medicaid are all entitlement programs.

This contrast also explains why Ryan White CARE Act has to be reauthorized. When Congress creates and funds a discretionary program, they set a time limit for the program, and when that limit is reached, Congress reviews the program to decide if it is still needed. In the case of the CARE Act, Congress decided to review it (e.g. “reauthorize” it) after five years. The official date by which reauthorization should occur is September 30, 2005.

To place the CARE Act in context, it’s helpful to see a visual representation. A recent Congressional Research Service report, AIDS Funding for Federal Government Programs: FY1981-FY2004, details federal spending for Fiscal Year (FY) 2003. Chart 1 shows the overall estimated spending on HIV for FY 2003 to be $16.6 billion. Ryan White funding is a large proportion of the Health and Human Services (HHS) discretionary funds.

[Note: OPM-FEHB is Office of Personnel Management – Federal Employees Health Benefits (e.g. health insurance for federal employees) and AID is the Agency for International Development].

Chart 2 shows spending on HIV Treatment in FY 2003. Both Medicaid and Medicare surpass Ryan White as a source of funding for treatment. However, these are both entitlements; whereas Ryan White is discretionary and is by far the largest block of HIV treatment funding that Congress has direct control over. That makes the CARE Act the largest source of federal funding (treatment and otherwise) dedicated solely to HIV medical support services. As a result, the CARE Act is the most visible, and among the most needed, sources of HIV treatment funding in the U.S.
[Note: VA is the Department of Veterans Affairs]

Announcements
1. The U.N. Releases World Youth Report 2003
On Tuesday, April 27, the United Nation Department of Economic and Social Affairs released a report called the “World Youth Report 2003.” The report, which is 408 pages, details that “up to 7,000 [young people] become infected with HIV daily” around the world, and it provides policy recommendations for limiting HIV’s spread among the world’s youth.

In addition to monitoring the state of HIV in young people, the report focuses on education, employment, extreme poverty, health, environment, drugs, juvenile delinquency, leisure-time activities, girls and young women, participation in decision-making, globalization, information and communications technology, conflict prevention, and intergenerational relations.

The report is available at: http://www.un.org/youth. Printed copies can be purchased from U.N. Publications by e-mailing publications@un.org.

2. APHA Unveils Community Solutions to Health Disparities Database
As part of the activities for National Public Health Week, April 5 to 11, 2004 (for more information, see APHA Holds Town Hall to Open National Public Health Week in the This Week in Washington section), the American Public Health Association has unveiled the Community Solutions to Health Disparities Database. This new tool enables members of the public health community to search for information about programs and interventions that have succeeded in addressing different forms of health disparities in communities across the country.

This searchable database, which is accessible for free via the APHA Web site, consists of the descriptions of programs and initiative that have been submitted for inclusion by APHA members and partners. Individuals looking for information can search the database by keyword, state, and target population (with search options for gender, race/ethnicity, and age). At the present time, the database contains over 500 entries with more being submitted every day. The database will continue to be available after National Public Health Week, and members of the community are encouraged to continue submitting their programs for inclusion.

To access the Community Solutions to Health Disparities Database, visit http://www.apha.org/nphw/solutions/.

To learn more about National Public Health Week, visit http://www.apha.org/NPHW/.

3. Guide to Social Security Benefits for People Living with HIV/AIDS
The Social Security Administration (SSA), has released a new document: Social Security Benefits for People Living with HIV/AIDS, which describes how people living with HIV can apply for benefits under two SSA programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). In addition, the document covers the following topics: eligibility for benefits; disability definitions; how to file for benefits; questions asked during the eligibility process; how eligibility determinations are made; how to expedite processing of claims; and what happens if recipients return to work. This document serves as a replacement for the discontinued A Guide to Social Security and SSI Disability Benefits for People with HIV Infection, which is no longer available.

To view Social Security Benefits for People Living with HIV/AIDS, go to
http://www.ssa.gov/pubs/10019.pdf.

4. The 2004 Minority Women’s Health Summit To Be Held August 12 – 15
The 2004 Minority Women's Health Summit will be held in Washington, DC over a four-day period from Thursday, August 12 to Sunday, August 15. With its theme, Women of Color, Taking Action for a Healthier Life: Progress, Partnerships & Possibilities, the summit will build on the outcomes of the 1997 National Conference Bridging the Gap: Enhancing Partnerships to Improve Minority Women's Health. Among the key women’s health issues that will be highlighted are HIV/AIDS, cardiovascular disease, cancer, and diabetes. The summit’s objectives are below:

• Explore current prevention strategies that work in various communities, both urban and rural.
• Promote dialogue among policy makers, service providers, community women, academia and other stakeholders to address current health care issues for women of color.
• Recommend action-oriented strategies to increase positive health outcomes for women of color across the lifespan, from rural and urban communities.
• Foster community partnerships to identify and implement best practices that target prevention, diagnosis and treatment of diseases that disproportionately affect women of color.
• Promote strategies to diversify leadership in health sciences, education, research and policy.
• Ensure health issues of women of color remain at the forefront of national, state and local health policy agendas.
  

For more information on the summit, link to http://www.4woman.gov/mwhs/ or contact one of the following people:

• Elizabeth David at (202) 205-0571,
• Adrienne Smith at (202) 690-5884, or
• Frances Ashe-Goins at (202) 690-6373.

5. Early Registration Period for the Ryan White CARE Act Grantees Conference Ends April 30
The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act 2004 Grantees Conference, We CARE. We Act: Putting It All Together, which is sponsored by the Health Resources and Services Administration (HRSA) and its HIV/AIDS Bureau (HAB), will convene for four days, Monday, August 23 to Thursday, August 26, 2004, at the Marriott Wardman Park Hotel in Washington D.C.

Developed under six broad tracks, including 1) Access to Care; 2) Quality; 3) Program Development; 4) Coordination and Linkages; 5) Administration: Fiscal and Program Management; and 6) Data, Evaluation, and Outcomes, the conference aims to provide a rewarding and productive exchange of valuable training and technical assistance that focus on four objectives. They are as follows: 1) Identify strategies to improve systems of care for people living with HIV; 2) Increase grantees' knowledge of programmatic and administrative requirements; 3) Enable grantees to share models of care; and 4) Encourage collaboration and networking among grantees.

All participants and presenters are responsible for their own travel, hotel, and registration fees which should come from CARE Act grants. Early registration fee is $375 through April 30, 2004. The regular fee is $475 and onsite registration is $525. Registration fees will cover the costs that cannot be covered by the HIV/AIDS Bureau such as meals, breaks, and other conference materials.

What’s more, this annual conference for CARE Act grantees will be held for the second time in conjunction with the CARE Act Clinical Conference, which is now in its seventh year.

The goal of the Clinical Conference is to provide a comprehensive overview of current clinical issues in HIV management and current strategies in HIV care for practitioners in RWCA Title I, II, III, and IV funded programs. This continuing medical education (CME) program will include didactic lectures and interactive workshops.

Further information on these conferences, including registration forms, is available online at http://www.psava.com/rwca2004/general.asp.

6. AIDSWatch, to Be Held May 17 to 19
AIDSWatch, an annual advocacy event organized by National Association of People With AIDS (NAPWA), will be held this year from May 17 to May 19 in Washington, DC. As a sponsor of the event, AIDS Action encourages its members to come to the capital and participate in AIDSWatch activities. AIDSWatch brings together advocates from across the country and provides them with the training and information they need to have successful meetings with legislators and their staff members and to persuade these policymakers to support domestic and global HIV/AIDS programs. In order to ensure this success, AIDSWatch will provide participants with a full day of hands-on advocacy training, which will include an update on federal HIV/AIDS policy and funding. Participants will then meet with their elected representatives, along with other AIDSWatch participants. In addition, some AIDSWatch groups will be joined by staff and board members from national HIV/AIDS organizations.

Registration for the event is free, and any information you include on your registration will be kept confidential. To register, link to http://www.napwa.org/AIDSWatchsub.html.