Services for Persons with HIV/AIDS
Summary
New York State leads the nation in AIDS cases, with more than 157,000 reported cases at the end of 2002, approximately 62,000 of those persons were still living. In the first years of the AIDS epidemic, a diagnosis of AIDS was considered a “death sentence” but in recent years, HIV has become a highly treatable disease. As of the end of 2002, a total of 80,088 New Yorkers had died of AIDS. The rate of HIV infection has slowed in recent years due to prevention activities, increased testing of persons at risk of HIV and AIDS, and the development of pharmacological treatments. There continues to be no known cure for the disease.
Conference Position
The Catholic Conference supports public policies that will increase access to quality health and mental health services, in addition to community-based supports and testing, for persons living with, or at risk of, AIDS and HIV.
Rationale
Advances in the treatment of HIV and AIDS have not benefited all persons at risk of the disease. Although HIV infections and AIDS deaths have declined, AIDS and HIV disproportionately affect people of color. African-Americans were 45 percent of New Yorkers living with AIDS and Hispanics were 30 percent of that group in 2002. The HIV costs and services utilization study of access to AIDS care indicated that African-Americans, Hispanics, women, the uninsured and persons with Medicaid, receive less than desirable health care (JAMA, June 23/30, 1999).
Research has determined that most new HIV infections in the U.S. occur through injection drug use. Long waiting lists at substance abuse treatment centers have prevented injection drug users from accessing treatment for their addiction. In order to stem the rate of HIV infection among injection drug users, the Catholic Conference advocates for increased funding of substance abuse treatment programs to break the cycle of addiction for injection drug users.
Adolescents are also at high risk of infection by HIV. In 1997, HIV was the seventh leading cause of death among Americans ages 15-24 (MMWR, 6/4/99). Young African-American women are particularly at risk of infection (CDC Update, 9/98). Prevention programs targeted at the individual and families have proven highly effective in reducing the transmission of HIV through sexual activity. Prevention activities must focus on eliminating risky behaviors that place individuals at risk of exposure to HIV. A program that recruited mothers and their adolescent children demonstrated the role of parents and family members in helping teens to abstain from sexual activity through enhanced communication, improved decision-making, and enhanced self-efficacy.
The CDC estimates that one-third of HIV-infected people in the United States will not learn their serostatus until they are diagnosed with an AIDS-associated illness. It has been estimated by the NYS Health Department that there could be as many as 50,000 New Yorkers infected with HIV, but are unaware of their infection. The Conference supports continued access to confidential HIV/AIDS testing and counseling for persons at risk of infection. Recent studies by the Center for Disease Control and Prevention (MMWR, June 25, 1999) confirm that anonymous and confidential testing programs continue to play an important role in identifying persons at risk of HIV or infected with AIDS. Anonymous programs are preferred by those men and women who perceive a stigma attached to their risky behavior. The benefits of early testing and access to antiretroviral therapies, have improved the quality and length of life for persons infected with HIV/AIDS.
In spite of the improved prognosis for persons living with AIDS, the disease continues to have a significant, deleterious effect on families and children. New York State Comprehensive Newborn Screening Program data from 2003 indicates that one in 357 women giving birth in New York State had a positive HIV test result. When one or both parent finally succumbs to AIDS, dependent children are often thrust into family care or foster care. New York has provided limited funding for transitional programs targeted to the needs of these children, but efforts to expand services have stalled. The Catholic Conference supports efforts to provide supportive services and assistance to those children who have been orphaned by the death of a parent from AIDS.
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