AID At­lanta fac­ing debt

Teams up with con­tro­ver­sial na­tional group

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At­lanta and na­tional HIV/AIDS ac­tivists are de­nounc­ing the de­ci­sion of AID At­lanta to be­come an af­fil­i­ate with the AIDS Healthcare Foun­da­tion, led by the con­tro­ver­sial fig­ure Michael Weinstein.

AID At­lanta an­nounced the de­ci­sion to “join forces” with AHF on June 19; al­most im­me­di­ately there was back­lash from lo­cal HIV ac­tivists who took to so­cial media to crit­i­cize the move. No lo­cal ac­tivists would go on the record with Ge­or­gia Voice, how­ever.

AID At­lanta boasts a $7.6 mil­lion an­nual bud­get. Its main sites are in Midtown At­lanta and a clinic in New­nan, Ge­or­gia. AHF also has a clinic in Litho­nia, Ge­or­gia.

Con­tro­versy sur­round­ing AIDS Healthcare Foun­da­tion and PrEP

AHF’s con­tro­ver­sial stance on pre-ex­po­sure pro­phy­laxis, or PrEP, angers many HIV ac­tivists. PrEP, dis­trib­uted as a pill known as Tru­vada, can re­duce the risk of con­tract­ing HIV up to 92 per­cent when taken con­sis­tently.

AHF’s pres­i­dent, Michael Weinstein, has called PrEP a “party drug,” al­leg­ing that gay and bi­sex­ual men would only use the pill as a way to tell them­selves it was OK to have ca­sual and anony­mous sex.

James Hughey, In­terim CEO of AID At­lanta, said, as he un­der­stands it, Weinstein is not op­posed to PrEP, and he pointed to an ed­i­to­rial ad AHF placed in sev­eral LGBT news­pa­pers this month as part of a new cam­paign.

“What did you get from that that says he does not sup­port PrEP?” Hughey asked the Ge­or­gia Voice.

Hughey then said AID At­lanta has a grant with Gilead—a one-year, $79,000 grant that be­gan in March—to is­sue PrEP. But, he added, PrEP is not be­ing read­ily pre­scribed in metro At­lanta be­cause of the high costs as­so­ci­ated with it. Cur­rently AID At­lanta, which boasts serv­ing 5,000 peo­ple an­nu­ally, has 14 pa­tients tak­ing Tru­vada.

“If you look at PrEP in the com­mu­nity, pa­tients don’t have the abil­ity to pay. There is lit­tle use of PrEP. It is dif­fi­cult to pay for, in­clud­ing the physi­cians and labs. I hope we can bring that into the dis­cus­sion—how do we pay for it? I don’t hear that in any di­a­logue.”

—James Hughey, In­terim CEO of AID At­lanta

“If you look at PrEP in the com­mu­nity, pa­tients don’t have the abil­ity to pay. There is lit­tle use of PrEP. It is dif­fi­cult to pay for, in­clud­ing the physi­cians and labs. I hope we can bring that into the dis­cus­sion—how do we pay for it?” he said. “I don’t hear that in any di­a­logue.”

But does Hughey be­lieve in re­mov­ing all bar­ri­ers to get­ting PrEP into the hands of those who want it?

“Yes, with the caveat that the de­ci­sion as to whether to take PrEP is al­ways one that should be made be­tween a pa­tient and his or her provider,” Hughey an­swered.

Does Hughey be­lieve PrEP is not cost ef­fec­tive at all?

“The point I was try­ing to make is re­lat- ed to peo­ple that do not have in­sur­ance or the abil­ity to pay,” he said. “It is dif­fi­cult for AID At­lanta to pro­vide free PrEP with­out hav­ing a means to cover the physi­cian and lab costs even with free med­i­ca­tion. For in­sured pa­tients we can see pa­tients and pre­scribe PrEP for those pa­tients, when ap­pro­pri­ate. We will con­tinue do­ing this for the com­mu­nity, as ap­pro­pri­ate.”

At Pride Med­i­cal, a for-profit agency, there are more than 150 pa­tients tak­ing Tru­vada.

“Since the FDA ap­proval [of PrEP], ev­ery per­son who has come to Pride Med­i­cal to get on Tru­vada for PrEP has had their in­sur­ance com­pany pay for it or Gilead has given them the med­i­ca­tion for free,” said Lee Anis­man, for­mer CEO of Pride Med­i­cal and one of the Pride Med­i­cal pa­tients tak­ing PrEP.

“Quite a few peo­ple are talk­ing about that com­ment Hughey made [about PrEP cost ef­fec­tive­ness]. Very pro­gres­sive states such as New York and Cal­i­for­nia have been very proac­tive in set­ting up pro­grams to get the res­i­dents who are at high risk for in­fec­tion on PrEP. It’s an undis­puted fact that peo­ple who are com­pli­ant with their PrEP reg­i­men are over 92 per­cent less likely to con­tract HIV. Stud­ies done by the CDC show that con­doms are less than 70 per­cent ef­fec­tive when used cor­rectly and con­sis­tently. I am an ad­vo­cate of con­doms and PrEP, which gives close to 100 per­cent pro­tec­tion,” Anis­man said.

Mark King, a for­mer staff mem­ber of AID At­lanta and a long­time HIV ac­tivist now liv­ing in Bal­ti­more, has writ­ten about AHF’s trou­ble­some stance on PrEP at his blog, My Fab­u­lous Dis­ease. He told the Ge­or­gia Voice he was very dis­turbed by this new re­la­tion­ship and is­sued a state­ment.

“AHF’s cam­paign of mis­in­for­ma­tion around PrEP makes them the most dan­ger­ous en­tity in the HIV arena right now. Their stub­born de­nial of the sci­en­tific proof that pre-ex­po­sure pro­phy­laxis (PrEP) has now been proven mar­velously ef­fec­tive has made them out­liers and out­casts in the preven­tion arena,” King said. “Now that they have swal­lowed up AID At­lanta, you can ex­pect to see the same mis­in­for­ma­tion in At­lanta. And that is a fright­en­ing prospect in­deed, con­sid­er­ing the high rates of HIV in­fec­tion and the ur­gent need for preven­tion tools such as PrEP.”

At­lanta is ranked No. 5 among U.S. cities for new HIV in­fec­tions with Ge­or­gia rank­ing in also at No. 5 as the state with the most new HIV in­fec­tions.

Hughey said AID At­lanta would con­tinue to pre­scribe PrEP if it was in the best in­ter­est of the pa­tient.

“What I am re­ally clear on is if a physi­cian and pa­tient agree this is the best for the pa­tient, then we will pre­scribe PrEP. But the money there is lim­ited, re­gard­less of want­ing to do more,” he said.

AID At­lanta faced ‘sig­nif­i­cant debt’

Hughey said AHF was one of nu­mer­ous or­ga­ni­za­tions he spoke to when it was de­cided the At­lanta-based AIDS ser­vice orga-

niza­tion needed to team up with another in or­der to re­main sus­tain­able.

“Sig­nif­i­cant debt” was one rea­son AID At­lanta sought to be­come an af­fil­i­ate of AHF, Hughey ac­knowl­edged in an in­ter­view with Ge­or­gia Voice, but he de­clined to use ex­act num­bers.

“We are in a good po­si­tion and will still need to strengthen our donor base to in­crease the peo­ple we serve in the At­lanta and New­nan com­mu­ni­ties,” Hughey said. AHF did not as­sume all of AID At­lanta’s debt.

Hughey, who came on board to head AID At­lanta in Fe­bru­ary af­ter the res­ig­na­tion of Jose Diaz, said AID At­lanta had strayed from its mis­sion and he feels AHF is the “solid part­ner” it needs to re­turn fo­cus to the mis­sion of serv­ing HIV/AIDS clients in the metro At­lanta re­gion.

“I’ve met with as many com­mu­nity lead­ers as I can, I’ve met with ev­ery one of our 21 grantors, and each and ev­ery one is in sup­port of this. I think this is a great op­por­tu­nity for us to be a solid an­chor,” he said.

Hughey stressed that AID At­lanta would re­main AID At­lanta and AHF would not be tak­ing over any ser­vices, such as HIV test­ing. AID At­lanta is one of sev­eral af­fil­i­ates that are part of what is called the AHF Fed­er­a­tion. Other af­fil­i­ates in­clude: AIDS Task­force of Greater Cleve­land; WORLD (Women Or­ga­nized to Re­spond to Life-threat­en­ing Dis­eases) in Oak­land, Cal­i­for­nia; AIDS Cen­ter of Queens County in New York; South Side Help Cen­ter in Chicago; Is­land Coast AIDS Net­work (ICAN) in Florida; and the Im­pulse Group, an in­ter­na­tional vol­un­teer group.

“AHF is not tak­ing over any­thing to my un­der­stand­ing, and I have a clear un­der­stand­ing. What we are is an af­fil­i­ate. What AHF wants is to get peo­ple tested, linked to care and into care. We will still be AID At­lanta,” Hughey said.

AID At­lanta wants to link HIV-pos­i­tive pa­tients to care

What Hughey con­sid­ers the big­gest ben­e­fit of af­fil­i­at­ing with AHF is AHF’s fo­cus on get­ting 20 mil­lion peo­ple with HIV linked to care, he said.

At­lanta ASOs do talk a lot about the need for HIV test­ing, but there is not a lot of talk about the abil­ity to get those who test pos­i­tive into care, Hughey said.

“I don’t think we are hav­ing enough con­ver­sa­tions about that. What AHF does re­gard­less of a per­son’s abil­ity to pay is to get them into care. This is a mis­sion we all need to be fo­cused on. The num­bers vary, but some 16,000 [HIV-pos­i­tive] peo­ple are not in care, and another 17,000 to 18,000 do not know they are HIV pos­i­tive and are not in care,” he said.

(Photo via AHF)

AID At­lanta is team­ing up with AIDS Health Care Foun­da­tion, led by con­tro­ver­sial fig­ure Michael Weinstein.

(Cour­tesy photo)

Na­tional HIV ac­tivist and for­mer AID At­lanta staff mem­ber Mark King said AHF is the ‘most dan­ger­ous en­tity in the HIV arena right now.’

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