A town hall meeting that featured senior officials from the de Blasio administration showed that AIDS activists have reached a kind of détente with the city agencies they were picketing not long ago.
“We were put into an uncomfortable place,” said Dr. Sue Blank, who heads the sexually transmitted disease unit in the city health department. Then, alluding to the adage that suggests making lemonade when life hands out lemons, she said, “We’re definitely in a lemonade-making place.”
ACT UP, the AIDS activist group, convened the February 8 meeting at the Lesbian, Gay Bisexual & Transgender Community Center. After several 2015 protests, including pickets at City Hall and another outside a city health department office in Queens, the town hall was a cordial and respectful affair.
Will eased tensions lead to cooperation or will AIDS activists’ impatience flare again?
In a 2015 town hall organized by ACT UP and the Treatment Action Group, which was also held at the Center and drew roughly 170 people, activists put signs on empty chairs at the front of the room with the names of the senior city health department staff, including Blank, who were invited to the meeting, but did not attend.
“Today’s meeting is how to work together better,” said Victor Thompson-Mas, an ACT UP member, toward the close of the roughly three-hour event that was attended by about 50 people.
James Krellenstein, also an ACT UP member, noted that recent increases in funding for sexually transmitted disease testing and treatment and HIV prevention at the city health department were due, at least in part, to the protests and sometimes contentious meetings that ACT UP and other groups had with the city last year.
On February 8, activists presented 16 items that they believe the city and state must respond to. Broadly, they touched on HIV prevention and care, assistance for LGBT youth, protection and assistance for sex workers, and then how the people in the room can follow up with the city and state to ensure that action is taken.
Each item received its own presentation from an ACT UP member or from another AIDS or housing group, and then one or more of the five government panelists responded. Dr. Demetre Daskalakis, who heads HIV programs at the city health department, Dan O’Connell, the head of the state AIDS Institute, Dan Tietz, chief special services officer at the city’s Human Resources Administration, and Susan Haskell, who oversees youth services at the city’s Department of Youth and Community Development, joined Blank on the panel.
Much of the agenda was related to the Plan to End AIDS, which aims to reduce new HIV infections in New York State from the current roughly 3,000 a year to 750 annually by 2020. The city now says that new infections here will be reduced to 600 annually by 2020, making it responsible for the lion’s share of the reduction. The panelists’ responses made it clear that there is a great deal of work that has yet to be done to get to 750 by 2020.
The plan uses anti-HIV drugs in HIV-negative people to keep them uninfected. HIV-negative people can take one dose of Truvada a day as pre-exposure prophylaxis (PrEP) to prevent infection, and people with a recent exposure to HIV can take a 28-day course of anti-HIV drugs as a post-exposure prophylaxis (PEP) to stay uninfected. The plan also counts on treating HIV-positive people with anti-HIV drugs so they are no longer infectious.
“We’ve seen increases in PrEP utilization, but not on the scale that we need,” O’Connell said. Last year, the AIDS Institute launched a program to help New Yorkers pay for PrEP called the PrEP Assistance Program. To date, it has enrolled 316 people.
“I hear you about PrEP AP,” O’Connell said. “Three hundred isn’t enough, 316 isn’t enough.”
The city health department, which is seeing an increase in PrEP uptake, is launching PrEP and PEP services at its eight currently operating sexually transmitted clinics, and it has expanded hours at those clinics allowing it to serve more New Yorkers. The city’s ninth clinic in Chelsea is closed for a gut renovation into 2017. That clinic closure was a source of conflict between activists and the city.
“From a PrEP perspective, we have a number of things that we’re rolling out,” said Daskalakis, who is relentlessly upbeat in his assessments of the city’s performance.
Asked during a February 12 event held at Woodhull Medical Center — one of 11 public hospitals operated by the city — if he agreed with O’Connell’s view that progress to date has not been enough, Daskalakis said, “We think that there is so much work to do.”
A major item that activists and the de Blasio administration want is to pass HASA for All, which is city legislation that would give HIV-positive people access to services currently given only to people with an AIDS diagnosis at the HIV/AIDS Services Administration. The city has said consistently that enacting the legislation requires state support.
“There’s HASA now and there’s HASA in the future,” Tietz said. “It’s very clearly in the mayor’s budget, the money is there… We need the state to equitably contribute to it.”