COUNCIL OF THE CITY OF PHILADELPHIA2 COMMITTEE ON PUBLIC HEALTH AND3 HUMAN SERVICES4 5 6 Room 400, City Hall7 Philadelphia, Pennsylvania Wednesday, October 27, 20108 10:20 a.m. 9 10 PRESENT: COUNCILWOMAN MARIAN B. TASCO, CHAIR11 COUNCILWOMAN JANNIE BLACKWELL COUNCILMAN W. WILSON GOODE, JR.12 COUNCILMAN CURTIS JONES, JR. COUNCILWOMAN DONNA REED MILLER13 COUNCILWOMAN BLONDELL REYNOLDS BROWN 14 RESOLUTION 100565 - Resolution authorizing the15 Council Committee on Public Health and Human Services to hold hearings regarding the16 HIV/AIDS infection epidemic in Philadelphia. 17 - - -18 19 20 21 22 23 24 25 2 1
Good2 morning. Thank you all for coming this3 morning to this hearing with the4 Committee of Public Health and Human5 Services regarding our Resolution 100565,6 HIV/AIDS infection epidemic.7 We will ask the Clerk to read8 the resolution, and we'll begin with our9 testimony.10
Resolution 100565,11 resolution authorizing the Council12 Committee on Public Health and Human13 Services to hold hearings regarding the14 HIV/AIDS infection epidemic in15 Philadelphia.16
This is a17 resolution and not a bill, which does not18 require -- a resolution does not require19 a vote. Therefore, we do not need a20 quorum at the beginning, but we will --21 Councilmembers will be coming in during22 the course of the hearing.23 Let me recognize Councilman24 Wilson Goode, Jr., who is a member of25 3 10/27/10 - PUBLIC HEALTH - RES. 1005651 this Committee. And as other Committee2 members come, we will introduce them to3 you.4 My name is Marian Tasco and I5 am the Chair of the Committee on Public6 Health and Human Services for City7 Council.8 November 7, 1991, for many this9 date changed the public face of HIV. On10 November 7, 1991, NBA legend Earvin11 "Magic" Johnson announced that he was HIV12 positive. This announcement and various13 subsequent announcements moved our nation14 into a broader public discussion15 regarding the nature of this infection16 and AIDS. In response, HIV/AIDS17 research, prevention and treatment moved18 to the forefront of our collective19 conscience as an issue that must be20 addressed.21 In just 11 days, we will reach22 the 19th anniversary of this23 announcement. Although much has been24 accomplished, it feels as though we as a25 4 10/27/10 - PUBLIC HEALTH - RES. 1005651 city, state and nation have moved on to2 confront other public health issues.3 However, the impact of HIV/AIDS is just4 as important now as it was 19 years ago,5 especially in Philadelphia.6 In our city, we have HIV7 incident rates five times higher than the8 national average, even higher than New9 York City. In fact, our infection rates10 rival those of some third-world nations.11 As a result, these higher HIV incident12 rates have had a devastating effect on13 our city, particularly in the African14 American and the Latino communities.15 This effect has reached epidemic16 proportion, and it motivates us as a city17 to develop new ideas, policies and18 strategies to address this public health19 crisis. From this perspective, it is my20 goal that these hearings will be a21 catalyst for this change.22 So today we welcome you to this23 Chamber. As you present your testimony,24 hopefully we will come up with some25 5 10/27/10 - PUBLIC HEALTH - RES. 1005651 recommendations that we can present as a2 way to further address and join in all3 the groups who have really spent a lot of4 time in educating and trying to treat5 those individuals in our city who are6 HIV/AIDS infected. So I welcome you this7 morning.8 Our first testimony will be --9 let me recognize Councilwoman Donna Reed10 Miller, who has joined us. She's also a11 member of the Committee.12 Our first witness is Jamira13 Burley, a member of the Youth Commission.14 (Witness approached witness15 table.)16
Good morning,22 Councilwoman Tasco and members of City23 Council. My name is Jamira Burley and I24 am a member of the Philadelphia Youth25 6 10/27/10 - PUBLIC HEALTH - RES. 1005651 Commission. As a member of the2 Philadelphia Youth Commission, it is my3 responsibility, as well as the4 responsibility of the Commissioners, to5 advocate on behalf of young people across6 the City. I am here today to help stress7 the importance of City Council's hearing8 in regards to the issues of HIV and AIDS.9 The HIV and AIDS pandemic is a10 health crisis that is affecting not only11 individuals in the United States but also12 people in countries around the world. On13 a local level, a recent 2009 report from14 the Philadelphia Department of Public15 Health claims that currently 28,27416 Philadelphians are currently living with17 the HIV or AIDS virus. According to the18 same report, in 2009, there were 911 new19 HIV infections in Philadelphia. Of these20 new HIV infections, over 38 percent of21 them occur among age groups of 13 to 29.22 These young people are now living with a23 new illness that will significantly24 impact their quality of life for the25 7 10/27/10 - PUBLIC HEALTH - RES. 1005651 years to come.2 Clearly, there is a great need3 for City Council hearings in regards to4 these issues. Hopefully these hearings5 can help devise strategies to prevent new6 cases of HIV infection and to help7 improve the quality of life for the8 people currently infected. To help get a9 firsthand view of what it is like for a10 young Philadelphian living with the11 virus, I would like to introduce Kim, a12 17-year-old young lady involved with the13 Haven Youth Center, an organization that14 helped to support services for young15 people infected with HIV.16
Thank you.17 And Kim is going to testify via telephone18 this morning.19 Is she ready.20 MR. McNALLY: Yeah, she's21 ready.22 KIM: Hello. Good morning.23
Good24 morning, Kim.25 8 10/27/10 - PUBLIC HEALTH - RES. 1005651 KIM: My name is Kim.2
And thank6 you for taking the time to testify and to7 share with us.8 KIM: Thank you for allowing me9 to be here today. I'm very grateful.10
You may11 proceed with your testimony.12 KIM: I am a 17-year-old young13 lady. I am currently an 11th grader at14 Science Leadership Academy. I am an A/B15 student. I have a GPA of 3.65. I have16 loving, caring family members, friends,17 and they care for me so much, and I am18 very grateful for them. But I was19 infected with HIV at birth due to my20 mother's unwise decisions, which led to21 her dying of full-blown AIDS.22 My mother is now not living,23 which has a very huge impact on my life.24 I now live with a foster family that25 9 10/27/10 - PUBLIC HEALTH - RES. 1005651 loves and cares for me very, very much,2 and I don't know what I would do without3 them.4 My foster mother helps me on a5 daily basis when it comes to my HIV. My6 sisters and my brothers also.7 How HIV has affected my8 childhood has affected me in positive9 ways, also negative ways. Some of the10 positives are that I have loving, caring11 friends that I can come to on a daily12 basis. I have centers that I can go to.13 I have negatives also that come14 along with being HIV positive. Some of15 the negatives are that there is a lot of16 stigma out here. The stigma comes when17 it comes to my friends. Sometimes I18 don't know how to talk about being HIV19 positive to them, so I just don't talk20 about it at all, and sometimes they can21 have a huge impact on me.22 But what people need to23 understand is that we're all human, and24 we mainly have different shades of skin,25 10 10/27/10 - PUBLIC HEALTH - RES. 1005651 but we all bleed the same color. And so2 that me being HIV positive, I've done so3 many grateful things with it, and that4 I'm also grateful to be here. Some of5 the more positive things that I have are6 camps. I go to a camp called Camp Dream7 Catcher, which allows me to enter it with8 other kids that are infected with9 HIV/AIDS and affected by HIV/AIDS.10 I go to a center, as you guys11 have heard, called Haven Youth Center.12 The faculty that are there are wonderful.13 I can't express how wonderful they are.14 When it comes to taking medication, when15 it comes to relationship issues, when it16 comes to problems at home and especially17 school work, they are a big, big part of18 my life, and I don't know what I would do19 if it was not for them. And so I think20 that having them in my life is really a21 good impact on me.22 Having to take medication, the23 medications that I take on a daily basis24 is really hard for me, and I think that25 11 10/27/10 - PUBLIC HEALTH - RES. 1005651 because being HIV positive and the2 medications that we have today, I'm3 grateful for them, but at the same time,4 I struggle with my pills. Sometimes I5 take them and sometimes I don't, and6 sometimes I feel like I'm not normal7 because of what's in my blood, not8 because of what -- because of me, but9 because what's in my blood, and it hurts10 at times. It really does. And I think11 that I shouldn't be judged by what's in12 my blood, but me.13 HIV awareness is very, very,14 very important, and I think that if we15 had more centers and more places like16 Saint Christopher's Hospital and Haven17 Youth Center and different organizations18 that are around but that are very small,19 if we had more of those, more people20 would be aware of the issue of HIV and21 AIDS. They will be more willing to get22 tested, more willing to know how they can23 catch the virus and not be so scared of24 the virus.25 12 10/27/10 - PUBLIC HEALTH - RES. 1005651 I think that being positive has2 affected me in more positive ways than3 negative, but I still have the negative4 ways. I think that I have loving, caring5 friends and family that help me on a6 daily basis, principal-wise,7 friends-wise, family-wise, school-wise.8
Well, we9 certainly thank you for calling in to10 share your testimony regarding your11 experience of having HIV/AIDS. It seems12 that you have a good support system. We13 certainly understand the emotional, you14 know, roller coaster that you experience,15 but you sound very positive and certainly16 understand your situation. And I agree17 with you, education is very key, and some18 day you will use your voice to help19 educate our citizens in Philadelphia20 about the whole issue of HIV/AIDS.21 We've come a long way. I mean,22 this room, when I first came into Council23 back in 1988, we were dealing with the24 whole issue of HIV/AIDS and what to do.25 13 10/27/10 - PUBLIC HEALTH - RES. 1005651 Certainly the medications that have2 been -- that are used now to help people3 deal with HIV/AIDS has somewhat -- people4 think it's a cure, but it really isn't.5 But the urgency doesn't seem to be there6 anymore.7 But, Kim, we certainly thank8 you and we appreciate your testifying,9 and we're there for you. There are10 members of this Committee here. We will11 ask them if they have some questions or12 they want to make some comments.13 Let me recognize Councilwoman14 Blondell Reynolds Brown, who has joined15 us. She's a member of this Committee.16 Would anyone like to make any17 comments?18 (No response.)19
Thank you20 very much, Kim.21 KIM: Thank you so much. It22 was lovely. Thank you.23
Thank you,24 sweetheart.25 14 10/27/10 - PUBLIC HEALTH - RES. 1005651 Very powerful.2 Our next witness will be3 Mr. Henry Bennett and Waheedah4 Shabazz-El.5 (Witnesses approached witness6 table.)7
Good morning,8 Councilmembers. Good morning,9 Councilwoman Tasco.10
I14 certainly want to say to the young lady15 from the Youth Commission, the City of16 Philadelphia -- I believe it was led by17 Councilwoman Brown -- urged the City to18 set up a city Youth Commission, and I'm19 proud that they have taken time. They20 are really involved, because we want to21 hear from young people what they are22 experiencing, what they hear, how we can23 be helpful to them as they navigate their24 early life.25 15 10/27/10 - PUBLIC HEALTH - RES. 1005651 Let me recognize Jordan Harris,2 who is here, who is Executive Director,3 does a great job. I'm constantly getting4 e-mails from him about what he's doing.5 And I must say that my granddaughter has6 found a place to work with them, and I'm7 very proud of her, too. Thank you very8 much.9 Good morning.10
Good morning.11 I think I'll begin. My name is Waheedah12 Shabazz-El.13
16 I'm a Native American -- a Native17 Philadelphian, I should say. I'm a18 homeowner here. I'm a retired postal19 worker. I'm employed by Philadelphia20 FIGHT as an HIV tester and counselor. I21 am Chair for the CAB, for the Community22 Advisory Board at the University of23 Pennsylvania Center for AIDS Research, a24 founding member of the United States25 16 10/27/10 - PUBLIC HEALTH - RES. 1005651 Positive Women's Network and a long-term2 member of the AIDS Coalition to Unleash3 Power. 6 As a person living with HIV,7 this is one of the most important days of8 my life, because it carries the potential9 to guarantee a closer examination of the10 enormity of the cause and effects of the11 rates of HIV infections escalating12 amongst African Americans, Latinos, women13 and young people in the City of14 Philadelphia. 21 I would like to personally22 thank Dr. Amy Nunn for her background23 research on the HIV epidemic that is24 brewing in the City of Philadelphia and25 17 10/27/10 - PUBLIC HEALTH - RES. 3 I would like to thank both4 Councilwoman Tasco and Councilwoman5 Blackwell for their spirit, their6 leadership in introducing this7 resolution. Because HIV has been8 wreaking havoc in our communities and our9 families for nearly 30 years. So this is10 long overdue. 12 Recently, July 13th, 2010, I13 had the honor to meet President Barack14 Obama. Myself, along with many other15 AIDS activists, were invited to the White16 House to a reception where he announced17 the first time in history that the United18 States had developed its own National HIV19 Strategy to reduce the number of HIV20 infections in this country and increase21 access to care to those who need it. So22 adopting this resolution here today is23 certainly in proper alignment with the24 President's national plan to stop the25 18 10/27/10 - PUBLIC HEALTH - RES. 2 In order to be present here3 today in front of this City Council, I4 had to make a most difficult decision,5 because today, October 27th, I was6 invited back to the White House by the7 Office of National AIDS Policy to take8 part in a discussion around HIV and9 aging. But as a person living with HIV10 who lives in Philadelphia, I felt a great11 responsibility to appear here and be a12 part of this meeting today, where local13 government will move to address the HIV14 crisis, and to put a face on AIDS. 18 So I stand here today in19 support of this resolution, and I stand20 for African Americans and I stand for21 communities of color. I stand for women,22 and not just black women. I stand here23 for all women, including transgendered24 women. I stand here for Latino women and25 19 10/27/10 - PUBLIC HEALTH - RES. 1005651 Muslim women and other women of faith. I2 stand as a parent of adult men and women3 who are at risk for HIV and as a4 grandparent of young teens who are at5 risk for HIV. I stand here for people6 over 50, who are rapidly being infected7 with HIV. I stand here for the8 heterosexual man, who seems to have been9 forgotten in this epidemic. I stand here10 for the gay community, who without their11 advocacy in the early years, there would12 be no services for HIV and who supported13 me when I found out that I had AIDS. And14 I stand here for the homeless, who are at15 risk for HIV, and the mentally16 challenged, the substance user and for17 those men and women behind bars who can't18 be here to represent themselves. 21 In closing, I want to point out22 that as you read the statistics that are23 revealed in the resolution, please24 understand that they are the same people,25 20 10/27/10 - PUBLIC HEALTH - RES. 3 These people's lives have4 value. )23
Thank you.24 Thank you so much for that informative25 21 10/27/10 - PUBLIC HEALTH - RES. 1005651 and caring testimony, and I'm glad you2 chose to stay with us today. We would3 not have had the benefit of your4 testimony and the wonderful words that5 you have shared with us this morning.6 Stay at the table. When we7 finish with Mr. Bennett, then we'll open8 up the floor for questions.9 Mr. Bennett.10
Tasco. Council18 President and esteemed members of City19 Council.20 Fellow colleagues, residents of21 Philadelphia, we are gathered this22 morning here in Philadelphia because we23 are all concerned and interested in the24 welfare and well-being of our fair city.25 22 10/27/10 - PUBLIC HEALTH - RES. 1005651 The adoption of Resolution No. 100565 on2 the 16th of September 2010 makes things3 quite evident, that first and foremost4 that the City Council of Philadelphia is5 aware of the raging epidemic that is6 taking place in our city with African and7 black people.8 Based on the data collected9 from the epidemic profile, the numbers10 continue to rise and at an alarming rate.11 Why? Why when there are already in12 existence programs and institutions13 designed to stem the rising tide of this14 epidemic? With few exceptions, the15 majority of the programs and institutions16 were not designed for these specifically17 targeted populations. They were not18 designed for women. They were not19 designed for teens and young adults.20 They were not designed for African21 American and heterosexual communities.22 And this gravely affects me to watch my23 African American neighbors, friends and24 community being ravaged by this disease.25 23 10/27/10 - PUBLIC HEALTH - RES. 1005651 I thank you and commend you,2 City Council, for this resolution to3 investigate and examine effective4 strategies on how to combat this crisis.5 And here again, I'd like to put in my two6 cents.7 Whatever is done, be sure it is8 culturally appropriate. Be sure it is a9 collaborative partnership that includes,10 but is not limited to, the schools, the11 churches, the mosque, the clinics, mental12 health and behavioral health13 organizations, community centers,14 recreation centers, and businesses and15 business organizations.16 This is something that not one17 individual or one institution or one city18 government can do on its own. And I19 thought that if each of us put our own20 two cents in, the organizations,21 environments, people in activities, we22 will find that with this united front, we23 have the funds and capacity to win this24 battle.25 24 10/27/10 - PUBLIC HEALTH - RES. 1005651 I thank you for allowing me2 this opportunity to express myself.3
Thank you4 very much. We really appreciate you5 coming in to testify.6 Comments from the members of7 the Committee, questions?8 (No response.)9
Thank you10 very much. I think we don't have a lot11 of questions. We want to hear how people12 feel, what recommendations they have.13 Because this Council has been down this14 road many, many times. And so what we're15 looking for are recommendations to see16 what the City can do to address this17 issue further.18 It seems that when patients19 stopped dying and the headlines went20 away, there was a feeling that there was21 no more issue with HIV/AIDS. But it is a22 very quiet killer, a quiet disease that23 impacts families and certainly, as we24 heard from Kim, throughout their lives.25 25 10/27/10 - PUBLIC HEALTH - RES. 1005651 So we're going to hear some2 more testimony. So don't feel like we're3 not interested. We're here listening.4 So thank you. We don't have the answers,5 and we're getting the answers and the6 comments from you.7 Our next panel will be our8 Health Commissioner, Dr. Donald Schwarz,9 and Jane Baker, Director of AIDS10 Activities Coordinating Office.11 (Witnesses approached witness12 table.)13
And I see14 our friend Kevin Vaughan is joining them,15 Deputy Commissioner.16
Good18 morning. How are you? Would you19 identify yourself for the record, please,20 Commissioner, and begin your testimony.21
Chairwoman Taco,22 Councilwoman, members of the Committee on23 Public Health and Human Services, I'm24 Donald Schwarz. I'm the Health25 26 10/27/10 - PUBLIC HEALTH - RES. 1005651 Commissioner for the City of2 Philadelphia. 19 As of December the 31st, 2009,20 there were 19,237 people living with HIV21 or AIDS in Philadelphia. This number22 differs from the number that was23 presented earlier, and I want to point24 this out, because many people who at some25 27 10/27/10 - PUBLIC HEALTH - RES. 3 percent of the7 population in Philadelphia. 17 Estimates from the Philadelphia18 Department of Public Health put the rate19 of new HIV infection of Philadelphia20 residents at 114 infections per every21 hundred-thousand population 13 years of22 age and older in 2006. And I use 200623 principally because we can compare that24 to data from other places in the country,25 28 10/27/10 - PUBLIC HEALTH - RES. 1005651 which haven't been able to be updated2 since 2006. 3 That rate was five times the4 national rate, which was 23 infections5 per hundred thousand. 10 Individuals between 13 and 2411 years made up 15 percent of newly12 infected; 25 to 44 years old, 51 percent;13 of those 45 and older, 34 percent. 6 percent of the City's25 29 10/27/10 - PUBLIC HEALTH - RES. 4 percent of new cases of HIV in3 2009. The estimated rate of new HIV4 infection among African Americans is 1765 infections per hundred-thousand adults,6 13 and older. 38 in Latinos or Hispanics. 13 Turning to prevalence, and I14 want to highlight the difference. So15 I've been talking about new cases most16 recently. I want to talk about total17 people infected. I started with that,18 talked about new cases. We'll go back19 and talk about all those who are infected20 that we estimate in Philadelphia. 23 It is estimated that about24 12,800 African Americans are living with25 30 10/27/10 - PUBLIC HEALTH - RES. 1005651 HIV or AIDS in Philadelphia. This means2 about 2 percent of all African Americans3 are HIV infected, or one in 50. S. 12 As you know, race and poverty13 are highly correlated, and Philadelphia's14 poverty rates are the highest of the15 largest ten cities in the nation. 25 31 10/27/10 - PUBLIC HEALTH - RES. 1005651 The socioeconomic issues2 associated with poverty, including3 limited access to quality healthcare,4 housing and HIV prevention education,5 directly and indirectly increase the risk6 for HIV infection and affect the health7 of people living with HIV. 11 Men who have sex with men, or12 MSM, are acquiring HIV at an alarming13 rate in Philadelphia. Again, these new14 cases tend to disproportionately affect15 those of color. Based on local estimates16 of the size of the MSM population, almost17 21 percent of men who have sex with men18 in Philadelphia are living with HIV or19 AIDS. 20 Between 2007 and 2009, there21 was a 25 percent increase in newly22 diagnosed HIV cases among men who have23 sex with men. 25 32 10/27/10 - PUBLIC HEALTH - RES. 1005651 We're also aware that men who2 have sex with men may also have sex with3 women. 9 Persons unaware of their HIV10 status drive this epidemic. Persons11 underestimate risk and worry about12 stigma, especially in heterosexual13 populations where a woman may be unaware14 of her partner's exposure and her partner15 may be afraid to speak about having had16 many sexual contacts potentially,17 including those with another man. 23 Based on national estimates, 2124 percent of people infected with HIV or25 33 10/27/10 - PUBLIC HEALTH - RES. 8 The AIDS Activities9 Coordinating Office administers federal,10 state and city-funded HIV/AIDS programs11 in Philadelphia through collaborative12 service contracts with community-based13 organizations.
In addition, AACO14 coordinates HIV/AIDS planning and policy15 activities through the Philadelphia16 Department of Health; more broadly,17 conducts AIDS surveillance activities in18 accordance with federal, state and county19 laws and requirements; oversees the20 Department's epidemiologic activities21 related to HIV and AIDS, including22 publication of quarterly reports, which23 are available on our website; and24 conducts HIV/AIDS education and training25 34 10/27/10 - PUBLIC HEALTH - RES. 1005651 for professional, civic and community2 groups. 6 AACO approaches HIV prevention7 by focusing on HIV testing to identify8 people unaware of their HIV status and9 works with HIV positive persons to help10 stop transmission; to connect newly11 diagnosed persons and persons lost to12 care to HIV medical treatment; and to13 connect newly diagnosed persons to14 partner services to notify partners of15 possible exposure to HIV and provide HIV16 testing to them. 20 AACO has developed a strategy21 for early identification of individuals22 with HIV and AIDS. It is a multi-faceted23 strategy to implement routine HIV24 screening in clinical settings and to25 35 10/27/10 - PUBLIC HEALTH - RES. 1005651 reach high-risk populations through2 targeted programming in clinical and3 community-based settings so that4 individuals in high-risk groups routinely5 come into contact with HIV screening6 programs. A total of 42 organizations7 receive funding for HIV prevention8 services, in addition to those services9 that are provided by the Department10 directly. Overall, 42 percent of AACO11 providers are considered minority12 providers. 18 The key to HIV prevention is to19 encourage everyone to get tested20 regularly. 25 36 10/27/10 - PUBLIC HEALTH - RES. 1005651 Providers are instructed to offer the2 test to everyone. 12 Philadelphia still supports13 anonymous testing sites, but works with14 clients with a preliminary positive15 result to change the confirmatory test to16 confidential. 19 In the past, a significant20 problem with testing was that individuals21 had to wait days to weeks to get test22 results. During this period, many never23 came back to get their results. Today,24 rapid testing, where the person being25 37 10/27/10 - PUBLIC HEALTH - RES. 17 Extra efforts are made to18 ensure good contact information is19 obtained for all those who need a20 confirmatory test and intensive follow-up21 is done to ensure that those with initial22 positive test results return for23 confirmatory results and, if truly24 positive, get referred and linked to25 38 10/27/10 - PUBLIC HEALTH - RES. 2 AACO concentrates HIV testing3 efforts on targeting populations that are4 particularly high risk. These include5 incarcerated individuals; youth with many6 sexual partners, particularly those who7 are older; adult men who have sex with8 men; heterosexuals with many sexual9 partners; and injection drug users. 18 In 2009, AACO provided over19 73,000 HIV tests. 5 million is allocated to HIV21 testing programs. Of the testing done22 last year, almost 40 percent of tests23 were among youth 24 years of age and24 older; 58 percent of tests were among25 39 10/27/10 - PUBLIC HEALTH - RES. 8 Still we have a lot of work to9 do to reach those who are not aware of10 their HIV infection. For younger folks,11 we have created an innovative text12 messaging media campaign, which we're13 happy to talk more about. 17 Our newest campaign will begin18 during the week of November 7th through19 the 13th of this year, in collaboration20 with the Mayor's Office of Faith-Based21 Initiatives. AACO is collaborating with22 local African American and faith-based23 organizations to offer HIV prevention and24 AIDS specific education and testing on25 40 10/27/10 - PUBLIC HEALTH - RES. 2 Five prominent African American3 ministers, I'm proud to say, have come4 together to reach many churches and5 mosques in the City, and they have all6 been HIV tested as part of this7 collaboration.
15 In addition, we will unveil new16 billboards to be strategically posted in17 high-traffic inner-city locations to18 promote HIV testing, with endorsements of19 the five local faith leaders. With one20 exception, the billboards should be21 installed by next week. The Billboard22 Initiative will be complemented by a host23 of congregationally based programs that24 faith leaders can offer on location at25 41 10/27/10 - PUBLIC HEALTH - RES. 1005651 ministry or congregational sites2 throughout the City. 7
10 I'd be delighted. 19139, 19146, 19121,11 19132 and 19144. But we're encouraging12 ministries throughout the City. 17 On a regular basis, there's a18 network of 76 HIV care sites in19 Philadelphia, 38 HIV medical sites, 5520 medical case management sites. Some are21 co-located, including both22 community-based organizations and23 hospital-based HIV specialty clinics, the24 Philadelphia Department of Health's25 42 10/27/10 - PUBLIC HEALTH - RES. 1005651 health centers -- where I have to tell2 you we serve more HIV infected people3 than in any other center in the City --4 other community health centers and AIDS5 service organizations. 21 In 2009, only 216 persons -- and I know22 that's too many, but it's better than23 we've been in the past -- were diagnosed24 with AIDS in Philadelphia, which is a25 43 10/27/10 - PUBLIC HEALTH - RES. 2 Intravenous drug abuse as a3 mode of transmission of HIV has4 consistently declined as a proportion of5 new HIV cases each year following the6 introduction of syringe exchange programs7 in Philadelphia more than 15 years ago,8 and we really appreciate Council's9 support on those programs. 13 The continued services provided14 by AACO and its providers and partners15 have had an impact on the HIV epidemic in16 Philadelphia. We have reached many17 Philadelphians with HIV testing and other18 prevention services and provide19 high-quality care to those who are20 infected with the virus, but more needs21 to be done. We need HIV brought to the22 forefront, as in these hearings, to get23 the message across that HIV remains a24 grave threat to the health of25 44 10/27/10 - PUBLIC HEALTH - RES. 3 We need new strategies and4 better targeting of services to impact5 the epidemic. With the implementation of6 a series of new grants, we plan to be7 even more successful in implementing8 strategies to reduce the incidence of HIV9 and AIDS in Philadelphia. As was10 mentioned, many of the programs that11 we've had we've had for a long time, and12 the federal response to the epidemic13 began a long time ago. 23 The planning phase for this24 grant is just beginning, but we're25 45 10/27/10 - PUBLIC HEALTH - RES. 6 There are many barriers to our7 success. As I've mentioned, poverty,8 stigma and fear are substantial. At risk9 heterosexuals are a large and diverse10 population and are hard to reach with11 prevention services. Men who have sex12 with many partners, men who have sex with13 many partners, may be both ashamed of14 their own behavior and afraid to have15 that behavior disclosed. They often will16 not agree to testing. 21 At the same time, I want to22 highlight, we have lost key funding from23 the state within the last year due to24 budget reductions. More than $2 million25 46 10/27/10 - PUBLIC HEALTH - RES. 1005651 that had been used for outreach to youth2 were cut from Philadelphia, cut from3 Philadelphia specifically. 8 The Department of Public Health is aware9 of our many challenges. 19 Thank you for allowing me to20 present testimony on this important21 issue. I'll be happy to answer22 questions, if you have any. I am here23 with Jane Baker, who is the Director of24 the AIDS Activities Coordinating Office,25 47 10/27/10 - PUBLIC HEALTH - RES. 2
Well,10 we'll probably get some questions that11 they may want to answer.12 Thank you so much for your13 testimony. And, as you said, it's been a14 long time that Council has been involved15 in this issue, and certainly hopefully16 that we'll be able to work with the17 organizations who are out in the street18 trying to bring about awareness to be19 more successful in reaching our community20 about the importance of prevention.21 The Chair recognizes Councilman22 Goode. I believe you had your light on23 first.24 Councilwoman Brown.25 48 10/27/10 - PUBLIC HEALTH - RES. 1005651
Good4 morning. As with many public health5 issues and other issues, there's a6 recurring theme with regard to poverty7 and race, and we keep statistics with8 regard to those demographics because we9 should, but quite often as we cite10 statistics for both poverty and race, we11 may sometimes confuse the issue.12 So the first question is, to13 what extent is the issue of race really a14 poverty issue? When we talk -- to what15 extent is the higher incidence among16 African Americans a result of their17 impoverished condition? So what extent18 are we really talking about poverty19 rather than race or to what extent are we20 talking about race?21
It's a great22 issue, and as you know, across pretty23 much every health issue there's a24 balance. So is poverty important here?25 49 10/27/10 - PUBLIC HEALTH - RES. 1005651 It is. It's important in terms of access2 to care. It's important in terms of3 people's linkage to any place that they4 get information, because we know people5 who are poor tend to be less connected.6 However, we also know this is a7 sexually transmitted infection in largest8 part, and we know that people tend to9 have sex within their racial or ethnic10 group. Not all the time, but more likely11 so.12 So, yes, this is an issue13 related to poverty, particularly in terms14 of progression of disease and people who15 have died and die from this.16 Transmission is affected by17 people's knowledge about the disease and18 who they have sex with and who they share19 needles with, although needle-sharing20 fortunately because of great work has21 become a smaller part of the issue, but22 we can't move away from it. However, who23 you have sex with is a critical issue.24
So as we25 50 10/27/10 - PUBLIC HEALTH - RES. 1005651 approach new solutions for this problem,2 do we approach them both from a racial3 perspective and a poverty perspective, or4 how do we distinguish?5
We need to6 approach them from both, but we have to7 be careful, as you're pointing out, so8 that we try to target high-risk9 communities. And I've tried to highlight10 those who we know are most likely to be11 infected, and you'll notice that they12 don't say poor people, they say people13 particularly related to who they have sex14 with, because it's principally a sexually15 transmitted disease.16 But in terms of programming, we17 have to be very much aware that there are18 communities where we could identify19 infection, we could present prevention20 information, but those communities may21 not have access to the tools that they22 need either to prevent the disease or23 prevent progression. So poverty is an24 issue that we have to be aware of as25 51 10/27/10 - PUBLIC HEALTH - RES. 1005651 well.2
Is there any3 data related to moderate- to4 middle-income African Americans versus5 lower-income African Americans?6
I don't know -- I9 don't know that we have specific data on10 it.11
Okay. Next12 question is -- and I'm not challenging13 the data, first just look for some14 clarification of data. Your testimony15 says that African Americans accounted for16 66.4 percent of new HIV cases in 2009.17 Where does that data come from?18
Would you20 identify yourself, please, and speak into21 the microphone.22
I'm Jane Baker.23 I'm the Director of the AIDS Activities24 Coordinating Office, and I thank you for25 52 10/27/10 - PUBLIC HEALTH - RES. 1005651 the opportunity to come here, Marian2 Tasco and members of the Council3 Committee.4 That comes from our5 surveillance unit, who goes out and does6 surveillance activities for HIV/AIDS7 cases and identifying that.8
So it's9 local data generated locally. And what's10 the methodology?11
Through counseling15 and testing, looking at data and16 information from the CDC, because we17 report directly to them.18
The reason I19 ask and that's why I want to distinguish20 between whether it's local data, whether21 it's CDC data, particularly because I was22 paying attention, I did read the23 testimony, and it says that 66.4 percent24 of new cases are African Americans, but25 53 10/27/10 - PUBLIC HEALTH - RES. 1005651 also says that 60.5 percent of those2 tested were African Americans.3
So if5 two-thirds of the people that you test6 are African Americans and two-thirds of7 new cases are African Americans, there8 might be a correlation there. If there9 is not, then please explain why there is10 not.11
So remember that12 only a fraction of those who are tested13 are positive. That's the first thing.14 So that 66 percent and 66 percent --15
It still16 doesn't mean there's not a correlation17 between the two.18
It doesn't mean19 there's not.20 How best to do it? So if we21 had tested -- if of the people tested22 only a third were African American, the23 rate of positivity, so the number of24 people positive compared to the entire25 54 10/27/10 - PUBLIC HEALTH - RES. 1005651 population, not just the tested2 population, should be relatively3 constant. But if we were testing only a4 third of the people we tested who are5 African American, we would worry that we6 weren't giving information and finding7 people. So what we try very hard to do8 is to make testing available,9 particularly in communities that we10 believe and the CDC believes are at11 higher risk.12 Your initial question was13 methodology. So the national methodology14 for estimation comes from the Centers for15 Disease Control and its estimation.16
I'm actually17 just dealing specifically with the data18 within this testimony.19
So the20 proportionate data comes from two things.21 One, who is tested in Philadelphia,22 what's the rate of positivity, who are23 those populations, are they incarcerated24 populations, are they women, are they25 55 10/27/10 - PUBLIC HEALTH - RES. 1005651 men, are they young, are they old. Those2 are then interpreted or estimated based3 on national --4
So there is5 still a possible correlation between the6 two, between the fact that two-thirds of7 people tested are African American and8 two-thirds of new cases are African9 American. Because you're relying upon10 information from the testing.11 I'm not saying it's wrong. I12 mean, it actually could be two-thirds.13 I'm just saying, is there a possible14 correlation? And from everything you15 said so far, there still is.16
So the methods17 that are used would not make it make18 sense that there was an actual19 correlation there.20
So that the22 estimates are based on the rate of23 positivity in those people who are being24 tested, and the rate of positivity in25 56 10/27/10 - PUBLIC HEALTH - RES. 1005651 people who are being tested varies across2 all the different groups who are tested.3 I could give you a mathematical4 explanation, which might be the easier5 way to do it. I just don't know how to6 do it easily in words in this situation,7 other than to say the two shouldn't be8 directly related to each other, and I'm9 happy to send you or show you10 mathematically why.11
Well, I'm12 not trying to make this point or push13 this point too far. I'm actually just14 trying to find out.15
So the next18 place I'll go is simply asking, you don't19 test the entire City. You choose where20 you go to test, and you choose who you're21 reaching out to. So by that, you are22 actually creating a correlation.23
Between who25 57 10/27/10 - PUBLIC HEALTH - RES. 1005651 you decide to test and do outreach to.2
If we gave you3 the number of tests, you would be right,4 but the issue with the proportion here is5 based on who does get tested and how they6 demographically relate to a larger7 population. It's the same for sampling.8 So if there's an opinion poll, people try9 to figure out who is going to vote in10 Philadelphia. There are certain11 populations that --12
But in an13 opinion poll, there's a controlled14 sample.15
So the national16 sample from CDC in that same way, if I17 understand what you mean by control, is18 the controlled sample. So we use19 their --20
The numbers that23 you have are Philadelphia numbers24 interpreted in light of CDC's25 58 10/27/10 - PUBLIC HEALTH - RES. 1005651 methodology.2
Let me18 first seize the moment to say on the19 record, Dr. Schwarz -- and I'm sure Chair20 Lady and members of this Committee21 agree -- on how much we deeply appreciate22 your continued work there at the Health23 Department. It's appreciated, and we24 need to say that every chance we get.25 59 10/27/10 - PUBLIC HEALTH - RES. 1005651 And the resonance of this issue is just2 further affirmation of the work that your3 team is doing.4 I have a number of questions,5 and I'm going to start with, my6 inspiration for submitting a bill for the7 Youth Commission and the ultimate law8 creating it was that young people ought9 to have a voice in a number of public10 policy issues. So I want to thank the11 leadership of the Youth Commission for12 being here, as the Chair has already13 recognized.14 To young people, in the breadth15 of places where you do all of your work,16 unless I missed it, there's no mention of17 high schools. And it gets back to18 Councilman Goode's point. I put here19 education; others might call it20 awareness. I put here access; Councilman21 Goode says availability.22 What work is done in our high23 schools, even if it's nothing more than24 awareness education across the board for25 60 10/27/10 - PUBLIC HEALTH - RES. 1005651 young people, given when you state in2 your testimony that individuals between3 13 and 24 years old make up 15 percent of4 the newly infected?5 So what are we doing to touch6 them and capture their attention early7 and all that comes with that?8
Good morning. We9 have health resource centers in eight of10 our high schools across Philadelphia. We11 also fund providers who do work with12 youth in Philadelphia. I too have had13 the opportunity of meeting with the Youth14 Commission and really applaud that being15 introduced and them coming to AACO and16 telling me how they want to be a part of17 this here and help us with planning.18 We're getting them connected to our local19 Ryan White HIV Planning Council so that20 they could be involved at that level as21 well.22 But right now, like I said, we23 do health resource counseling, education.24 We're not testing in the schools, but25 61 10/27/10 - PUBLIC HEALTH - RES. 1005651 testing is available through mobile2 testing venues that we have that do3 target youth.4
Of the5 eight high schools, did that happen6 because the leadership of that school;7 namely, the principal, was okay with it8 or did that happen because young people9 in that school said we want it? Why is10 it not universal?11
It happened because12 we had worked with the School Board to13 try to get this here into the schools.14 It wasn't the schools saying that we15 wanted it. We knew that it needed to be16 there, there was a need for that, because17 we are doing some STD testing in high18 schools and we noticed rates of chlamydia19 and STDs and they thought that this was20 only a natural progression, that if we21 didn't get involved for HIV and AIDS,22 that this would really be problematic.23 So we did work with the School Board --24 at the time, Louis Bonia and Judith25 62 10/27/10 - PUBLIC HEALTH - RES. 1005651 Peters -- to try to bring services2 through the school. There were a lot3 of --4
Was that5 during the leadership of Mr. Paul Vallas6 or under the current leadership of7 Dr. Ackerman?8
And the11 reason why it's limited to eight schools12 is because of lack of resources, or what?13
So this goes back19 to Dr. Hare when we had a Board of20 Education, Dr. Ruth Hare, who was the21 President of the Board of Education. And22 early in the HIV epidemic, people23 throughout the City came together to say24 we need to be able to do counseling in25 63 10/27/10 - PUBLIC HEALTH - RES. 1005651 schools and we need to be able to make2 condoms available. And so the School3 District passed a resolution in, I4 believe, '89 allowing condoms to be made5 available in high schools.6 The Family Planning Council of7 Southeastern Pennsylvania and the Health8 Department have a long partnership, but9 the Council has taken -- and you'll be10 hearing from people later from the Family11 Planning Council -- tremendous leadership12 in creating these centers in high13 schools. So we are related to about14 eight of them. There are about 14, I15 think, total in high schools in16 Philadelphia, not every high school, and17 that is not related to high school wants18 it or not. It is that the resolution19 from the School District says that the20 District won't provide the service with21 its own personnel. It must be provided22 by outside helpers now. And so willing23 providers have to be identified and then24 funding is needed.25 64 10/27/10 - PUBLIC HEALTH - RES. 1005651
And there are3 funding limitations and there are4 provider limitations. So before I took5 this job, I ran two of those health6 resource centers in schools in West7 Philadelphia, and we started in the first8 year and it continues to the present.9
Is there a10 correlation between those eight high11 schools and the zip codes where you say12 there's the highest incidence of -- any13 correlation at all?14
So some of16 those high schools sit in some of those17 zip codes?18
All right.21 Instead of doing what Chair Lady Tasco22 said, which was listen first, I started23 writing a series of questions. And then24 at the end of your testimony, you spoke25 65 10/27/10 - PUBLIC HEALTH - RES. 1005651 to what I would consider a2 non-traditional audience, and, that is,3 the clergy community. So I'm thrilled to4 hear that that bridge has been connected.5 And what is the expectation, if any, in6 growing the number of churches that are a7 part of the faith-based effort?8
We have been9 working with the Mayor's Office of10 Faith-Based Initiative, Reverend Handy11 and Minister Byrd, and they've been very12 instrumental knowing a lot of the clergy,13 particularly the black clergy throughout14 Philadelphia, and bringing them together15 in groups and helping us to plan testing16 events, as well as them bringing about17 awareness. Again, they've been tested18 themselves, and I think that that reduces19 some of the stigma for people to see them20 out front and taking a stand with it. So21 it's been very positive thus far, but we22 still have a lot more work to do with23 them. And, again, this is just now24 starting with the --25 66 10/27/10 - PUBLIC HEALTH - RES. 1005651
So there's2 a written plan on how the effort will hit3 across -- there are a number of4 denominations within black clergy, and so5 I'm asking, is there -- for me if it's6 not in writing, it doesn't exist. That's7 what works for me.8 So is a written comprehensive9 plan with rollouts on how you're going to10 touch each denomination of the black11 clergy?12
We've selected for13 the week of November 7th through the 14th14 ten different churches strategically15 located throughout the City, in Southwest16 Philadelphia, North Philly, West17 Philadelphia, Germantown, to try and18 start this, and we're going to look at19 what that pans out and then to continue20 this.21 This is not just a one-shot22 thing that we want to do. We want to23 continue this, because we know it's an24 integral part of what we're doing and25 67 10/27/10 - PUBLIC HEALTH - RES. 1005651 reaching their congregations and2 educating them and having them help us in3 this fight.4
Okay.5 I'll pay close attention to that.6 One population that has come to7 my attention that is touched on in your8 testimony -- and this is purely what they9 call anecdotal experience -- are senior10 citizens. Is there any reach into the11 senior citizen community on this with12 regards to this issue as well?13
Our Education Unit14 at the AIDS Activities Coordinating15 Office goes out to senior centers and is16 working with the senior centers to have17 education and presentations. We go to18 health fairs and bring the same19 information to them, offer testing as20 well.21
All right.25 68 10/27/10 - PUBLIC HEALTH - RES. 1005651 Might there exist, in terms of best2 practices, condom machines? It's a weird3 idea, but clearly it's non-traditional4 approaches that are going to ultimately5 make the difference in reducing all of6 these numbers, which means we have to7 think out of the box in every way, and8 just like everything else is available9 via vending machines and since10 accessibility is an issue, has that --11 across the country is anyone doing12 anything like that?13
Yes. It was very17 controversial, as you can imagine, where18 they might be located and --19
I told20 her, she can start that business. Get21 some vending machines. There's no law22 against it. So we'll talk about that.23
No, we haven't --25 69 10/27/10 - PUBLIC HEALTH - RES. 1005651
But you2 said it was discussed. Was it discussed3 locally or was it discussed with a task4 force someplace in the country, what?5
I think6 anecdotally, like you said, we heard7 about it. It's not something that we've8 actively pursued here in my office, but,9 you know, it's an idea.10
The one thing I12 will say on the record that I want to13 make sure everyone knows is that Medical14 Assistance pays for condoms. So that15 anyone who is on Medical Assistance can,16 for free with their medical card, get17 condoms. In addition, there are sites18 throughout the City that for free give19 out condoms.20
So all of the22 family planning sites in the City and23 other sites that are funded by AACO give24 out condoms for free.25 70 10/27/10 - PUBLIC HEALTH - RES. 1005651 Now, your question is an2 interesting one, which is will people at3 the time of being interested in having4 sex either want to go to a pharmacy to5 get condoms or go to a health site to get6 condoms. If it's Saturday night at 107 o'clock --8
Not. So your10 point of we have a system where people11 need to plan ahead is an important one.12 And there are other countries in the13 world that have tried this, and it's been14 long talked about within HIV prevention.15 So it's an interesting idea.16 COUNCILWOMAN BROWN:17 Interesting. So is it safe to assume18 that persons with Medical Assistance are19 fully aware?20
So that22 suggests that there's a gap there in23 awareness and education. Like we get24 these little pull-outs in our PECO bill25 71 10/27/10 - PUBLIC HEALTH - RES. 1005651 and PGW bills, do they get with their2 Medical Assistance check or do they get3 with their Medical Assistance card a list4 of services available to them, like the5 availability of condoms?6
So there are a7 whole series of issues like this.8 Obesity education services are available9 under Medical Assistance for children.10 Smoking cessation benefits are available11 under Medical Assistance, if you're on12 the right pharmacy plan. But, yes. And,13 as you know, the Department of Public14 Health is working with Medicaid and the15 Medicaid Managed Care companies in the16 country to talk about how do we publicize17 the benefits that are available to the18 communities that are particularly high19 risk.20
You gave a21 lot of discussion to funding. Where are22 we in terms of trends and funding from23 the CDC and others? Is there an uptick?24 We know clearly what's happening with the25 72 10/27/10 - PUBLIC HEALTH - RES. 1005651 state or not happening with the state,2 but with regards to CDC and the other3 funding source that you talked about,4 where are we? Has there been a decrease?5 Is there a trend of increased dollars6 from the CDC, or what?7
We just recently8 received a new planning grant from the9 CDC as a result of the National AIDS10 Strategy. We have a planning grant, and11 as a result of this resolution, we are12 enlisting the support of Dr. Amy Nunn to13 help us with this planning grant to look14 at our system and see what's working and15 what's not working. But we did get a16 slight increase in our CDC prevention17 funding for this year.18
So the19 planning grant allows you only to plan,20 not to do any service delivery?21
Okay.24 I'll push the pause button for there and25 73 10/27/10 - PUBLIC HEALTH - RES. 1005651 allow other members to ask questions.2
Thank5 you. Thank you, Madam Chair.6 Good morning, everyone.7
Good morning.8 COUNCILWOMAN MILLER:9 Dr. Schwarz, you brought back memories.10 I worked for many, many years with family11 planning agencies, and we were a part of12 that whole getting the permission for the13 schools, not just on condoms but on14 family planning classes. So you just15 brought back some memories. I was like,16 I forgot all about that.17 I'm really interested in18 finding out what's happening specifically19 in zip code 19144, which is Germantown.20 It's an area I live and represent. With21 the schools, with other youth service22 agencies, what's happening there? What23 programs do you have that's based in that24 zip code, and what exactly are they doing25 74 10/27/10 - PUBLIC HEALTH - RES. 1005651 around education, prevention, testing? I2 would assume that testing is at the3 public health center, but also at like4 Covenant House and some of the other5 community-based health centers.6
Thank you,7 Councilwoman. That is an area that is8 underserved, and we recognize that and --9
We recognize that18 the Germantown area is an area that's19 underserved and we're cognizant of that,20 and when we do our planning, we will be21 looking to putting services in that area,22 because, as you said, currently it is23 just our health center. We did have an24 agency there, Positive Effect, years ago.25 75 10/27/10 - PUBLIC HEALTH - RES. 1005651
Yes, but it's no4 longer -- I mean, they're currently5 funded, but they're not providing6 services in that area at the time.7 They've since relocated.8
Well, we9 need to look at that, because certainly10 zip code 19144 is one of the zip codes11 that you identified as being a targeted12 area.13
Could I14 follow up on that? Because it's been on15 my mind for a minute.16 My area, it's not 44, but my17 constituents live in that area. But do18 you reach out to find organizations to19 provide -- to fund, to provide the20 service, or do you wait until someone21 comes to you to seek funding? Because if22 you identified these zip codes, how do23 you plan to reach out to the community to24 provide the services there?25 76 10/27/10 - PUBLIC HEALTH - RES. 1005651
We widely publicize2 our procurement process. We don't sole3 source to providers, but through our4 procurement process, we tell them which5 services we're looking to fund and in the6 areas that we're funding.7 Currently, if we have an RFP,8 we would tell providers that this area is9 underserved and we would prefer to fund10 someone from that area as opposed to11 having a provider in Center City go to12 Germantown. We would prefer to have13 someone who is already in Germantown.14 But these aren't folks that have applied15 with us through our procurement process.16 COUNCILWOMAN TASCO:17 Dr. Schwarz, when you talked about -- and18 I don't mean to take -- I just want to19 follow up on this whole thing.20 You talked about 42 agencies21 receiving funding for HIV prevention.22 Are these organizations tied into these23 zip codes somewhat?24
Are they5 broad based? How many of the groups are6 in Center City or how many are in7 neighborhoods?8
I would need to get9 that information to you. I wouldn't want10 to venture and give you misinformation,11 but I can forward that to you. I will12 send you a list.13
Okay. I14 have other questions around that, but15 I'll let Councilwoman Miller.16
You said17 that Positive Impact is still -- Positive18 Effect is still in business?19
Right.25 78 10/27/10 - PUBLIC HEALTH - RES. 1005651 So what's happening in Germantown, other2 than the public health center? What is3 going on at Germantown High School, for4 example? Do you have one of the resource5 health centers there?6
Okay.8 Good. And I'm particularly interested in9 education prevention and, of course,10 testing services. And what would be the11 indicator that would have a doctor test a12 13-year-old for AIDS, for HIV? I mean,13 that's not a normal -- I just raised a14 daughter. I mean, she's an adult now, of15 course. When I took her to the16 pediatrician, they did not check her for17 HIV. So I want to know what makes a18 doctor check a young child that age for19 HIV. What's going on in that child's20 life or what's happened, and how much21 of -- how many 13-year-olds do you know22 locally, nationally, how big of a problem23 is this? Because if that's the case,24 then we need to be in middle schools.25 79 10/27/10 - PUBLIC HEALTH - RES. 1005651
I don't think it's2 necessarily commonplace that a doctor3 would just do that when a child presents,4 unless they're there for other reasons5 and they are seen as high risk for some6 other disorder or reason for their visit.7 I don't think that they're just asking8 them to be tested for it.9
No. I10 didn't say they were. I was just11 wondering why, how would a 13-year-old12 end up being tested for HIV.13 See, my assumption is, when you14 recommend that HIV testing be a routine15 part of my yearly physical or anybody's16 yearly physical, I don't think about17 13-year-olds. I think about adults. So18 the recommendation, though, would be19 what?20
Okay.25 80 10/27/10 - PUBLIC HEALTH - RES. 1005651 Does health insurance pay for HIV2 testing?3
Does the5 City's health insurance? We don't pay6 for a lot anymore, but anyway, do we pay?7
So10 nothing else is going on in Germantown, I11 assume, other than the health center and12 the center at Germantown High School?13
That's it. We have17 mobile testing units that go to18 Germantown for different venues, but not19 just there all the time.20
So that's21 an underserved. What other areas of the22 City are underserved?23
Southwest24 Philadelphia. But we now currently have25 81 10/27/10 - PUBLIC HEALTH - RES. 1005651 three providers in Southwest2 Philadelphia, which we're pleased. We3 have Haven Youth Center that has4 relocated to Southwest Philadelphia. We5 have Neighborhoods United Against Drugs,6 and we also have the Family Annex that7 does clinical care and case management8 services.9
Before I10 became a City Council person, I worked11 for Representative Richardson, David12 Richardson, who was Chair of the13 Pennsylvania State's Health and Welfare14 Committee, and every month we received15 statistics from actually the Philadelphia16 Health Department telling us what was17 going on with the incidence of HIV/AIDS,18 and I used to read them every month, so I19 really used to keep up with this. But20 it's interesting that -- and it came from21 the City government. Now that I work for22 the City, I never get them.23
We could make that24 available to you. We do have -- and it's25 82 10/27/10 - PUBLIC HEALTH - RES. 1005651 on our website.2
Well, I3 don't have time to go on websites.4 Everybody talks about websites. Child,5 please. Sometimes my computer doesn't6 get turned on for weeks, because that's7 not -- I mean, I don't have time for8 that. Send it to us. I can just read it9 real quick.10 But anyway, I think it's11 important that we know, particularly the12 underserved areas know, that you're13 looking for someone, because we're14 meeting and talking and going out to15 events and going out to meetings all the16 time, and if we know that this is17 something -- this is one of your goals,18 then we can help you with that.19
I had no21 idea until this hearing, until this22 testimony that 19144 was a very high-risk23 category and that it's underserved. So24 keep us informed. We can work with you.25 83 10/27/10 - PUBLIC HEALTH - RES. 1005651
I have a7 number of questions, but what I'd like to8 do, we have another panel that's going to9 be working with you, Dr. Nunn and --10 Ms. Nunn. Is it doctor?11
Dr. Nunn.13 So I know, Dr. Schwarz, you may not be14 able to stay, but if Ms. Baker could15 stay --16
-- come18 back and answer questions we may have,19 but we'd like to bring the next panel on.20 And then if you could stay, we'd21 appreciate that.22
Thank you24 very much.25 84 10/27/10 - PUBLIC HEALTH - RES. 1005651 The next panel will be Dr. Amy2 Nunn, Associate Professor of Brown3 University Medical School; Lisa Bowleg,4 Professor of Drexel University; and Lee5 Carson, Research Associate, Philadelphia6 Health Management Corporation.7 Would the three please come8 forward.9 (Witnesses approached witness10 table.)11
Good12 afternoon. We didn't want you to wane.13 And the other people are here too, so we14 had two more panels, and we want to make15 sure that we get everybody in on the16 testimony.17 Good afternoon, Dr. Nunn. You18 want to begin your testimony? Identify19 yourself and proceed with your testimony.20 Because you've been doing some wonderful21 work in the City, and I participated on22 one of your panels relative to this whole23 issue of HIV/AIDS, and this hearing came24 as a result of the work that you're doing25 85 10/27/10 - PUBLIC HEALTH - RES. 1005651 in the City.2
Thank you so much3 for your kind words and particularly for4 your leadership on this critical social5 justice issue. I also want to thank6 Tyrone Smith, long-term AIDS activist,7 who has made everything that I've done8 possible.9 (Applause.)10
And has been11 whispering in my ear about strategy on12 how to make all this come together. I'd13 be remiss not to thank him.14